Alzheimer’s. Researchers at the RAND Corporation noted the conundrum across severalstudies and came to roughly the same conclusion: “Medical innovations will result in better health and longer life, but they will likely increase, not decrease, Medicarespending.”In one study, the researchers postulated three different scenarios for the health costs of seniors entering Medicare from 2002 to 2030. Scenario A took into account everythingthat we know today about the health of the current cohort of seniors entering Medicareand future enrollees, up to 2030. (This is a mixed bag. Seniors’ health started improvingin the 1980s, but rates of chronic diseases have been increasing rapidly in recent years,and newer enrollees are likely to be sicker and thus more expensive.) Scenario Bassumed that future cohorts would be as healthy as those in the 1990s. And Scenario C(the most optimistic) assumed that seniors’ health would continue to improve. Underrosy Scenario C, the researchers found, health spending would be $10,275 per Medicareenrollee in 2030—just 8 percent lower than under Scenario A. Why? Healthier seniorslive longer and accumulate more costs; also, costs are rising faster among less disabledseniors, presumably because they use more new drugs and devices that prevent themfrom becoming disabled (knee replacements, for example).In another study, RAND researchers looked at how ten important medical innovationslikely to emerge in the near future might affect Medicare spending in 2030. Theseincluded anti-aging compounds for healthy people, cancer vaccines, tiny defibrillatorsimplanted near the heart, better treatments for stroke and cancer, and Alzheimer’sprevention. Every hypothetical innovation, the researchers found, would increaseMedicare spending. Even the cheapest, an anti-aging compound taken by healthy peoplethat would cost just $11,245 per life-year saved, would increase health-care spending by 14 percent in 2030—because there would be 13 million more beneficiaries collecting benefits.Finally, RAND examined the effects of fighting four risk factors for heart disease. If wecould get all the elderly to stop smoking and control their diabetes, their health wouldimprove, of course, but costs would rise, again because those ex-smokers and diabetics would eventually be vulnerable to other health problems. If we effectively treatedhypertension and slashed obesity rates by 50 percent, however, health would improveand costs would fall. Reducing obesity produced the clearest gains because obesity,though it sharply increases costs, doesn’t reduce longevity significantly. What all three studies suggest, then, is technological innovations or disease prevention will likely result in slight savings or even increased costs (though obesity may be theexception to this trend). This doesn’t mean, of course, that we shouldn’t keep inventingdrugs and devices to keep people alive longer, or that we shouldn’t develop betterprevention strategies. It just means that we should stop pretending that good health isalways cheaper. Sometimes, you really do get what you pay for.