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Tuesday, February 05, 2008

Popular Ideas Die Hard

It is always gratifying to find one’s beliefs confirmed by experts.

In earlier postings, I have disputed the assumption that the cost of health care could be reduced if people lived healthier lifestyles. My argument (which I learned from Larry Mathis and others) has been that healthy people lived longer and ended up using more health care.

Now I see that this belief has been confirmed by research. A news story appearing in various places on February 4, 2008 reported the results of a study conducted by Pieter van Baal, an economist at the Netherlands’ National Institute for Public Health and the Environment. The study involved three groups of 1,000 people each. One group was thin and healthy. A second group was fat. The third group smoked.

Following each group from age 20, the study found that the average lifetime cost of health care per member of the thin and healthy group was about $417,000. The comparable number for the fat group was $371,000 and for the smokers $326,000.

I don’t take that as an argument against healthy lifestyles. The thin and healthy people lived four years longer than the fat ones and cost $46,000 more, or about $11,000 per year of added life. They lived seven years longer than the smokers and cost $91,000 more – or $13,000 per year. I consider both to be bargains.

But people want very much to believe that healthy living saves health care dollars. For example, while the report on health care costs recently published by the federal Congressional Budget Office stated that “….proposals that encourage more prevention and healthy living can help promote better health outcomes, although their net effects on federal and total health spending are uncertain,” it went on to elaborate ways to encourage healthier living, ending with the statement that “There could be great value in exploring these and other mechanisms that offer the potential of constraining health care spending without diminishing the quality of care that people receive.”

So I predict the van Baal report will be widely ignored, at least for awhile.

Popular ideas die hard.

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