Well, it's that time of the year again: CMS has given us the accounting of our National Healthcare Expenditures (NHE) in a paper published in Health Affairs. I am sure you have already heard that the spending only went up by 4% this year over last, an all-time low.
At the same time, we have achieved the highest ever NHE as a proportion of the GDP (17.6%) and as expenditures per capita ($8,086). But the GDP proportion is a somewhat deceptive number on the one hand, as the GDP has suffered a substantial drop from its 2008 value of $14.4 trillion to $14.1 trillion in 2009. On the other hand, this implies that healthcare is eating into the rest of our expenditures on life. At the same time the per capita expenditures have continued their relentless rise.
Let us look at the components of the NHE individually and see what they can tell us.
post where I cited some startling statistics about some broad categories of causes of premature death in the US. Access to medical care accounted for a measly 10% of those, and the rest were attributable to behavior, genetics, environment and social factors. So, while, by inference, fixing medicine may impact 10% of these premature deaths, in reality 97% of the entire NHE goes to medicine rather than to potentially more impactful public health interventions. And the real travesty is that, despite these astronomical expenditures, we are still losing 1,000 lives per day to our broken healthcare system.
Looking a bit more closely at the "personal health" category, we see that, just as in years past, hospital costs and professional services comprise the bulk of this spending.
To be sure, the total research expenditure of $45 billion is nothing to sneeze at. The big question is, however, are we spending it on the right research. I am not at all sure that the answer is yes, given that we still struggle with the same issues at the bedside that we have been struggling with for over a decade. But more on this later.