The Cost of Illness

Okay, I'll semi-concede the point to Nathan Newman. If I implied that a healther population would in no way reduce health care spending I was wrong. Some health care spending goes to treating people who get sick, then recover. Insofar as people don't get sick in the first place, you can save money on that kind of spending. More importantly, there's an economic cost to illness in terms of non-productivity. I'm certainly not one of those people (i.e., Republicans) who thinks that the way to build economic strength is through an Alabama-style low-wage, low-tax workforce featuring little education and bad health care (indeed, the madness of Southernomics deserves a whole discussion of its own; it's like the Middle East, where there's oil -- as in Texas -- things sort of work, elsewhere it's more like Jordan). Nevertheless, the fact remains that the bulk of public sector health care expenditures come from treating the terminally ill. The desperate measures taken near the end of life are very costly. And, to raise a point I've raised before, physically healthy people have a tendency to spend years and years requiring very costly nursing home care because of alzheimer's and whatnot.

That's not to say that we shouldn't promote measures to get people to live healthier lifestyles. There are plenty of other good reasons to do it. But it's not going to work as a primary method of reducing the rate of growth of health care expenditures, something America's mixed public-private health care system is uniquely bad at. You either need to march forward into command-and-control supply and price management, or else backwards into a real market system where people just die if they can't afford medicine. The combination of market pricing with all sorts of subsidies (both hidden and explicit) to prevent the undesirable consequences of market pricing (i.e., people just dying because they can't afford care) just pushes costs up, up and away in a manner that diet and exercise can't do much to mitigate.