As health-care costs spiral upward, pundits and patients alike have scrambled for someone – or something – to blame. Chronic diseases, greedy drug companies and profiteering hospitals and insurance companies seem to top the list of suspects.
But there’s a new disease that deserves to be included on that list: “preventionitis.” Many in the health-care community have succumbed to the utopian delusion that government investments in “prevention” – eating better, exercising more and so on – will cut society’s health bill by curbing the growth of the many chronic diseases brought on by bad lifestyle choices.
Of course, exercising and maintaining a healthy diet are good ideas. But most “preventionistas” aren’t calling for a rebirth in personal responsibility. Instead, they’re calling for massive government intervention to change society’s habits, paid for by tax hikes that will allegedly reap dividends in the future.
But it’s unlikely that such action will make us any healthier or save us any money.
Preventionitis-afflicted politicians tout conclusions like those in a new report funded by three weighty nonprofit groups: the Trust for America’s Health, the California Endowment and the Prevention Institute. The report concludes that investing $10 per person annually in “prevention” – encouraging physical activity, better nutrition and smoking cessation – would result in savings 5.6 times greater than costs within five years.
Overall, they claim annual savings of $16 billion.
That’s nothing to sneeze at. But with annual health-care spending exceeding $2 trillion today, we’re looking at cost savings of less than 1 percent. And health-care spending will go up. Some estimate it could rise in the United States to $4.3 trillion by 2017.
Relative to overall health-care spending, prevention measures clearly don’t have much impact. But that hasn’t stopped politicians from spreading preventionitis far and wide.
In 2006, New York City Mayor Michael Bloomberg waged a very public and successful campaign to ban trans fats from city restaurants. Many jurisdictions have followed suit.
California Gov. Arnold Schwarzenegger recently signed a law requiring chain restaurants to post calorie counts of their burgers, fries and shakes on their menu boards. Supporters claimed the measure could help California avoid a staggering 50 million pounds of extra weight a year.
Of course, that best-case scenario assumes people who eat fast food seven times a week would lose 5.4 pounds each thanks to the calorie signs – a rather rosy assumption.
Food labels haven’t proven effective in deterring obesity. In 1994, the federal government mandated that packaged foods contain caloric information. And yet between 1995 and 2007, the percentage of obese Americans increased by two-thirds.
Some studies suggest that labeling food with fat content and calorie information has actually led people to eat more. Many consumers misjudge appropriate serving and portion sizes on labeled food. Others may assume that a food tagged as “low fat” is healthy, when in reality it may contain more calories than something higher in fat.
It may seem counterintuitive, but even successful government-sponsored prevention initiatives don’t cut health-care costs because they keep people alive longer to consume greater amounts of expensive end-of-life care. In fact, one study found that of healthy people, the obese and smokers, the healthy end up costing taxpayers the most.
This doesn’t mean encouraging people to make healthy choices with regard to nutrition and exercise is a bad thing. However, forcing the American people to cede personal lifestyle choices to the government in order to save money at some future date is logically spotty at best – and morally questionable at worst.
Lowering health-care costs is of paramount importance to any meaningful health-care reform. But forcing prevention on everyone won’t accomplish that aim. Health-care reformers should take care that they, too, don’t come down with a nasty case of preventionitis.