Americans have the most expensive health care system in the world, although they don't have the most efficient one. Additionally, they don't get the most for their money. That's the assessment of two recent studies of health care in the U.S. Now, researchers paying more attention to where the money goes and what changes can be made to improve health care.
U.S. health care costs have doubled in the last 30 years, but Americans are not necessarily healthier than they were in the 1980's. Hamilton Moses analyzed the changes and trends and published his findings
in the Journal of the American Medical Association.
“All of our information comes from publicly available sources. That’s a very important point. This is freely available information, although the challenge was to compile it in a way that was interpretable,” said Moses.
The researchers found Americans spent between $2.5 trillion and $3 trillion dollars on health care in 2011, more than any other developed country. The report highlights two major factors that are driving up costs.
The first is that the price of medical and administrative services has gone up, along with the cost of drugs, procedures and devices.
Moses says Americans' love of technology is part of the problem.
"The U.S. has a technology bias. We have a technology preference. We look to technology for the solution of all problems,” explained Moses.
The second factor is simple to identify, but more complex to address. Poor lifestyle habits, such smoking and over-eating, have resulted in epidemic levels of obesity and diabetes as well as heart disease, joint pain and lung diseases. Managing chronic disease is expensive.
“We have not invested heavily in chronic care management or for that matter in health care service innovation nearly to the degree that we have in medical technology,” said Moses.
Many of these diseases can be prevented though exercise, diet and maintaining a healthy weight, yet in the U.S. prevention has not historically been part of medical care. Consulting with a nutritionist, either by phone or in person, or participating in wellness activities can be expensive, and those services are not normally covered by health insurance.
“The overall amount of spending that occurs with people who have chronic illness is about 85 percent of the total,” said Moses.
Moses' research shows that those who spend the most on chronic disease are not elderly, and that their investment in care does not guarantee a long life.
Meanwhile, a new report
from the Organization of Economic Cooperation and Development shows that the U.S. spends between 250% to 300% of what other member nations spend. Despite that, the United States trails other developed countries in life expectancy, coming in at 26th place out of the 36 members of the organization.