Tag Archives: Health care in the United States

Is ‘population diversity & behaviors’ to blame for lower U.S. life expectancy…?

Posted on by • Posted in health care, Program Administration, Uncategorized • Tagged , , , , , , , , , , , , • 3 Comments
Government Spending

Government Spending (Photo credit: Tax Credits)

Last week I posted article asking a pertinent question “If U.S. Spending is so Outrageous, Are We Getting the BEST?”

https://marketahouskova.wordpress.com/2013/04/22/if-u-s-health-care-spending-is-so-outrageous-are-we-getting-the-best-2/

The answer is “kind of”.

We do have the best technological and medical advancements in the world, and our acute care and treatments can deliver miracles.  We don’t have to wait 4-6 month for a surgery, we mostly get timely care, good care, and we do have great outcomes. However, as wonderful as that is, it does not impact the overall measurements of ‘life expectancy’ as it falls under the category of ‘acute care’ and we do really well here.

It is injuries or conditions lasting more than 6 months that are considered ‘chronic’ and require ongoing management, ongoing medication, follow-up doctors visits, repeated test, etc… and that’s where the U.S. is seriously lacking. So yes, while we are very good at acute care, we lack in chronic care management – and that does impact the overall ‘life expectancy’ and quality of life.

Which brings me to the fact that even after spending over $8,000 per capita in overall healthcare expenditure in 2010 (the highest in the world) , the U.S. has a lower life expectancy compared to other OECD nations. Why is that? Is “healthcare”  to blame? Is “public health” to blame? Or is it due to our “population diversity and behaviors“?  I have heard many  blaming it on the “diversity & behaviors” part, but in that case a question remains –  isn’t it the health and life expectancy of the whole population, no matter what diversity groups it includes, that makes for ‘life expectancy’ studies, surveys and measurements?

I agree with you that our diverse population is an integral part of our society, however, it is 21st Century and everybody knows that if you want to live longer and have a good quality of life, when you are not feeling well or have certain episodes – you should go see a doctor. And this is where the crux of “it is population diversity & behaviors fault” argument weakens, as 50 million of low-income working Americans (yes, majority about 80% are working and 82% are legal citizens) DO NOT have options or access to a non-acute or preventive care, so they go without seeing a doctor, without taking medications, and without ongoing management of preventable conditions – NOT because of their population diversity or behaviors – but because under the current system they have no viable option for obtaining health plans!

This clearly and directly impacts the overall life expectancy and thus the overall quality of healthcare we as ‘all Americans’ get.
If 1 in 5 Americans don’t have access to health care – it seriously impacts all of us in terms of loss of economic potential, loss of productivity, and in the end, in an increase in overall health care spending.

I ask again, does $8,000 per capita (twice as much as others developed nations) deliver the best health care to our society? Does it…?

Now, since we established that “population diversity & behaviors” are not to blame for lower U.S. life expectancy, is it a fault of healthcare, or public health? The answer is “yes” as the status of U.S. health care and it’s overall total health care spending and expenditures is a direct result and implication of U.S. health policies implementations. States are responsible for health care but federal government plays its role in Medicare, Medicaid, CHIP & other programs.

Medicaid, for example, by covering health care needs of pregnant women and prenatal care is not only delivering health care, but also implementing a U.S. public health policy. Smoking cessation programs – public health issue, or health care issue? Both, as continued smoking leads to lung cancer, COPD, emphysema etc… and that is very costly in terms of health care spending. Public health programs are offering smoking cessation in order to prevent future health care spending, a clear integration of health care and public health policies.

Without proper public health policies we will not be able to deliver proper health care to our diverse population. Clear and simple.

P.S.

Yes, while certain “diverse” behaviors cause increase in health care spending (i.e. smoking, bad diet etc..), if we look at it closer – these behaviors span all socio-economic levels, not only diverse population often mentioned. So we are back at the beginning, why the U.S. has lower life expectancy that other OECD nations? The one clear answer is that it is not due to “population diversity and behaviors”.

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If U.S. health care spending is so outrageous, are we getting the BEST?

Posted on by • Posted in health care, Uncategorized • Tagged , , , , , , , , , , , , • 10 Comments

In today’s heated political and economic debates, healthcare reform and healthcare spending remain a hot topic of conversation – and rightfully so!

Why is it that while the U.S. spent over $8,000 per capita on health care in 2010 (almost 50% more than Norway and Switzerland in 2nd and 3rd place), per OECD ratings, we deliver only average level of care based on U.S. lower life expectancy, lower than Switzerland or Norway. Life expectancy graph puts the U.S. roughly in the middle of the developed countries in life expectancy at birth (the longest gevity is in Japan). How Does the United States Compare page 1.

The problem with that is that other developed countries who show even higher life expectancy than the U.S. are able to bring their population to such age for a fraction (or at least for 50% less) of total health care cost than here in the U.S. It shows that the huge per capital spending does NOT necessarily assure or ensure longer gevity delivered through better care or more advanced technological treatments.

So WHY does health care cost so much in the U.S.?

The answer comes under the cloak of science, as the most significant contributor to U.S. health care cost growth is technology innovation & medical advancement. Clear and simple. We have the best diagnostics, imaging, new-surgery-techniques, technological possibilities and acute care treatments & capabilities in the world – bar none. The fact that we are also a wealthy country contributes to our income growth meaning that the wealthier the country – the more of healthcare consumer spending and insurance-induced demand there is.

It stands to reason that while new medical technology may be expensive, when used in time and appropriately, it does extend patients lives, improves their quality of life which in turn makes them live longer and makes them more productive. So technology – it’s a go! But the need for increased healthcare efficiency with curbed spending will bring a major strain on the U.S. health system in the coming years.

While the U.S. has the best diagnostic and acute health services in the world, we are lacking in preventive care and in management of chronic diseases and conditions affecting a large segment of U.S. (aging) population. Additionally, the wealthiest country in the world and we have around 50 million un-insured people from working families! Yes, you heard right, a vast majority are from working families – as in low-income workers unable to afford private or employer-based health plans premiums. Kaiser Family Foundation Primer (2010) states that 50% of ALL health care spending is used to treat 5% of the population and they are the people with 3+ chronic diseases needing ongoing medical & nursing care, list of medications, follow-up doctor’s visits and other services. http://www.kff.org/insurance/upload/7670-03.pdf

Needless to say that the un-insured have overall much worse health conditions as, due to financial constrains, they do not go see doctors with first symptoms, do not get medications to correct or manage conditions, do not go for tests or follow ups to see how such condition(s) can be treated or fixed or improved. So such condition(s) grow in silence and when finally there is a life-threatening event – they will go to emergency rooms where they will get the care including all those technology innovation & medical advancement tests, images, diagnostic procedures and latest treatments, but they will also get a bill for all that technology innovation & medical advancement. And anybody who went through ER and spent a couple of days in a hospital knows the amount I am taking about here! And without insurance plan to help cover the large amount, they are left with a stark total! http://www.kff.org/uninsured/upload/7451-06.pdf

Let’s not forget, these un-insured are not insured not because they don’t want to or feel like getting a health insurance, but because their low-income jobs leave them unable to pay for private or employer-sponsored health plans and not eligible for Medicaid and too young for Medicare (over 65 y.o.)  Yes, it is true, hospitals can write something off, but on average, it still leaves the low-income un-insured with a bill of about 1/3 of the hospital cost. And good luck with that!