Prevention May Prove Costly

"Experts have concluded that a large fraction of preventive care adds to spending but should be deemed 'cost effective,' which means that it provides clinical benefits that justify those added costs," he said. In cases where the provision of preventive medical care saves money, "potential savings from expanded federal support might be limited," he said.

As for wellness, designing government policies that are "effective at inducing people to be healthier is challenging," he wrote. However, even successful efforts "might take many years to bear fruit" and could involve significant costs, he added.

As with preventive medicine, he said the "net budgetary effect" of government support for wellness services depends on the balance of two factors: The reduction in government health spending for people who reduce their future use of medical care and the costs to the government of providing or subsidizing wellness services.

Although some case studies suggest that certain employer wellness programs reduce subsequent medical care, "little systematic evidence exists," he said. The findings from case studies may not be applicable to programs that would be implemented more broadly.