The Price of Prevention

Source: Josh Goodman, Governing, April 2008

Woody Allen once described death as “a very effective way of cutting down on your expenses.” In the past decade, states all over the country have gone to great lengths to prove that the comedian was not only morbid but wrong. They have embraced the idea that keeping people healthy is both humane and fiscally smart; if the public is healthier, public spending will decrease. And they seem to agree that the way to keep people healthy is to prevent them from getting sick in the first place. They are investing in healthy-diet promotion and anti-smoking campaigns even as they cope with symptoms of diabetes and other chronic illnesses. “We’re trying to drive people to understand that health status is the goal,” says Marcia Nielsen, of the Kansas Health Policy Authority. “You don’t want more medical care and you don’t want more medical insurance, unless they’re a means to an end.”

To some hardheaded scholars and calculating critics, the problem is that, discouraging as it might seem, Woody Allen had a point. A large body of research suggests that preventive care may help people live longer, healthier lives (no small achievement) but doesn’t actually save money. As a result, governments may be forced to come to grips with the notion that, when it comes to health policy, the right thing to do and the thrifty thing to do are very different.

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