Economic issues affecting the health care system

Economic issues affecting the health care system

Examine at least three current and future economic issues confronting today’s health care system.

Analyze the significant implications of the issues in question for market efficiency of the health care system.

Provide specific examples to support your rationale from readings throughout your program or from peer-reviewed journal articles.

Overview

Historically, long-run improvements in health have been tied to economic growth through 3 broad mechanisms: better nutrition, enhancements in public health infrastructure (such as sanitation and cleanliness of water supply), and more effective medical technology (such as antibiotics and vaccines). The results of many studies exhibit this familiar wealth-health connection, both across nations and within them. Citizens of nations with higher average incomes tend to live longer and, despite that, experience fewer years of disability. Women in higher-income nations have lower rates of anemia. Babies born in those countries have higher birth weights.

Within countries, people with higher incomes also tend to live longer. Children growing up in wealthier households are healthier. Infant and childhood mortality, as well as childhood illness rates, are lower. Lives lengthened in Japan after its economic booms in the 1960s and 1970s. Lifespans fell during the Great Depression. A recent study of US recessions and mortality from 1993 to 2012 by Sarah Gordon, MS, and Benjamin Sommers, MD, PhD, also found that a slowing economy is associated with greater mortality. According to their work, lower income and greater poverty are more strongly associated with higher mortality rates than is the unemployment rate.

Effects of Economic Expansions

Still, there is also a substantial body of research that in the short run, economic expansions can be detrimental to health. Or, conversely, recessions can improve the health of some. During the Great Recession of 2007–2012, unemployment spiked, but to different degrees in different countries. Exploiting this, one study of Europe found a 1 percentage point increase in the unemployment rate associated with a half percent decline in the mortality rate. A similar relationship has been observed at other periods, both in Europe and in the United States. The effect in the United States translates into about 13 000 fewer deaths for every 1 percentage point increase in the unemployment rate.

How can wealth improve health while slowing economies reduce mortality? Broadly speaking, the relationship between economic conditions and health is context dependent, can vary over time, and can be different in the short-term vs long-term. It can change due to the nature of the economy (such as agrarian vs industrial vs service). The depth of recessions and the strength of economic surges also play a role. Finally, the composition of the population is relevant, since different types of individuals are susceptible to the effects of economic changes to different degrees.