Using unique individual-level panel data, we investigate whether preventive medical care triggered by health checkups is worth the cost. We exploit the fact that biomarkers just below and above a threshold may be viewed as random. We find that people respond to health signals and increase physician visits. However, we find no evidence that additional care is cost effective. For the “borderline type” (“pre-diabetes”) threshold for diabetes, medical care utilization increases but neither physical measures nor predicted risks of mortality or serious complications improve. For efficient use of medical resources, cost effectiveness of preventive care must be carefully examined.So far as we can tell, there isn't much reason for healthy people to see a doctor.
On the other hand there is strong evidence that women who get pre-natal care have healthier babies, even when the checkups lead to no interventions at all. So this is a complicated business, and there may well be interventions that help. The ordinary sort of medical check-up just doesn't seem to be one of them.
This has some political importance when it comes to health care policy. Liberals have long hoped that universal health insurance would save a lot of money, because people would get to the doctor when their problems were small and easily treatable, rather than waiting until they are really sick and going to an emergency room. But the evidence that this saves any money at all is weak, and the cold truth seems to be that the more health insurance you give people the more they spend on health care.