It doesn't matter how productive they are if the savings are being equally cancelled out: the health cost issue is then zero-sum, but that means any productivity that wouldn't have occured without preventative care is a positive gain. And even without economic benefit one way or the other, I figure most people wouldn't mind having a healthier mom around a little longer. You cant narrowly focus on only economic benefits, and then narrowly only on the most obvious and easiest to calculate, and expect to arrive at anything like a coherent and inteligent point of view.