IDEAS home Printed from https://ideas.repec.org/a/aea/jecper/v35y2021i2p101-18.html
   My bibliography  Save this article

An Ounce of Prevention

Author

Listed:
  • Joseph P. Newhouse

Abstract

I look at prevention through an economic lens and make three main points. First, those advocating preventive measures are often asked how much money a given measure saves. This question is misguided. Rather, preventive measures can be thought of as insurance, with a certain cost in the present that may or may not pay off in the future. In fact, although most medical preventive measures improve expected health, they do not save money. Various lifestyle and early childhood interventions, however, may both save money and improve health. Second, preventive measures, including medical and lifestyle measures, are heterogeneous in their value, both across measures and within measure, across individuals. As a result, generalizations in everyday discourse about the value of prevention can be overly broad. Third, health insurance coverage for medical preventive measures should generally be more extensive than coverage for the treatment of a medical condition, though full coverage of preventive services is not necessarily optimal.

Suggested Citation

  • Joseph P. Newhouse, 2021. "An Ounce of Prevention," Journal of Economic Perspectives, American Economic Association, vol. 35(2), pages 101-118, Spring.
  • Handle: RePEc:aea:jecper:v:35:y:2021:i:2:p:101-18
    DOI: 10.1257/jep.35.2.101
    as

    Download full text from publisher

    File URL: https://www.aeaweb.org/doi/10.1257/jep.35.2.101
    Download Restriction: no

    File URL: https://www.aeaweb.org/doi/10.1257/jep.35.2.101.ds
    Download Restriction: no

