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Fixin' Healthcare

Friday, December 09, 2011

More Transformation

My last post touched upon the concept of transformation. Some might think it is an introduction to the transformation of medical care but it is an introduction to the transformation of society to achieve improved health status of the population and the individuals within the society. Medical care, even reformed medical care, cannot do that. It is time for the United States to wake up and accept the implications of the health outcomes resulting from a health system usurped by medical care.

The United States spends more on medical care and derives less benefit from it than almost every other industrialized nation. Meanwhile, social support programs, public health and primary prevention are afterthoughts of a medical care system. What are the outcomes? The US ranks in the bottom half of comparable nations for life expectancy and infant mortality. But we are winners when it comes to obesity and chronic metabolic diseases. These problems are not cured but many of them can be prevented.

An interesting viewpoint is presented by combining what countries spend on medical care with spending on social services, like rent subsidies, employment-training programs, unemployment benefits, old age pensions, family support and other services that can extend and improve life. In that analysis the US no longer leads among comparable nations. "America is one of only three industrialized nations to spend the majority of its health and social service budget on health care." And in the US that health care budget is overwhelmingly spent on medical care. The study revealed that countries with high health care spending relative to social spending had lower life expectancy and higher infant mortality than countries that favored social spending.

Changing this situation will not be easy. Far from it. Reallocating medical care funds to social services is a start. That alone will change society. But addressing the social, commercial and political environment that promotes unhealthy lifestyles resulting in much of the chronic disease requires transformation of American society. Without it we are becoming a nation of metabolic cripples. 

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