The single greatest opportunity to improve health and reduce premature deaths lies in personal behavior

I have argued on many occasions that capabilities, values and behaviors are often more determinative of outcomes than are mere circumstances. Not always, but often. Here is further evidence supporting that position. Health advocates have long argued that access to universal healthcare is the predicate to improved health outcomes. That was an underpinning argument for Obamacare.

The supposition was always suspect and further undermined by the outcomes of the Oregon Healthcare Insurance Experiment which indicated that increased health insurance access had no measurable impact on health outcomes. That was from 2012.

Apparently there was even earlier evidence from 2007. From Disparity in Life Spans of the Rich and the Poor Is Growing by Sabrina Tavernise.

Limited access to health care accounts for surprisingly few premature deaths in America, researchers have found. So it is an open question whether President Obama’s health care law — which has sharply reduced the number of Americans without health insurance since 2014 — will help ease the disparity.

That article references We Can Do Better — Improving the Health of the American People by Steven A. Schroeder

Health is influenced by factors in five domains — genetics, social circumstances, environmental exposures, behavioral patterns, and health care (Figure 1). When it comes to reducing early deaths, medical care has a relatively minor role. Even if the entire U.S. population had access to excellent medical care — which it does not — only a small fraction of these deaths could be prevented. The single greatest opportunity to improve health and reduce premature deaths lies in personal behavior. In fact, behavioral causes account for nearly 40% of all deaths in the United States.

The single greatest opportunity to improve health and reduce premature deaths lies in personal behavior - You wouldn't know that based on the policy solutions which politicians focus on.

Restructuring the health insurance market from top o bottom? Plenty of crony capitalist opportunities in that policy choice. Getting people to change their behaviors? Not so much opportunity there. So which branch in that particular decision tree did politicians take? It wasn't the one that lead to better health outcomes for citizens.