Denis Leary had a great line from his Broadway show/CD "No Cure for Cancer". It goes a little something like this:
"I love these little facts. "Well you know. Smoking takes ten years off your life." Well it's the ten worst years, isn't it folks? It's the ones at the end! It's the wheelchair, kidney dialysis years. You can have those years! We don't want 'em, alright!?
The Leary premise is quality over quantity. If the late years aren't good ones, the theory goes that you may as well do what you want. No mention of the cost of health care during the late years. That doesn't translate too well into comedy, especially the Leary version of comedy.
Not to worry. Arthur Garson's got you covered in this column from Governing Magazine, where he and Carolyn Englehard argue that preventative care just doesn't pay out:
"If you're among those who think prevention saves money, and will help reduce the overall cost of medical care, you're not alone. But while an apple a day might keep the doctor away, at least for awhile, it also might cost more than you think. Preventive medicine can help avoid costly illnesses earlier in life, only to increase the population of elderly and infirmed people who will most likely require expensive treatments for other illnesses later.
Even worse, unhealthy habits such as tobacco smoking may actually save money in the long run as people who smoke die earlier and use fewer health care dollars. "This doesn't make sense," you say, "Smokers are less healthy than nonsmokers." That may be true, and smokers do use up to 40 percent more medical care while they are alive. A recent study from Holland showed that, on average, smokers die at age 77 and save $100,000 in lifetime medical care costs compared with non-smokers who die at 83.
The same is true for people who are obese. While obesity-related conditions such as Type-2 diabetes, high blood pressure and heart disease are associated with high medical expenditures, the costs that are saved by preventing obesity will only be offset later in life by diseases unrelated to obesity that accompany living a longer life. In the Dutch study, obese people die at 80 and save $50,000 compared with non-obese people who die at 83."
Wow, there it is. It's cheaper to allow people to make their own decisions about lifestyles because we don't have to spend money on them once they're gone - it's cheaper overall to let them do what they want.
What the column doesn't explore is ramifications of preventative care for employers. The ten years at the end are largely funded by the government. What about the 5/10 year ROI scenario for employers that invest in programs that get people to stop smoking or drop their blood pressure. Is the ROI there for the companies that choose to do that?
That's the million dollar question (literally) for employers in America.