McCain Confuses on Health Care
More adventures in tweeting from Senator John McCain (R-AZ) who tells us: “It’s not the quality of health care it’s the cost – wellness and fitness!” Like Ezra Klein I don’t really understand what that means.
One possible reconstruction is that McCain is saying that our problem is that health care costs are too high because of insufficient attention to wellness and fitness. This is, I think, a bit of a misunderstanding. It’s true that investments in wellness and fitness would be highly cost effective ways of improving public health. But it’s in the nature of the human species that even very healthy people eventually get sick and die. Consequently, it’s often far from clear whether or not healthier behavior reduces health care costs in the long run. Dying of lung cancer at 57 could be cheaper than developing Alzheimer’s and living to 97. Which isn’t to downplay the importance of “wellness and fitness”—these can do a lot to improve quality of life. But they’re more-or-less separable from the issues of who gets health insurance, what does it cover, what does it cost, and how efficiently are health care services directed.
27 Responses to “McCain Confuses on Health Care”
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June 30th, 2009 at 5:29 pm
And I’ll make three. It’s a great bumper sticker, though, and in the long run that’s what really matters, doesn’t it?
June 30th, 2009 at 5:33 pm
Health care is expensive because too many people aren’t well?
I guess you can’t argue with logic like that.
June 30th, 2009 at 5:35 pm
I would have thought that combining Twwweeeeting with McCain’s telegraphic “style” ought to work better. However, I think what McCain “means” is that one should do things to enhance one’s own wellness and fitness — the excessive cost of health care stems in part from people not doing that, and if you are unfit and a general physical mess, the quality of the health care you receive is not so important. Now, wasn’t that clear?
June 30th, 2009 at 5:38 pm
Don’t waste your time trying to perceive a coherent thought behind McCain’s statement — likely there is none.
His Presidential campaign should have taught us all that the man habitually makes statements that have no thought behind them at all — they’re just flatus vocis, verbal utterances. Like the lyrics to many songs, they don’t really mean anything; they’re just intended to sound memorable.
June 30th, 2009 at 5:40 pm
You are making the mistake of assuming that he meant something.
June 30th, 2009 at 5:43 pm
Oh, well, if it’s a cost problem, it’s easy. Get the people in a room who have the most and the most direct impact on cost, and do the deal. Do the deal. It’s not that complicated.
June 30th, 2009 at 5:44 pm
Dying at 57 knocks ten years off of paying taxes. You have to look at lots of figures, it’s not so easy to say dying young saves money. It also strips some of the prime earning years (and tax paying years) from the system.
June 30th, 2009 at 5:54 pm
He may be referring to the piece in (I think) the WaPo which looked at the cost of preventative care. But who knows, my friends?
June 30th, 2009 at 5:55 pm
McCain is confused? Knock me over with a feather. I met McCain when he was first running for the Senate. He was already a cranky old man. And he wasn’t even an old man yet. As for health and costs, I should get a discount for smoking. I’ll die younger and quicker. Of course, I have some serious genetic defects which will cause me to have cancer whether I smoke or not. So maybe it doesn’t matter. Everyone in my family dies young from cancer regardless of how they behave. I’m guessing it’s a combination of genetic defects and living in the highest Radon concentration in the world. Of course, those genetic defects might be a result of the Radon. In medicine, there are just too many variables to sort out. That’s why we have insurance. Or should have insurance. And I’ll get it when someone let’s me have it. But I’m in the class of people that nobody wants to insure. And for good reason.
June 30th, 2009 at 5:55 pm
bdb sez,
But that is the just the point that MY has demolished. It is often said, for example, that it is by no means clear that smoking has cost the British NHS anything. As Matt has explained, it is really a separate issue. Wellness and fitness is indeed important (critical even) if you are concerned about health and quality of living. But the current healthcare debate in the US is about a quite different set of problems that are both failing to distribute health-care effectively and bankrupting the country.
June 30th, 2009 at 5:56 pm
Uh, this is flatly bizarre coming from a guy who’s had skin cancer six hundred and thirty times.
Would more “wellness” have prevented his cancer?
So, yeah, we definitely suck at wellness. And we should do more of it. That’s partially because we think it might save healthcare costs down the line. But it’s mostly because we are DAMN CERTAIN that it will improve people’s health for years and years which means money and productivity and all good things.
I mean, I’m sure that getting rid of smallpox meant there would be more women living long enough to die in childbirth. This is not, in fact, an argument against spending money to get rid of smallpox.
