Lack of public health investment may drive up overall costs


If the United States invested more in public health and preventive care, it could cut its costs dramatically. However, the economics of the nation's healthcare delivery appears to get in the way, creating an upward spiral of expenditures.

That's the opinion of Ryan Gamlin, a former executive with HCPG and UnitedHealth who is currently a student at the University of Cincinnati College of Medicine. He noted in Medical Economics that of the more than $9,500 per capita spending on healthcare in the U.S. in 2014, less than $300 was spent on public health initiatives.

Gamlin observed “a rational system of health promotion would invest in wellness, rather than reveling in its ability to cure disease, yet under traditional fee-for-service compensation models, prevention has been a business model without profit, and the fractured and often fractious landscape of federal, state, and local public health spending has often left public health agencies without adequate resources and direction to achieve their mission.”

Healthcare delivery in the U.S. is the costliest on the planet by a wide margin, but quality of care is also far behind other nations. A fragmented payer system is also blamed for driving up costs as well.

Gamlin did note that the move away from fee-for-service healthcare finance and toward outcomes-based systems such as accountable care organizations is helpful, but is not occurring quickly enough.

“Until we create a system that rewards investment in wellness and healthcare dollars not spent, there is reason to fear that the negative effects of healthcare excesses will continue to be borne by households, businesses, and governments,” he concluded.