Healthcare cost crisis ignores prevention as a ke​y driver

  • The United States currently spends more than $420 million per hour on healthcare, a number that is increasing by the minute and is expected to top $12 trillion in 2040, according to
  • The U.S. currently spends about twice as much as what other high-income nations do on healthcare — more than $3.6 trillion in 2018, according to the latest estimates from the Centers for Medicare & Medicaid Services.
  • Despite the higher spending, the U.S. consistently ranks near the bottom on major health indices such as life expectancy and infant mortality.
  • Health spending per person is growing  2X faster than household income driving more than 57 million Americans to cut back household spending to pay for healthcare or medicine.
  • The focus on healthcare spending continues to be cost but very little is said about prevention.

Fact: healthcare costs in the US are a crisis. 45% of American adults fear that a major health event in their household could lead to bankruptcy. Even with employer health coverage, a family earning $45,000 a year must budget at least 20% of their income for health expenses including premiums and out-of-pocket costs. But the focus continues to be around costs of treatment not prevention.

Diabetes was the condition with the greatest increase in spending, rising by $64.4 billion between 1996 and 2013. Most of this money went to pharmaceuticals prescribed to treat it. The single most important risk factor for type 2 diabetes is obesity, noted Dr. Patrick H. Conway of Blue Cross Blue Shield of North Carolina.

According to STAT News “In terms of risk factors, being overweight or obese accounted for $1.7 trillion, or 47 percent of the total cost. Approximately 8.7 percent of health-care spending in the U.S. is attributable to cigarette smoking; 60 percent of that is paid by public sources — Medicare, Medicaid, and other U.S. federal and state health programs. Health problems caused by excessive drinking cost $27.4 billion in 2010, or 1 percent of the total cost of chronic diseases and 11 percent of the total costs of alcohol abuse.

The fastest way to lower costs, or at least to slow the upward spiral, is to reduce the number of Americans who carry excess weight, smoke, or drink too much alcohol. The share of American adults classified as obese increased from 13 percent in 1960 to almost 40 percent in 2016. Another 33 percent are overweight. Epidemiologic research has established a strong link between obesity and chronic diseases such as heart disease, kidney disease, and several types of cancers.

“As a nation, we are fighting the wrong healthcare battle,” said American Public Health Association executive director Georges C. Benjamin. “Although there is a wealth of evidence supporting the value of prevention as a way to save lives and save money, the majority of every healthcare dollar goes towards treating illness. Essentially, health reform should include a strong focus on prevention. Behaviors, such as smoking and obesity, are limiting our nation’s ability to make progress and costing billions in unnecessary, preventable healthcare costs.”

The Bottom Line

Americans love to assign blame for everything but while healthcare costs are rising faster than wages we, as a country, are not doing enough to stop preventable diseases. The US was able to make smoking taboo through a huge awareness campaign but I am puzzled why we can’t do the same for obesity and other preventable health conditions. About 11 million deaths a year are linked to poor diet around the globe and add to the burden of increasing healthcare costs.

Several colorful arrow street signs with words Not Me – His, Her and Their Fault, symbolizing the twisting of the truth and shifting of blame

Failing to address prevention is doing us all a huge disservice.