The Big Picture of American Health Issues

DECEMBER 26, 2016 BY ADMIN LEAVE A COMMENT (EDIT)

Factors of Annual Deaths

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)

Smoking: 435,000 to 467,000
Preventable medical errors in hospitals: 210,000 to 448,000
High blood pressure: 395,000
Overweight-obesity: 111,909 to 216,000 (Additional Info)
Inadequate physical activity and inactivity: 191,000
High blood sugar: 190,000 (Additional Info on Diabetes)
High LDL cholesterol: 113,000
High dietary salt: 102,000
Low dietary omega-3 fatty acids (seafood): 84,000
High dietary trans fatty acids: 82,000
Infectious Diseases: 75,000
Alcohol use: 64,000 to 85,000 (averted 26,000 deaths from heart disease, stroke and diabetes, because moderate drinking reduces risk. But outweighed by 90,000 alcohol-related deaths from traffic, injuries, violence, cancers and others).
Low intake of fruits and vegetables: 58,000
Toxic agents including toxins, particulates and radon: 55,000
Traffic collisions: 43,000
Preventable colorectal cancers: 41,400
Firearm deaths: 31,940
Sexually transmitted infections: 20,000
Drug abuse: 17,000
Low dietary poly-unsaturated fatty acids: 15,000
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?

Money Spent on Healthcare

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 –

32% Hospital Care
20% Physician and Clinical Services
10% Prescription Drugs
3% Administration
4% Dental
5% Non-traditional location Health Care
3% Home Health Care
5% Nursing and Retirement Facilities
4% Medical Products
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

Increasing Efficiency in Healthcare

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.”

Other Sources

NIH
MedlinePlus – Health Conditions
USPTF Recommendations
Cochrane Review Evidence