And none of this is an argument AGAINST fixing a healthcare system that would rather lop off a diabetic’s foot than help him control his blood sugar so his foot doesn’t need to be lopped off. Sure, it would be better to have him eat vegetables so he never got diabetes in teh first place. But right now we have the option of preventing the foot-lopping. Let’s go for that, and work our way backwards to the vegetables, okay? Kind of like we dealt with the smallpox and THEN fixed the dying in childbirth.
June 30th, 2009 at 6:00 pm
As McCain made clear during the campaign, the problem with health care is that Americans use to much of it. He prescribes wellness and fitness as the remedy for overuse. What that means is that sick people should just go ahead and die, already. Unless they’re rich, of course – then they can buy as much health care as they want. That’s McCain’s view.
June 30th, 2009 at 6:01 pm
‘Wellness’ includes things like Asthma, Diabetes, various addictions that are long term, chronic conditions that can be controlled, but can have very expensive costs if not controlled.
June 30th, 2009 at 6:23 pm
I think we can all agree that the most efficient health care reform from a wellness perspective would be the one outlined in Logan’s Run, although the actuaries would probably bump the mandatory “retirement age” up to 60 or 65.
June 30th, 2009 at 6:52 pm
The caption to this photo should be:
CLOWN FOR RENT
June 30th, 2009 at 6:57 pm
It is not up to us to interpret the meaning of the Oracle. Whatever we think it foretells, there will be a twist and we end up SLEEPING WITH OUR OWN MOTHERS!! And then we see; oh, THAT’s what the oracle meant. That’s how I see McCain’s tweets anyway.
June 30th, 2009 at 7:05 pm
As joejoejoe (#7) points out, the benefit of keeping someone well as long as possible is to extend their productive years. The end-of-life costs may be the same for lung cancer for a 25 y.o. as an 85 y.o., but the otherwise healthy 85 y.o. put a hell of a lot more $$$ into the system.
June 30th, 2009 at 7:18 pm
Chris dornan, thanks so much for commenting on my comment. The thinking you attribute to me was prefaced in my comment by “I think what McCain “means” is …”. I”m afraid you are in no position to get snippy about anyone else’s befuddlement. As the good book says, “knucklehead, disabuse thyself.”
June 30th, 2009 at 8:46 pm
There is a video of Mccain saying “wellness and fitness” a bunch of times: http://www.youtube.com/watch?v=k3JVzb9E0Ms&feature=channel
June 30th, 2009 at 8:47 pm
Another reason that Twitter is evil.
June 30th, 2009 at 11:26 pm
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June 30th, 2009 at 11:41 pm
Wellness & Fitness absolutely has a lot to do with health care costs. Getting Type 2 diabetes, heart disease, hypertension, and complications from these diseases due to overeating, bad diet and lack of exercise at 45 usually condemns one to many years of high health care costs. This is definitely more costly than a case of someone getting these diseases because their body wore out at 85. Smoking and drinking to excess do not necessarily immediately cause quick lethal diseases, but can easily cause many years of increased health care costs on the road to the lethal disease. Better fitness and diet could definitely lead to lower health care costs in the US.
July 1st, 2009 at 12:36 am
One thing McCain needs to learn about tweeting is to use up most if not all of his character allotment.
I mean, you don’t want people like Ezra Klein coming along and capping your tweet. Especially when you are prone to uttering pure nonsense.
July 1st, 2009 at 5:04 am
McCain may be a blithe idiot, and I have no idea what he meant, but Matt is trying to top him by claiming that health care costs are not higher because of poor health habits. Every study ever done on the subject concludes otherwise. People who eat right, exercise, and refrain from the nasty things not only live longer, they also cost the medical system much less. One of the reasons American health care is so high is because of the crappy food most people eat. If people could be persuaded to eat better and exercise more, we could afford universal care, because it wouldn’t cost so much. Unfortunately, many of the people least able to pay for heath care – the poor – have the worst health habits and thus the highest health care costs, and because they are poor they also get the lowest standard of treatment. Kind of sucks all the way around. Matt’s minimizing of this issue is inexplicable, unless it’s because Matt himself just happens to like junk food and a couch potato lifestyle, and wants to pretend there’s no societal cost to this sort of thing.
July 1st, 2009 at 6:51 am
McCain has had several melanomas removed from him. The quality of the surgery was very important to him; that he has survived so long is a testament to the skill of his surgeons. Quality is important only when applied to the likes of him.
July 1st, 2009 at 3:38 pm
Mobius & PD hit the point. Type II diabetes is a health-care time bomb – rough quote from a diabetes research at MGH. Dismissing the impact of wellness & preventative medicine shows either ignorance or obfuscation.
There are many factors to the high cost of health care, but that doesn’t mean that working on any one of them is not worthwhile.