When you factor in the cost of health insurance, prescriptions, and deductibles, few Americans would be surprised to learn that health care costs account for a much higher percentage of the economy than any other major nation. For example, major European countries spend about 9 to 12 percent of their GDP on health services. Spending over 17%.
However, despite significant investments in health services, results are actually as good or worse on some key health indicators, such as infant mortality and the prevalence of chronic disease. Masu. So why did I spend so much and get so little back?
A hint comes from the balance of spending in the United States between health services and social services such as housing assistance, food assistance, and child support. Medical experts are coming to the conclusion that improving these “social determinants” often results in better long-term health outcomes than intensive and expensive medical care. This has led to developments such as the American Academy of Pediatrics asking its members to screen all patients for food insecurity as a way to address poor childhood development and health problems in adolescence. Doctors and hospitals are starting to ask more questions about patients’ home life and community supports, and some are taking steps to help patients enroll in services such as housing and food assistance.
In the United States, spending on social services is significantly higher than on health care. On average, major (OECD) countries spend about $1.70 on social services for every dollar spent on health services. But the United States spends only 56 cents on every dollar spent on health care. However, research shows that basic measures of national health are more closely and positively associated with social services spending than with health spending. This is true even when looking at different states in this country. States with higher ratios of social and health spending have significantly improved health outcomes in many areas, including adult obesity, diabetes, lung cancer, asthma, and heart disease.
It is difficult to escape the conclusion that large amounts of funding should be gradually diverted from health services to so-called ‘upstream’ elements of health. In other words, it’s better to spend money on prevention than to spend money on expensive medical repair shops after the damage has occurred.
Unfortunately, deciding to reallocate funds in this way is not an easy task. First, we can expect stiff resistance from the healthcare industry, which is concerned about protecting profits and jobs. But his one way to alleviate that opposition is to decide to provide more social services from within the health sector. Fortunately, some leading health systems, such as Dignity Health and Trinity Health, are already investing in community health workers, housing, nutrition, and other upstream components, and other health systems can follow suit. is shown.
Silos in government budgets are also a problem. When systems like Dignity and Trinity invest in non-medical services, these investments often result in increased high school and college graduation rates and increased government tax revenue as more people work regularly. and create value in other ways that lead to improved health outcomes. However, there are financial disincentives to making these investments because Medicaid and other government health programs often do not cover these non-medical investments. Budgeting and payment rules must change to encourage hospitals and health care professionals to diversify and address social conditions.
Another obstacle is the difficulty in sharing information about individuals. Therefore, it is usually difficult to compile all the information about an individual’s housing conditions, educational background, medical history, and other aspects of life in one place. One reason for this is legitimate concerns about sharing personal information. It’s also due to technical issues such as computers and databases that don’t “talk” to each other, and bureaucracies that simply don’t like to share information. However, without effective and secure data sharing, it is extremely difficult to identify which resources can best be used to improve someone’s health over the long term. Furthermore, it is difficult to study which services are most effective in improving the health of particular types of people, making policy reforms more speculative and less evidence-based. Therefore, these issues also need to be addressed if we are to be confident that shifting health spending to social services will significantly improve community health.
The spending numbers clearly show that we have the will and the resources to improve health care for Americans and address health inequities. However, we need to realize that improving health and spending money on medical services are not necessarily the same thing.
Editor’s note: This article originally appeared on Inside Sources.