Education
- December 13, 2017
The Problem of Rising Deficit and Stagnating Growth & Revenue – CBO’s 2016 Long-Term Budget Outlook
Options created by CBO – Options for Reducing the Deficit: 2017 to 2026
Shown in the chart below, the top 2 causes of death by far are major cardiovascular diseases and cancerous tumors. Source: wiki
If we dig deeper, preventable causes of death and individual risk factors (combined from sources – wiki, harvard)
For children, the top are 1) Traffic collision: 260,000 per year, 2) Drowning: 175,000, 3) Burns: 96,000, 4) Falls: 47,000, 5) Toxins: 45,000
A next question is: What are the most effective and resource-efficient ways of reducing these deaths?
As we see in our overview of Federal Spending and CBO, Healthcare spending is 25% of the Federal Budget ($937 billion in FY 2015) – which is for – Medicare (592 billion in 2016), Medicaid (365 billion), Health Insurance subsidies and related (43 billion), and Children’s health insurance (14 billion).
When we look at total US spending in Healthcare (not just Federal), it totals to $3.2 trillion and by Service or Product –
The Sources of Funds by Program were 20% Medicare, 17% Medicaid, 33% Private Health Insurance, 11% Out-of-Pocket. Or by actual Source of Funds – 29% Federal Government, 28% Households, 20% Private Businesses, and 17% State and Local Governments.
Source: CMS
The money sink of the Health sector is unclear. There is a rumored myth that 90% of health money goes to patients in the last year of life (palliative care), when it is actually 13% – NIH. In a given year, 13% of costs are to patients at end-of-life, 49% goes to discrete events (patients’ costs drastically decrease the next year), and 40% goes to patients with persistently high costs.
Conclusion: Public health interventions to reduce health care costs should target that 40% pool of money – that goes towards patients with long-term chronic conditions and functional limitations.
Preventive Care – “There is no general consensus as to whether or not preventive healthcare measures are cost-effective i.e. they may or may not decrease the costs of treatment, or may or may not give extra health benefits. However, preventive healthcare measures increase the quality of life dramatically” (wiki).
Preventative Measures – A 2010 study reported that in the United States, vaccinating children, cessation of smoking, daily prophylactic use of aspirin, and screening of breast and colorectal cancers (and maybe screening for alcoholism, obesity, and vision failure) had the most potential to prevent premature death. Interestingly, comparing these measures to the past – former Governor Richard Lamm of Colorado stated in 1986 that “the major factors that brought health to mankind were epidemiology, sanitation, vaccination, refrigeration, and screen windows.”
NIH
MedlinePlus – Health Conditions
USPTF Recommendations
Cochrane Review Evidence