Health
A new study by researchers at the UCLA Fielding School of Public Health and McGill University in Montreal reveals that the United States health care system ranks 22nd out of 27 high-income nations when analyzed for its efficiency of turning dollars spent into extending lives.
The study, which appeared online this month in the “First Look” section of the American Journal of Public Health, illuminates stark differences in countries' efficiency of spending on health care, and the U.S.'s inferior ranking reflects a high price paid and a low return on investment.
For example, every additional hundred dollars spent on health care by the United States translated into a gain of less than half a month of life expectancy. In Germany, every additional hundred dollars spent translated into more than four months of increased life expectancy.
The researchers also discovered significant gender disparities within countries.
“Out of the 27 high-income nations we studied, the United States ranks 25th when it comes to reducing women's deaths,” said Dr. Jody Heymann, senior author of the study and dean of the UCLA Fielding School of Public Health. “The country's efficiency of investments in reducing men's deaths is only slightl better, ranking 18th.”
The study, which utilized data from 27 member countries of the Organization for Economic Cooperation and Development collected over 17 years (1991-2007), is the first-known research to estimate health-spending efficiency by gender across industrialized nations.
“While there are large differences in the efficiency of health spending across countries, men have experienced greater life expectancy gains than women per health dollar spent within nearly every country,” said Douglas Barthold, the study's first author and a doctoral candidate in the department of economics at McGill University.
The report's findings bring to light several questions. How is it possible for the United States to have one of the most advanced economies yet one of the most inefficient health care systems? And while the U.S. health care system is performing so poorly for men, why is it performing even worse for women?
The exact causes of the gender gap are unknown, the researchers said, thus highlighting the need for additional research on the topic, but the nation's lack of investment in prevention for both men and women warrants attention.
“The most effective way to stop people from dying prematurely is to prevent them from getting sick in the first place,” Heymann said.
Last year, the U.S. spent a tiny fraction of its $2.65 trillion annual health care budget on prevention. Health care spending is a large – and ever-increasing – portion of government budgets, particularly in the U.S.
Therefore, allocating the necessary resources for prevention and improving overall efficiency are both critically important to preventing premature deaths and wiser spending, the researchers stressed.
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NORTHERN CALIFORNIA – Partnership HealthPlan of California (PHC) is prepared for an influx of new members as a result of changes to the healthcare system under the Affordable Care Act and other reform initiatives.
“We have been planning for this for a long time,” said Jack Horn, chief executive officer of Partnership HealthPlan of California. “Over the past several years, PHC has made a number of changes to our technology infrastructure, hired more than a hundred new staff members, opened regional offices and established new relationships in the communities we serve.”
The latest wave of new members into the plan will come on January 1st with the conversion of the County Medical Services Program (CMSP) to managed care Medi-Cal. PHC will gain more than 34,000 new members as a result.
“The unknown at this point is the number of people who will be new to Medi-Cal because of expanded eligibility,” Horn said.
Under that expansion, the threshold for eligibility has increased from $11,500 a year or 100 percent of the federal poverty level to 138 percent of the federal poverty level or $15,700 a year.
This new eligibility threshhold will bring more people into PHC’s membership, but the exact number will depend on enrollment efforts.
An estimated 31,000 people in PHC’s 14-county service area could become members under the expansion of eligibility.
Whatever that number will be, PHC is ready.
“We’ve been here before,” Mr. Horn said. “When the state moved the Healthy Families program in managed care Medi-Cal, we took in 42,000 new members. And our September expansion into eight northern rural counties brought in 104,000 new members. These previous expansions have gone very well, and they’ve helped us to refine our strategies going forward. Our provider network and community stakeholders have been instrumental in helping us as well.”
PHC began operating in 1994 and serves Medi-Cal recipients in 14 northern California counties: Del Norte, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Shasta, Siskiyou, Solano, Sonoma, Trinity and Yolo.
Additional information can be found at www.partnershiphp.org .
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