Actually, the U.S. is NOT Spending More Than Any Other Country on Health | Sojourners

Actually, the U.S. is NOT Spending More Than Any Other Country on Health

Health care spending illustration, Andy Dean Photography /
Health care spending illustration, Andy Dean Photography /

Old News: U.S. spends more on healthcare, gets worse results

We Americans are first in the world when it comes to per capita healthcare spending, and yet we don't live as long (we're in 51st place), more of our mothers die in childbirth (we're in 47th place), more of our babies die in their first year of life (we're in 50th place) ... well, you've seen the statistics, and they aren't pretty.

Interesting Spin on Old News: Medical and social spending should be seen as a whole

"The truth is that we may not be spending more," wrote Elizabeth H. Bradley and Lauren Taylor in a 2011 New York Times article — "it all depends on what you count." If you count "the combined investment in health care and social services," such as "rent subsidies, employment-training programs, unemployment benefits, old-age pensions, family support and other services that can extend and improve life," we're in 10th place among developed nations. To compare:

For every dollar we spend on health care, we spend an additional 90 cents on social services. In our peer countries, for every dollar spent on health care, an additional $2 is spent on social services. So not only are we spending less, we’re allocating our resources disproportionately on health care.

Bradley, a professor of public health at Yale, and Taylor, formerly a program manager at the Yale Global Health Leadership Institute, believe that healthcare (primarily intervention after a health problem has occurred) is less effective than social services (primarily services that may prevent health problems) in keeping a nation healthy.

Unfortunately, we Americans do it backwards, and our ratio of healthcare spending to social spending is getting worse. In their forthcoming book, The American Health Care Paradox: Why Spending More Is Getting Us Less (November 2013), Bradley and Taylor write that for every dollar Americans spend on health care, we spend only an additional 60 cents on social services. Here's a picture of OECD spending compared with U.S. spending:

Really Disheartening Current Situation: Many U.S. legislators are trying to cut back social spending

Republicans in Congress are trying mightily to reduce or eliminate food stamps, for example. On Tuesday, the Health Impact Project (in collaboration with the Robert Wood Johnson Foundation and the Pew Charitable Trust) released a white paper called "Health Impact Assessment of Proposed Changes to the Supplemental Nutritional Assistance Program" (translation: the program formerly known as food stamps). Two scary sentences from the 218-page document:

Using a model employed by the U.S. Department of Agriculture to administer SNAP, Mathematica Policy Research conducted an analysis of how many people could lose eligibility or receive lower benefits under the proposed policy changes in H.R. 1947 and S. 954. Under the changes proposed in H.R. 1947, as many as 5.1 million people could lose eligibility for the program.

Lest you think this has nothing to do with health care, the document points out that:

it is well established in the literature that food insecurity (defined as difficulty in obtaining enough to eat) increases the risk of diabetes, heart disease, and depression or anxiety in adults; and asthma, cognitive impairment, or behavioral problems in children. Children in food-insecure families are more likely to be hospitalized in early childhood than those from food-secure households. Medical costs related to food insecurity in the United States amount to as much as $67 billion per year in 2005 dollars.

At the same time, Republicans in Congress are still trying to repeal the Affordable Care Act.

Hey, let's go back to 1900 before any of those lefty innovations got started!

No income tax! No government-backed social welfare programs! No Department of Health and Human Services! No Department of Education! No Medicaid or Medicare! No Social Security! No Maternal and Child Health Program!

Paradise, right?

Except that if you were lucky enough to make it to age 20, your lifespan was 62 if you were a white male, nearly 64 if you were a white female, and a lot lower if you weren't white at all. Worse, you had a 23 percent chance of dying before your 20th birthday. And out of 100,000 women who gave birth in 1900, 600-900 died (compare with 21 in the U.S. today).

Well, that's one way to keep Social Security from going broke ...

LaVonne Neff is an amateur theologian and cook; lover of language and travel; wife, mother, grandmother, godmother, dogmother; perpetual student, constant reader, and Christian contrarian. She blogs at Lively Dust and at The Neff Review.

Image: Health care spending illustration, Andy Dean Photography /

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