A team of researchers from Brigham Young and Harvard University just completed a landmark survey with a fairly intuitive finding: Clean air makes you live longer. In the case of urban residents, cleaner air -- the product of both technological advances and, yes, government regulation -- has added more than five months to average life expectancy in recent years. That's huge. In fact, it's hard to think of a recent medical intervention of comparable efficacy.But you can think of other regulatory interventions of comparable efficacy: Ripping lead out of walls, for instance. Taxing cigarettes certainly qualifies. Conversely, the proliferation of cheap sweeteners has done more to harm the nation's health than Vioxx could ever dream of. One of the problems with the health care debate in this country is that it's called "the health care debate." But it's not. It's the "health spending" debate. It's an economic issue. Successful health reform would do less to reduce illness than to reduce medical bankruptcy. Which is why it would be nice to cleave the debate in two. Continue health spending reform. That's urgent. Without it our national finances go the way of Citibank's balance sheet. But also have a health policy. There's much the government could do to make people healthier: To help them live longer, more active, more able lives. Harold Pollack has some ideas for how to do it the stimulus. Health Affairs has some ideas for how to do it outside of health policy. Phil Longman had a nice article on this topic back in 2004. Matthew Yglesias has a nice graph breaking down the determinants of health:
Part of the reason our health care is so expensive is that we tend to think health is the sort of thing that happens inside a doctor's office. But it's not. It happens when you breathe the air outside, when you decide whether to walk or drive, when you figure out how many friends you have, when you choose what to eat for dinner. What happens in the hospital is not health care, it's disease response. It's what happens when something has gone wrong in the other spheres of your life that make up your health. And the cheapest health reform of all would be the one that keeps us out of the health care system entirely.
Part of the reason our health care is so expensive is that we tend to think health is the sort of thing that happens inside a doctor's office. But it's not. It happens when you breathe the air outside, when you decide whether to walk or drive, when you figure out how many friends you have, when you choose what to eat for dinner. What happens in the hospital is not health care, it's disease response. It's what happens when something has gone wrong in the other spheres of your life that make up your health. And the cheapest health reform of all would be the one that keeps us out of the health care system entirely. 
