By now, we all know that President Obama said he would not pass a health care reform bill health insurance reform bill if it adds to the deficit. And one significant problem is that the Congressional Budget Office (CBO) has scored the reform that has made its way furthest in the political process (H.R. 3200) and said it would add $1 trillion over the next 10 years. That has left some House Democrats angry, saying that the CBO has not accurately accounted for the savings that will come from increased preventative care.

Unfortunately for them, the facts don’t support their claim. CBO Director Doug Elmendorf cited a study from the New England Journal of Medicine saying that in 80% of preventative care programs, the costs of treatment actually increase. A new article in the journal Circulation says that increased diagnosis and treatment of diabetes actually costs more than the alternative.

How can prevention of disease be more expensive than treatment? Two reasons. First, you have to test a whole lot of people before any of them show symptoms and many of them would not get the disease anyway, so that costs money. Second, because unfortunately it is cheaper to let someone go undiagnosed with diabetes and die prematurely than to spot it early and pay to treat them every year they live, especially when that treatment will make them live longer. As Stuart Varney essentially put it this morning: it’s cheaper to have someone drink a fifth of Jack Daniels and smoke a carton of cigarettes every day and die at 50 than it is to have them live long lives and have to spend money on them for 90 years. If you want to save on health care costs, encourage unhealthy behaviors and people die sooner, as health care costs rise significantly the older a person becomes.

That sounds absolutely horrible, right? Well that’s what happens when all you focus on is costs. When conservatives get up in arms over health care costs in this manner, they’re falling victim to the same distorted logic that liberals use when they say that our health care costs too much. Not all health care costs are bad — when we save lives with new pharmaceuticals and surgery techniques, and prevent disease with new methods of testing and diagnosis, that costs money. But aren’t those things good?

(Aside: We have a lower life expectancy in the U.S. than in many countries, but much of that is due to violent crime and automobile accidents, not health care — adjusting for that, we perform much better, and it’s likely due to our advances in medicine. If memory serves correctly, about 80% of Nobel prizes in medicine in the last 30 years have been given to Americans.)

When we make people live longer, that costs more money too. This is worsened by our Social Security system: since the program was created, life expectancy has increased by more than 10 years, yet we have only pushed back the age at which you can receive full benefits by 2 years. Old people keep living longer and they retire at the same age, so that increases the burden on everyone else. But despite this increase in costs, my questions remain: is the cost of health care the only thing that matters? What about the benefits?!

I remember a study I read about a few years ago which stated that the increase in life expectancy that has occurred in the last century has increased the overall benefits of the average person by over a million dollars. You live longer and have more health care costs, sure — but you have more time with your family, your quality of life increases, and we’re all better off as a result. Democrats say “we spend too much on health care” despite the fact that this spending ends up making us better off. (Here’s a study saying this very thing about the US, and another one saying the same thing for Japan.) And now Republicans are saying that spending more money on prevention is bad just because it costs more, ignoring the potentially beneficial effects on quality of life.

I think  Charles Krauthammer puts this in its proper context: prevention is not the magic bullet that some Democrats think it is, and it has its own costs – but it still can be a good thing, and worth paying if it means people live longer, healthier lives. A little more emphasis on the benefits of health care, not just the costs, would be a refreshing change — from both sides of the political spectrum.

P.S. I think there is an analogy here to the global warming climate change debate: some would argue that we should focus on prevention regardless of the cost, and impose taxes on carbon and other costly regulations, while others say we should focus on treatment — work to adapt to future climate change if and when it happens with economies that are stronger and better able to withstand fluctuations in climate.