Preventive Care is a Sick Idea

When it comes to unhealthy behavior, some of us can't be helped.


Despite the extraordinary energy exerted in trying to delay the inevitable, the inconvenient fact is we all die.

So it is no surprise that "preventive" health care, that game-changing fix to policy trotted out relentlessly by both Democrats and Republicans, is so appealing. And like many cure-alls, it's a myth.

Surely, for some, preventive health care is worthwhile. And no one is stopping you from eating an apple. But unless policy changes have the power to stop the Grim Reaper—rather than only postpone his arrival—it will make health care more expensive.

Let's begin with the morbidly obvious. The longer people hang around the longer they utilize the health care system. End-of-life care is often the most expensive. Old folks just love doctors. (I know I plan to unleash septuagenarian fury on physicians regularly.) As studies on Medicare have proved, easy availability to services at the tail end of life translates into lots of needless services.

Second, a government policy that prods people into incessantly visiting medical offices for checkups, screenings, and tests will only raise costs even further. According to studies, preventive medicine thwarts little, though it does mean early diagnoses for relatively harmless ailments—and treatments for them.

As H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy, contends: "Recent expansions in the definitions of diabetes, high cholesterol and osteoporosis defined millions more as suddenly needing therapy. A new definition of 'abnormal bone density' … turned 6.8 million American women into osteoporosis patients literally overnight."

There is another vital aspect of preventive health care that many health care professionals and bureaucrats simply refuse to accept: Some of us can't be helped.

A few years ago, I heard a highly educated and successful author maintain that a life without cigarettes and copious amounts of alcohol is a life not worth living. There exists no warning label, no bone-chilling study, no crafty public service announcement that is going to separate me from my sour cream- and cheese-infested burrito.

At this point, anyone who doesn't comprehend that french fries aren't a suitable vegetable substitute will not be aided by preventive health care—unless it includes the cost of a cerebral transplant.

There are also potential consequences to "prevention" policy.

For instance, you can "persuade" people to care by coercing them. Increasingly, elected officials are warming to the idea.

We've seen an explosion of intrusive legislation around the nation—sin taxes and ingredient bans, to name two. The more we collectivize health care policy the more your comrades will make it their business to demand preventive health calisthenics.

In a recent, amazingly uncritical article about preventive care in Time magazine, titled "This Doctor Does Not Want To See You"—because, as we all know, most doctors yearn for pervasive sickness—we read this pronouncement: "Ours is a system that rewards pills and procedures and nurtures a clinical culture in which the goal is primarily to fix what goes wrong."

You've got that right. Millions of Americans are now alive, living without excruciating pain, engaging in healthy sex lives, avoiding suicide, etc., because of pills and the clinical culture that many preventive care proponents like to denigrate.

It's one thing to blow off steam about corporate America, insurance companies, and overpriced drugs but quite another to undervalue technology. The idea that jumping jacks can take the place of pharmaceuticals is a dangerous one.

Moreover, diverting dollars from the "clinical culture" into programs that try to persuade me to get more colonoscopies would be a serious waste of time.

Very much like the entire institutionalized "preventive care" racket.

David Harsanyi is a columnist at The Denver Post and the author of Nanny State. Visit his Web site at www.DavidHarsanyi.com.