    File URL: https://libkey.io/10.1257/jep.35.2.101?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. James Heckman & Rodrigo Pinto & Peter Savelyev, 2013. "Understanding the Mechanisms through Which an Influential Early Childhood Program Boosted Adult Outcomes," American Economic Review, American Economic Association, vol. 103(6), pages 2052-2086, October.
    2. Hunt Allcott & Benjamin B. Lockwood & Dmitry Taubinsky, 2019. "Should We Tax Sugar-Sweetened Beverages? An Overview of Theory and Evidence," Journal of Economic Perspectives, American Economic Association, vol. 33(3), pages 202-227, Summer.
    3. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    4. Jorge Luis García & James J. Heckman & Duncan Ermini Leaf & María José Prados, 2016. "The Life-cycle Benefits of an Influential Early Childhood Program," NBER Working Papers 22993, National Bureau of Economic Research, Inc.
    5. Anonymous, 2019. "Letter from the Editor," Management and Organization Review, Cambridge University Press, vol. 15(1), pages 1-2, March.
    6. Jonathan Gruber & Botond Köszegi, 2001. "Is Addiction "Rational"? Theory and Evidence," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 116(4), pages 1261-1303.
    7. Nathaniel Hendren & Ben Sprung-Keyser, 2019. "A Unified Welfare Analysis of Government Policies," NBER Working Papers 26144, National Bureau of Economic Research, Inc.
    8. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408, Elsevier.
    9. Aaron Chalfin & Benjamin Hansen & Rachel Ryley, 2019. "The Minimum Legal Drinking Age and Crime Victimization," NBER Working Papers 26051, National Bureau of Economic Research, Inc.
    10. Liran Einav & Amy Finkelstein & Tamar Oostrom & Abigail Ostriker & Heidi Williams, 2020. "Screening and Selection: The Case of Mammograms," American Economic Review, American Economic Association, vol. 110(12), pages 3836-3870, December.
    11. Tomas J. Philipson & Dana Goldman, 2007. "Integrated Insurance Design in the Presence of Multiple Medical Technologies," American Economic Review, American Economic Association, vol. 97(2), pages 427-432, May.
    12. Emmanuel Saez & Stefanie Stantcheva, 2016. "Generalized Social Marginal Welfare Weights for Optimal Tax Theory," American Economic Review, American Economic Association, vol. 106(1), pages 24-45, January.
    13. Saurabh Bhargava & George Loewenstein & Justin Sydnor, 2017. "Choose to Lose: Health Plan Choices from a Menu with Dominated Option," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 132(3), pages 1319-1372.
    14. Becker, Gary S & Murphy, Kevin M, 1988. "A Theory of Rational Addiction," Journal of Political Economy, University of Chicago Press, vol. 96(4), pages 675-700, August.
    15. Anonymous, 2019. "Letter from the Editor," Management and Organization Review, Cambridge University Press, vol. 15(2), pages 215-216, June.
    16. Anonymous, 2019. "Letter from the Editor," Management and Organization Review, Cambridge University Press, vol. 15(4), pages 683-685, December.
    17. Benjamin R. Handel & Jonathan T. Kolstad, 2015. "Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare," American Economic Review, American Economic Association, vol. 105(8), pages 2449-2500, August.
    18. Andrew Goodman-Bacon, 2018. "Public Insurance and Mortality: Evidence from Medicaid Implementation," Journal of Political Economy, University of Chicago Press, vol. 126(1), pages 216-262.
    19. Hilary Hoynes & Diane Whitmore Schanzenbach & Douglas Almond, 2016. "Long-Run Impacts of Childhood Access to the Safety Net," American Economic Review, American Economic Association, vol. 106(4), pages 903-934, April.
    20. Michael Kremer & Christopher M. Snyder, 2015. "Preventives Versus Treatments," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(3), pages 1167-1239.
    21. Eric Budish & Benjamin N. Roin & Heidi Williams, 2015. "Do Firms Underinvest in Long-Term Research? Evidence from Cancer Clinical Trials," American Economic Review, American Economic Association, vol. 105(7), pages 2044-2085, July.
    22. Oster, Emily, 2018. "Does disease cause vaccination? Disease outbreaks and vaccination response," Journal of Health Economics, Elsevier, vol. 57(C), pages 90-101.
    23. Jorge Luis García & James J. Heckman & Duncan Ermini Leaf & María José Prados, 2020. "Quantifying the Life-Cycle Benefits of an Influential Early-Childhood Program," Journal of Political Economy, University of Chicago Press, vol. 128(7), pages 2502-2541.
    24. Charles E. Phelps, 1978. "Illness Prevention and Medical Insurance," NBER Chapters, in: The Economics of Physician and Patient Behavior, pages 183-207, National Bureau of Economic Research, Inc.
    25. Chaloupka, Frank J. & Warner, Kenneth E., 2000. "The economics of smoking," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 29, pages 1539-1627, Elsevier.
    26. Benjamin Handel & Joshua Schwartzstein, 2018. "Frictions or Mental Gaps: What's Behind the Information We (Don't) Use and When Do We Care?," Journal of Economic Perspectives, American Economic Association, vol. 32(1), pages 155-178, Winter.
    27. Ellis, Randall P. & Manning, Willard G., 2007. "Optimal health insurance for prevention and treatment," Journal of Health Economics, Elsevier, vol. 26(6), pages 1128-1150, December.
    28. Pogue, Thomas F & Sgontz, Larry G, 1989. "Taxing to Control Social Costs: The Case of Alcohol," American Economic Review, American Economic Association, vol. 79(1), pages 235-243, March.
