We've all heard the expression "an ounce of prevention is worth a pound of cure," but in an economic sense, that is not necessarily the case.

At least, not according to that trouble-maker of a Congressional Budget Chief who keeps popping utopian bubbles with doses of reality:

In yet more disappointing news for Democrats pushing for health care reform, Douglas W. Elmendorf, director of the Congressional Budget Office, offered a skeptical view Friday of the cost savings that could result from preventive care -- an area that President Obama and congressional Democrats repeatedly had emphasized as a way health care reform would be less expensive in the long term.

Obviously successful preventive care can make Americans healthier and save lives. But, Elmendorf wrote, it may not save money as Democrats had been arguing.

"Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall," Elmendorf wrote. "That result may seem counterintuitive.

"For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed. In such cases, an ounce of prevention improves health and reduces spending -- for that individual," Elmendorf wrote. "But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. ... Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness."

If you really think about prevention as an idea, it's not difficult to see why all sorts of chaos and waste would result once the heavy hand of government bureaucracy is in charge.

Imagine, for example if government safety Nazis (can I still say that without being accused by Nancy Pelosi of being a Nazi myself?) were in charge of preventing accidents and injuries. The cost of everything would go up astronomically. Children would be wearing safety helmets to walk outside, cars would be rendered nearly undrivable, food would be inedible, and everything would cost a fortune. And how many bad things would actually be prevented?

That's the biggest problem with prevention. You often don't know whether you're really preventing something. And the way the government works, preventive measures would tend to be imposed on everyone in the hope of preventing diseases that would only affect a small percentage of people.

Plus, fads change. When I was a kid, the medical "consensus" of many pediatricians was that children should have their tonsils removed to "prevent" infections and sore throats. Millions of children were subjected to this needless surgery and some died from it. Today we laugh, but in those days the skeptics were laughed at. (Need I mention the prefrontal lobotomy fad?)

Regrettable though it is that incorrect beliefs can lead to incorrect practices, the medical-scientific field at least has a tendency towards self correction -- something that is not generally true about even the best-intended government bureaucracies.

I think the best form of prevention is to keep the government the hell out of it.