Healthy is good, but it won't save health care dollars
Chris Auld, The Globe and Mail
The idea that a healthy lifestyle substantially decreases demand on the health care system has been repeatedly shot, stabbed, and poked at with sharp sticks, but it won't just die.
The zombie argument goes like this: poor health causes more use of the health care system. Poor health can be caused by an unhealthy lifestyle -- smoking, overeating, lack of exercise, and so on. Therefore, unhealthy lifestyles cause increased use of the health care system. In Canada, health care costs are largely covered by the government, so my costs affect your wallet. Therefore, policies which induce people to choose healthier lifestyles are rigorously justified since they mitigate such external effects and reduce demand on the public health care system. For example, last week Mike DeJong, B.C.'s Minister of Health, commented on a smoking cessation program:
Quitting smoking is not only good for your health and the health of those around you, but it is also good for our health-care system as it will avoid the millions of dollars it costs to treat respiratory illnesses, health disease and cancer.
This is obvious and common reasoning, implicitly or explicitly motivating many policies. And it has been well-known to be wrong for decades.
The basic problem with the argument that healthy lifestyles decrease health care use is it draws attention only to the gross costs of treating illnesses caused by unhealthy behaviors, but the relevant costs are net of the costs which would otherwise be incurred under a healthier lifestyle.