    29. Anonymous, 2019. "Letter from the Editor," Management and Organization Review, Cambridge University Press, vol. 15(3), pages 463-465, September.
    30. Keith Marzilli Ericson & Justin Sydnor, 2017. "The Questionable Value of Having a Choice of Levels of Health Insurance Coverage," Journal of Economic Perspectives, American Economic Association, vol. 31(4), pages 51-72, Fall.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Han Bleichrodt, 2022. "The prevention puzzle," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 47(2), pages 277-297, September.
    2. Herrera-Almanza, Catalina & Rosales-Rueda, Maria F., 2023. "Community-based health programs and child vaccinations: Evidence from Madagascar," World Development, Elsevier, vol. 170(C).
    3. Dugord, Clara & Franc, Carine, 2022. "Trajectories and individual determinants of regular cancer screening use over a long period based on data from the French E3N cohort," Social Science & Medicine, Elsevier, vol. 294(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gabriella Conti, 2013. "The Developmental Origins of Health Inequality," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 285-309, Emerald Group Publishing Limited.
    2. Arni, Patrick & Dragone, Davide & Goette, Lorenz & Ziebarth, Nicolas R., 2021. "Biased health perceptions and risky health behaviors—Theory and evidence," Journal of Health Economics, Elsevier, vol. 76(C).
    3. Grimard, Franque & Parent, Daniel, 2007. "Education and smoking: Were Vietnam war draft avoiders also more likely to avoid smoking?," Journal of Health Economics, Elsevier, vol. 26(5), pages 896-926, September.
    4. Chavas, Jean-Paul, 2013. "On Demand Analysis and Dynamics: A Benefit Function Approach," 2013 Annual Meeting, August 4-6, 2013, Washington, D.C. 149683, Agricultural and Applied Economics Association.
    5. Andrew M. Jones & Audrey Laporte & Nigel Rice & Eugenio Zucchelli, 2019. "Dynamic panel data estimation of an integrated Grossman and Becker–Murphy model of health and addiction," Empirical Economics, Springer, vol. 56(2), pages 703-733, February.
    6. Sijbren Cnossen, 2020. "Excise Taxation for Domestic Resource Mobilization," CESifo Working Paper Series 8442, CESifo.
    7. Strulik, Holger & Trimborn, Timo, 2018. "Hyperbolic discounting can be good for your health," Journal of Economic Psychology, Elsevier, vol. 69(C), pages 44-57.
    8. Maria Alessandra Antonelli & Valeria De Bonis & Angelo Castaldo & Alessandrao Gandolfo, 2022. "Sin goods taxation: an encompassing model," Public Finance Research Papers 52, Istituto di Economia e Finanza, DSGE, Sapienza University of Rome.
    9. Udo Schneider & Jürgen Zerth, 2011. "Improving Prevention Compliance through Appropriate Incentives: Theoretical Modelling and Empirical Evidence," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 147(I), pages 71-106, March.
    10. Sophie Massin, 2011. "La notion d'addiction en économie : La théorie du choix rationnel à l'épreuve," Revue d'économie politique, Dalloz, vol. 121(5), pages 713-750.
    11. Junmin Wan, 2004. "Consumption of Cigarettes, Nicotine, and Tar under Anti-smoking Policies: Japan as a Case Study," Discussion Papers in Economics and Business 04-12-Rev, Osaka University, Graduate School of Economics, revised Mar 2006.
    12. Marco Caliendo & Juliane Hennecke, 2022. "Drinking is different! Examining the role of locus of control for alcohol consumption," Empirical Economics, Springer, vol. 63(5), pages 2785-2815, November.
    13. Jones, A. M. & Laporte, A. & Rice, N. & Zucchelli, E., 2014. "A synthesis of the Grossman and Becker-Murphy models of health and addiction: theoretical and empirical implications," Health, Econometrics and Data Group (HEDG) Working Papers 14/07, HEDG, c/o Department of Economics, University of York.
    14. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    15. Chavas, Jean-Paul, 2013. "On the microeconomics of food and malnutrition under endogenous discounting," European Economic Review, Elsevier, vol. 59(C), pages 80-96.
    16. Strulik, Holger, 2018. "Smoking kills: An economic theory of addiction, health deficit accumulation, and longevity," Journal of Health Economics, Elsevier, vol. 62(C), pages 1-12.
    17. Sijbren Cnossen, 2006. "Alcohol taxation and regulation in the European Union," CPB Discussion Paper 76.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    18. Sijbren Cnossen & D. Forrest & S. Smith, 2009. "Taxation and regulation of smoking, drinking and gambling in the European Union," CPB Special Publication 76.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    19. Donald S. Kenkel & Robert R. Reed III & Ping Wang, 2002. "Rational Addiction, Peer Externalities and Long Run Effects of Public Policy," NBER Working Papers 9249, National Bureau of Economic Research, Inc.
    20. Hammar, Henrik & Carlsson, Fredrik, 2001. "Smokers' Decisions To Quit Smoking," Working Papers in Economics 59, University of Gothenburg, Department of Economics.

    More about this item

    JEL classification:

    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:aea:jecper:v:35:y:2021:i:2:p:101-18. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Michael P. Albert (email available below). General contact details of provider: https://edirc.repec.org/data/aeaaaea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.