If my bike riding routine prevents me from having a heart attack, why shouldn't we force everyone to exercise and thereby lower health costs?

Back to health care, obviously!

David Leonhardt has a good article in today's New York Times, giving an economist's perspective on the cost of preventive care. The campaign rhetoric we hear every day is becoming increasingly strident: we will save money if we prevent future health problems. Problem is: preventive care is costly. For me, it's the time I take to ride as much as 100 miles a week, or swim a mile a day. It's also the number of visits to the doctor, the cost of healthier food, etc.

Suppose now we had a universal health care system. The logic some candidates are tossing around is this: if we spent money on preventive care, we'd save money on the treatment of illness and disease; the money we'd save would allow us to provide basic healthcare coverage (including preventive care, of course) to everyone. Indeed, we could even require people to exercise in order to get access to some aspects of the system.

Trouble is, there's little evidence a) that preventive care reduces the overall cost of treatments, and b) that preventive care comes at a low price tag. In fact, preventive care is costly, whether I pay for it personally or the system pays for it generally. Hence, the economist suggests a skeptical outlook toward claims that preventive care policies will allow us to fund a universal healthcare program without an increase in costs.

That does not deny the fact that my own preventive actions (which have their costs) will probably help me. So pardon me while I go out for another ride!