At the RAND organization’s blog Jeffrey Wasserman brings up a too long overlooked point. Our healthcare system is far too focused on care and not focused nearly enough on health:
International comparisons of aggregate health outcomes provide additional evidence of the poor return America is getting for its national health expenditures. A 2015 report by the Commonwealth Fund, for example, found that the United States had the lowest life expectancy at birth and the highest infant mortality rate of the 13 high-income countries included in the study. The prevalence of chronic diseases was also highest in the United States. Ditto for the obesity rate.
It is important to recognize that even if the United States had a high-performing health care system, it is unlikely that it would improve aggregate health outcomes appreciably. This is because health care may account for as little as 10 percent of Americans’ overall health, with the balance due to social and environmental factors, individual behaviors and genetics.
Unfortunately, efforts to address some of these other factors, in particular social and environmental ones, have also come up short. The Commonwealth Fund report noted that the United States spent less on social services—pensions, employment programs, supportive housing, etc.—than the comparison countries. A similar result was obtained by a group of researchers from RAND Europe, which also found a high correlation between social service spending and key health outcomes.
Yet money alone is not the answer. In fact, the United States spends almost double the amount of the next highest-spending country (France) on health care. Instead, existing resources could be better targeted at high-value care and away from unnecessary and low-value care. This can be achieved through a variety of means that include improving the ways in which health care provider performance is measured and reported; creating user-friendly tools for consumers that enable them to make valid price and quality comparisons; and altering the financial incentives faced by health care providers in ways that reward providing high-value care.
How would a system in which the emphasis was on health rather than care be different from the present one? That’s a question. I’d really like to know the answer.
I suspect we’d be spending more on people from age 0 to 30 and spend less on those over the age of 65 but that’s just a guess.
That 10% number was just made up and is still cited by many people. It is one of those zombie stats that just won’t die. Best estimates put it at 50%.
What would it look like? First, note that in the last paragraph the author just cites his/her preferred methods for decreasing health care costs for health care. Next, I am not entirely sure about the age group spending, but we are looking at actually adding social workers instead of doctors and nurses for some of the projects we are starting as means of controlling costs by promoting health. Have contemplated teams of drivers who would regularly pick up and deliver the troubled chronic patients and/or home visits. I think we should also try to involve volunteer community groups, especially churches. They could do a lot more good helping sick or potentially sick people in their homes rather than picketing over abortion. Also looking at, this would really involve younger groups, integrating behavioral health with physical health measures at a much younger age.
Steve