Writing in the libertarian journal Cato Unbound, George Mason economics professor Robin Hanson claims our national medical budget can be cut in half with no ill effects on health.
Hanson writes that longer lifespans are based on lifestyle choices -- drinking, smoking, exercise -- rather than medical advances.
Health policy experts know that we see at best only weak aggregate relations between health and medicine, in contrast to apparently strong aggregate relations between health and many other factors, such as exercise, diet, sleep, smoking, pollution, climate, and social status. Cutting half of medical spending would seem to cost little in health, and yet would free up vast resources for other health and utility gains. To their shame, health experts have not said this loudly and clearly enough.
While Hanson cites only a small scale U.S. RAND Corp. experiment to back this claim, which is described in the book Free for All, there is evidence for it in aggregate health statistics. People in Cuba, which emphasizes preventive care and good health habits, live about as long as those in America, for instance.
Had Hanson used this tidbit in his argument, however, he would have run afoul of Cato's ideological biases.
Separating national health policy from national medical policy, and emphasizing spending on the former over the latter, seems like sound economics. But I refuse to believe that all the money we spend preventing heart disease and stroke with medicine is wasted. Or that clean living alone will extend the lifespan gains of the last century.
Still, Hanson's study is an important contribution to the debate. Should we be de-emphasizing medical care and expanding our health care efforts? And how can we do that if Americans prefer being couch or mouse potatoes?[poll id=5]