Analysis Describes Economic Anatomy of U.S. Health Care

(HealthDay News) – Despite the increases in resources devoted to health care in the United States, multiple health care metrics show that the United States is trailing peer nations, according to a special communication published in the Nov. 13 issue of the Journal of the American Medical Association, a theme issue on critical issues in U.S. health care.

Hamilton Moses III, MD, from the Alerion Institute and Alerion Advisors LLC in North Garden, VA, and colleagues used publicly available data to identify trends in health care mainly from 1980–2011.

The authors note that U.S. health care employed 15.7% of the workforce in 2011, with expenditures of $2.7 trillion. Since 1970, yearly growth decreased but, at 3% per year, exceeded any industry and gross domestic product overall. Despite the increased resources, the United States is trailing peer nations in multiple health metrics, including life expectancy at birth and survival with many diseases. Since 2000, price, not demand for services or the aging population, caused 91% of the cost increases; personal out-of-pocket spending has decreased; and chronic illnesses account for 84% of costs in the entire population. The most change was due to consolidation, information technology, and perception of the patient as a consumer. These forces create tensions between the aims of patients, physicians, and payers.

“A national conversation, guided by the best data and information, aimed at explicit understanding of choices, trade-offs, and expectations, using broader definitions of health and value, is needed,” Moses and colleagues conclude.

Several authors disclosed financial ties to the pharmaceutical and other industries.

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