Such a counterintuitive study, when there are highly motivated political actors trying to deprive people of social benefits, makes me highly skeptical. Catching bad things early is almost always better. Diabetes, cancer, heart disease, etc, cost hundreds of thousands to millions of dollars to treat caught late and prevent people from working or doing things they like to do, and mere thousands to treat early while preserving their quality of life.
Cancer, in particular, can be practically free to insurance if caught early. Colon and skin cancer are the poster children. Colon cancer can be treated in the process of doing the screening when caught early. And skin cancer is a pretty minor "just lop off that mole" procedure that also ends up being the treatment.
Letting it grow and catching it when symptoms arise is terribly expensive. The chemo, surgery, scans, and frequent doctors visits are all crazy expensive.
About the only way I could see preventative care not costing less is if you just let the people die and call it god's will rather than calling it a death that could have been prevented.
The challenge is that we have a rapidly evolving GLP/GIP/Other landscape being developed. In other words, you take a risk that the government buys the wrong thing. However, I think with a little push, you could have a highly competitive field to lower the federal cost, and the ROI should be easy to plot.
Actually, you don't need to do everybody all at once. Target the biggest (no pun intended) opportunities first.
The study is looking only at healthcare spending and two-year outcomes, so it doesn't really address people's intuition that healthcare spending is lower in the long term with preventative care.
That said preventative probably does result in more dollars being spent on healthcare; presumably significantly, if not completely, offset by economic benefits like increased productivity and quality-of-life benefits. Analyses that only look at the cost side of the equation IMO are unhelpful.
