Currently showing: Funding longer lives > Health/medicine

02 Aug 13 19:37

Peter A. Muenning, assistant professor of Columbia University, wrote an article about the reasons for U.S. relatively lower improvement on life expectancy from the year 1975 to 2005. This study compared the life expectancy in the U.S with twelve other wealthy nations. In the most times, obesity and smoking were used to explain such low life-expectancy ranking.

In fact, the U.S. had lower smoking rate and obesity percentage than most of those advanced countries. The author believes the U.S. health care system is responsible for the observed deterioration in survival. Although health spending in the U.S. significantly increased during the study period, fee-for-service treatments and fragmented care are likely leading to the impaired outcome.

For the detailed information, please refer to Peter A. Muenning's article as following:

P. A. Muennig and S. A. Glied, "What Changes in Survival Rates Tell Us About U.S. Health Care," Health Affairs Web First, Oct. 7, 2010.

Category: Funding longer lives: Health/medicine

Location: USA


Alicia Montoya - 9 Aug 2013, 5:36 a.m.

Thanks! Here's the study you mention:

What amazes me is how we keep going from public, to private, to public, to private... (repeat ad nauseum) healthcare models. Public models are accused of being inefficient and costly (like the UK's NHS), while private models (like the US') have been found to be costly and detrimental to overall health improvements because they lead to fragmented care?

So my question is, having tried every possible variation of both models now, can somebody not come up with a model that will stand the test of time? From where I stand, what seems woefully inefficient is to constantly go from one to the other.

Alison McLean - 21 Aug 2013, 10:16 a.m.

I think the challenge is that it is not as simple as a system being public or private. For example, the NHS obtains the funds through public taxation and many of the services are delivered by public providers but they do also use private providers as commissioners are allowed to use "any preferred provider". Much of the US funding comes through private purchasing of insurance however, there is a large amount of public taxation that is used to fund medicare and medicaid. So are those systems public or private? I think it is really a normative question about the priorities of society, for example do they prioritise equity of access, equity of financing or scope of coverage? Because these are normative questions, these will vary from country to country and as such the systems will be structured differently because they are trying to achieve different outcomes. The priorities are also likely to change over time and hence we end up with the health system also changing.

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