The theory behind the OP would only work if the options were:
A. Catch something early, treat it, eventually die of old age
B. Don’t catch it early, die young.
But option B generally isn’t what happens. Rather, people tend to catch something late and nasty, rack up expenses treating it, and then eventually die of old age. Obesity probably won’t kill you directly- but the years of diabetes, knee replacements, and heart surgery will add up before you eventually die.
But you are assuming that preventative health measures can’t reduce the incidence of diabetes, arthritis or heart disease. In fact we know of preventative measures which will reduce the incidence of at least two of these.
UDS I think that you and even sven are not saying anything that conflict.
The premise of the op is that you get sick sometime, so what if it is delayed until later?
even sven is stating that the costs along the way of managing those preventable chronic diseases for many years racks up. (They usually do not kill young at this point. Instead they and their many complications are treated with life expectancy several years but not decades reduced.) Hence the wisdom of investing in preventing them (and the documentation in Terr’s cites that money spent on preventing those things is indeed cost-effective).
Chronos, meh. Really it is not so quite safe to say.
The Black Death was a economic bonanza, at least for the poorest. Wages increased and property became affordable. Population decreased more than resources so the average person had more food availability. On net it is not so clear what the impact was. Seriously the economic impacts of epidemics are complicated but not always adverse:
There is also a major problem with the way in which Terr’s first cite is interpreted.
What is the difference between these two statements?
(Note: “reviewed” in this case being restricted to articles “published between 2000 and 2005.”)
Need some hints?
Hint 1: the second is a broad generalization.
Hint 2: the sum total of different “preventative measures” reviewed in that five year period in 599 articles were seven.
You get the idea. The article is bemoaning ANY broad generalization by looking at a small sample of specific measures studied in a fairly short timeframe. They are explicitly NOT stating anything about what preventative care does “overall.”
The second article does make a claim about overall … and overall there would be modest savings. If 90% of the population used advised preventative measures it would save 0.2% of the cost.
The actual article that that article references is very interesting and makes a case FOR preventative care, thoughtful intelligent preventative care. Not PSA for prostate cancer but programs like these:
Another point they make:
The folks who wrote this article are very confused.
They think that if preventative care keeps me healthier, we’ll save money because it’s expensive to take care of me when I’m sick.
As I’ve pointed out on this board many times, this is a very incorrect notion.
Good preventative care (see the article) might keep my insurers happy because until I reach retirement, they are the ones ponying up when I need healthcare. But then the real costs begin, on two fronts.
First of all, I’m going to live longer–maybe a lot longer, sucking off either the public dole or my company pension. Big bucks. Increased lifespan is already killing the original social security calculations when the program was invented.
Second, I’m gonna die eventually, and between retirement and death, lots of very expensive things need repair no matter how much preventative care I got. Everything wears out eventually. Plus End of Life care is super expensive, be it some sort of expensive Hospital death or some sort of Nursing Home care, or whatever.
The total cost of delivering a healthy person into a 30 year retirement while they get their joints fixed, their coronaries bypassed, their organs replaced and their bottoms cleaned is extraordinary.
Economically, we need to get people to smoke like chimneys (paying for smoking-related illness with cigarette taxes) and hope a bunch of 'em drop dead suddenly toward the end of their productive lives right before they retire.
The Marlboro men were dream citizens, economically.
Preventative care is very very pricey, as is a healthy fresh retiree.
Sample article here about how expensive it’s getting to die. And (plug your ears here) no amount of preventative care prevents Death…yet. When it does, of course, Social Security is toast from the expense of “preventative care” that worked.
Speaking from my own experience as a physician, the healthier a person is when they start to croak, the more we pony up to save them. When I started med school over 30 years ago, we’d have a big debate over whether or not to fix an aortic valve if a patient was in their 80’s. It’s not even a consideration now; the only consideration is whether or not the patient is basically healthy.
Medicine is getting fancier. Lots fancier. Within the lifetimes of people retiring now it will be common to replace organs, for example: kidneys; livers; hearts; lungs… Joints when they wear out. Various costly drugs such as anti-aging hormones. Gene therapy…
I mean, it’s gonna cost a fortune to die if you’ve had perfect preventative care and so you are healthy enough to basically always meet criteria to fix the one thing that’s gone sour.
It just makes me chuckle when I hear this notion that keeping us healthy is going to save us money. Don’t bet on it. Medical costs will not be plummeting Real Soon Now, nor will the cost of keeping healthy retirees (like me, pretty soon) feeding off the public teat.
CP your point is very cogent, but not too informative about preventative care overall.
Look at it this way … all these people, like you, who may live 25 plus years after you retire, are currently at risk of dementia developing along the way. One in three of you. And caring for those with dementia is very expensive. If we could get people to keep up with healthy lifestyles we could potentially cut the frequency of dementia by close to two thirds..
And we, as a society, need to address the huge costs that living longer incurrs. We really should be expected to work longer at this point because we really are able to be productive longer. We need to recognize that in terms of medicine more treatment is not the same as better treatment and that we can provide better value in our care than we do by avoiding the broad generalizations that some want to make. We can work together as teams to provide better care to the populations under our care and that model of care IS emerging.
I would put forth to you however that living longer on average is a fait accompli. Now we need to make those years be less costly to the system and of higher quality both at the same time. Intelligent preventative care and effective promotion of healthy lifestyle habits is an integral part of doing that.