In the ongoing journey to understand the intricacies of the healthcare system, one glaring fact stands out: the U.S. spends more money on healthcare than any other nation – over $4.2 trillion in 2021, or about 18% of our GDP. Yet, for all this expenditure, our outcomes are not the best. The question is, why?
The answer is straightforward yet complex. We're spending money at the wrong times and on the wrong things.
A staggering 25% of Medicare healthcare expenses in the U.S. are incurred during the last year of a person's life, often on high-intensity care with minimal impact on overall lifespan or quality of life. While end-of-life care is crucial, our disproportionate spending here contrasts sharply with our lack of investment in preventive care. Countries like Japan, Sweden, and Norway, with better health outcomes, invest heavily in early interventions and preventive measures, ensuring a healthier population throughout their lifetimes.
So, what should our focus be? First, we must advocate for a re-direction of funds towards prevention. For every dollar spent on vaccination, we could save $16 in future healthcare costs. Prenatal care, health education, regular screenings, and access to nutritious food can ensure that minor issues don't snowball into significant, costly health crises.
However, addressing the financial aspect is only part of the solution. Our disparities and lack of health equity stem not just from systemic biases, structural racism, and built-in inequities but also from our failure to focus on prevention.
It's time to address the elephant in the room: the social determinants of health. These non-medical factors – like housing, education, job opportunities, and community safety – play a monumental role in health outcomes. A child growing up in a safe environment with access to nutritious food and quality education is more likely to lead a healthier life than one who doesn't, regardless of the healthcare they receive.
To truly accelerate health equity, here's what we can advocate for:
1. Lobby for Increased Preventive Care Funding: Write to legislators and officials to allocate more funds for early interventions and preventive measures.
2. Empower Communities: Create community-led initiatives addressing localized social determinants of health. Advocate for affordable housing, better educational opportunities, and community safety measures.
3. Educational Campaigns: Champion health education campaigns that provide individuals with the tools and knowledge to make informed health decisions.
4. Support Grassroot Organizations: Back local organizations addressing health disparities at their roots.
In summary, while the U.S. healthcare spending is vast, we need a paradigm shift in where and how these funds are used. Only by addressing both the immediate medical needs and the broader social determinants can we truly pave the way for health equity. The journey might be long, but with collective effort, a healthier, more equitable future is within our grasp.
Denise Johnson, M. D. is an OB/GYN Physician, Health Equity Consultant, Former Physician General of Pennsylvania and a passionate advocate for Health as a Human Right.