Assume you have two people, one engages in a variety of wellness promotion activities, and the other engages in unhealthy behavior.
Person A may do things like eat a healthy diet high in omega 3 fatty acids, fruits, vegetables, protein, garlic, etc. Basically they’d practice the polymeal theory and then some. He also practices stress reduction, religious practices and regular exercise.
Person B eats a western diet and is sedentary. Her is also maladjusted, under stress and basically unhappy.
Diabetes can cut life expectancy by up to 12 years so lets assume that person A lives to be 87 and person B lives to be 69 (these are guesses based on an average male life expectancy of around 81).
Even though the healthcare costs of person B will be much higher (diabetic helathcare costs around 13k a year, healthcare for an average person is closer to 2500. For an overly health conscious person it is probably even lower I’m sure), he won’t live as long so he will only collect social security and medicare for four years while person A collects them for 22 years. So healthcare costs go up, but social security and medicare costs go down. In the long run it may even out, a few decades of 10k+ medical bills vs an extra few decades of social security and medicare.
Even though the quality of life for person A is higher than for person B which in and of itself makes it the better lifestyle irrelevant of whether it costs more or less I don’t know if economically there is a difference.
Lawd knows that I do not have the actuarial expertise to undertake a serious comprensive analysis of long term costs and economic benefits (since the economic analysis is your subject without putting on dollar value on the benefit of wellness of of year of life saved … in fact to your analysis, years of life saved after the “productive” years are a drain rather than a benefit).
Still, I know enough to know how complicated the analysis is. Who is paying when? If cost is reduced from the business community by premium reduction, does addition economic growth offset potential later increased social security costs for extended lifespans? As people stay healthier longer do we shift our model to later age of onset for social security and Medicare? What happens to the money saved? Is it invested to pay for those costs later on?
But the analysis is not as you described: healthy lifestyle and live longer vs unhealthy lifestyle costing more per year and dieing younger. We are living longer now not because we have en masses adopted healthy lifestyle choices (such as “polymeal” style eating and regular exercise) but because we are taking our statins and our hypoglycemic agents and treating the complications of our poor choices (but we’ve had those discussions before). These costs add up year after year after year. Megabucks. Health promotion may decrease some of those expenditures while maintianing the decreases in mortality and gaining more in the hard to economically quantify gain of wellness itself.
Suffice it to say that some of your economic concerns are already of issue and was the real problem that Bush so incompentently failed at addressing. We are already living longer. And we are costing more to do it. Can we live longer and cost ourselves less along the way too? That is the promise of health promotion through lifestyle choices.
The problem with the OP is a basic apples-v-oranges thing. Slob costs the system a lot in health care but saves it money in the long run by dying soon. Mr. Healthy is, contrariwise, not costing the system in terms of health care but extracts other benefits over the long term.
Hence, in the category of health care costs, Mr. Healthy saves money, plain and simple. The question, then, is what benefits to extend to healthy old people, not whether they are “costing” the system money because of their health.
By the OP’s logic (or the problem he is addressing though not necessarily buying into himself) if you really wanted to reduce costs then the best choice would be to kill everyone now. No health care costs thereafter! Similarly, if you want to have zero costs in business, all you have to do is not go into business.
If Person A follows a good health regimen of diet and exercise and doesn’t have a heart attack, is it because of the regimen, or is he one of the lucky people who wouldn’t have had a heart attack in the first place? So do we attribute Mr. A’s health to his regimen or his genes?
I’m addressing the idea that being healthy is cost effective. You can say the same thing about cigarettes, people always talk about how expensive cigarettes are in regards to excess healthcare costs but since smokers die early they save money in healthcare and social security.
I don’t support it and quality if life triumphs economics, but the argument that promoting wellness and health is cost effective could be totally untrue.
I just addressed this point. The smoker while alive costs the healthcare system MORE than the non-smoker. Apples and apples.
This same smoker while dead costs the social welfare system LESS than the non-smoker, who is still alive. Oranges and oranges.
So our conclusion isn’t that unhealthier people are cheaper per se. After all, a smoker who lives to age 75 but requires all kinds of surgeries, treatments, and drugs to sustain him (by no means an unrealistic example) costs the overall system a lot more than a non-smoker who lives to the same age without needing all that.
So what you’re ultimately saying is that dead people cost the system less than living people. That’s superficially true. Dead people also don’t contribute labor to the economy.
So the buried point in all this is that there is a class of people who are alive but not contributing labor to the economy: retirees. Therefore, the policy issue that this thread is ultimately addressing is what to do with retirees.
One is in his mid-80s, and from his history appears to have been consuming a lot of health care dollars for conditions quite possibly connected to his smoking (multiple major cardiovascular surgeries, lots of hospital and office visit time, and is on a raft of related prescription meds).
The other is in her latter 50s, with a less extensive medical history. Her cancer has already apparently metastasized (brain and other location(s)), so she will have cost the system far less by the time she dies.
The cost accountancy gets to be pretty complicated.
I am skeptical that massive attention to prevention will save us much money. There are however other ways to measure cost besides $$$.