Deciding what to spend on your health

Health spending decisions are made piecemeal, driven by marketing and anxiety, which produces households spending substantially on things with no evidence while skipping things that are free.

The free tier, which comes first

Everything here costs nothing or nearly nothing and has strong evidence.

Attending every screening programme you are invited to.

Vaccination for which you are eligible.

Blood pressure measurement.

Not smoking, which is the single largest modifiable factor and which is a saving rather than a cost.

Physical activity, including walking and bodyweight strength work.

Sleep.

Reducing alcohol.

Seeing someone promptly about symptoms.

Taking prescribed medication as directed.

And cooking from basic ingredients.

A household doing all of this is capturing the large majority of available health benefit before spending anything.

The low-cost tier

Small amounts with good evidence.

Fluoride toothpaste, interdental brushes and dental examinations at your risk-based interval.

Eye examinations at the recommended interval.

Generic medication and, where applicable, prepayment certificates.

Vitamin D where recommended, which costs very little.

A blood pressure monitor, validated, for anyone who needs monitoring.

Well-fitting shoes.

Resistance bands or a couple of dumbbells.

Basic first aid supplies and a first aid course.

Contraception and sexual health testing, frequently free.

And oral rehydration sachets, which cost pennies and are the correct treatment for a common problem.

The moderate tier, where it depends

Worth it in specific circumstances.

Physiotherapy for a specific problem, where the value is the assessment and the programme rather than repeated passive treatment.

Psychological therapy, where public waits are long and the need is present.

Dental treatment, which is cheaper the earlier it happens.

Glasses and hearing aids, where the function gained is substantial.

Gym membership, but only after the habit is established elsewhere.

A private consultation to obtain a diagnosis where the public route is blocked.

Travel health preparation.

And income protection insurance, which addresses the largest financial risk from illness.

The high-cost tier, approached carefully

Where the questions matter most.

Private treatment, where the questions in the previous article apply.

Private medical insurance, whose value depends heavily on the system you live in.

Elective and cosmetic procedures.

Orthodontics.

Fertility treatment, where add-on treatments in particular have been assessed as poorly evidenced by regulators.

And treatment abroad, where the saving is real and the follow-up problem is also real.

Where the evidence does not support spending

Stated plainly.

Whole-body screening scans and executive health packages in asymptomatic people.

Direct-to-consumer broad blood panels with proprietary optimal ranges.

Most supplements in people without a documented deficiency.

Detox products and programmes.

Blue light glasses for eye strain.

Home monitors marketed as preventing sudden infant death.

Most anti-ageing and immune-boosting products.

Alkaline water, hydrogen water and similar.

Food intolerance tests using IgG, hair analysis or similar methods.

And any treatment whose marketing includes the phrase that doctors do not want you to know.

The questions that sort them

Applicable to any health purchase.

What specifically will this change?

What is the evidence, and is it from trials in people like me or from testimonials?

Who is selling it, and do they benefit from the answer?

Is there a free or cheaper equivalent I am not using?

Am I buying this because of evidence or because of anxiety?

And what would happen if I spent this money on food, or on time, or on nothing?

The comparison worth making

Which puts most of it in perspective.

The annual cost of a supplement subscription, a private screening package and an unused gym membership is a substantial sum.

The same money spent on better food, on a physiotherapy course for a problem that is limiting activity, or simply retained as an emergency fund against illness, produces more.

And the interventions with the strongest evidence — screening attendance, vaccination, blood pressure control, not smoking, activity and sleep — cost almost nothing at all.

Which is an unglamorous conclusion, and it is what the evidence says.

General information only, not medical or financial advice. Consult a qualified clinician about health decisions and a regulated adviser about financial ones.