More spent on health care in U.S. than on everything in Britain

money-300x193What if you bought the hottest car around, only to find a neighbor found a model just as sporty and paid much less? How would you react if you opened your credit card bill and learned that the family budget was in tatters because your daughter commuted a few blocks to school by taxi, and your son had racked up huge charges for junky electronic gadgets and questionable movies online? Your consternation would be a tiny fraction of the great concern that most of us should experience due to a new study that finds that Americans spent $3.2 trillion on health care in 2014.

If you’re like me, when figures get that big, they become hard to grasp. But for comparison’s sake, the United States’ medical spending  exceeded the 2015 gross domestic product (the monetary value of all the finished goods and services produced within a given country’s borders in a specific time period) for the economies of: Britain, France, Canada, Russia, Italy, Mexico, Indonesia, Australia, South Korea, Spain, Turkey, Saudi Arabia, Nigeria, and the Netherlands.

Americans spent more on back and neck pain than Russia did on its military and national defense.

This new data gives policy- and law-makers another set of metrics to weigh as they get set to make 2017, if predictions and posturing hold, a year of giant political battles over health care, a sector that now comprises 17 percent of the U.S. GDP, and by 2030, may be 20 percent of GDP. By objective measures, Americans spend more for health care but get only equal or worse outcomes than most of their peers in the industrialized world. Although partisans will bicker wildly in the days ahead over access to health care, chiefly through affordability of services with health insurance, it continues to be less clear how the nation will cope with the constantly rising costs of medical services.

That makes sight lines into health care spending key, including through a recent study published in the peer reviewed Journal of the American Medical Association (JAMA).

The research  finds Americans spending most on chronic, often preventable conditions, with three of these leading: diabetes ($101 billion), the most common form of heart disease ($88 billion), and neck and back pain ($88 billion). The tab for injuries from falls is giant, coming in at $76.3 billion, while Americans spend $71.1 billion on depression and related disorders. The spending on oral-related issues tallies at $66.4 billion, with spending on vision and hearing woes coming in at $59 billion, and treatments for skin-related care at $55.7 billion.

Diabetes and neck and back pain are expenses growing at more than 6 percent annually. Much of the health care spending (38 percent of it) went for Americans 65 and older, and because of pregnancies and their longevity, women, on average, get more health care spending than do men.

The study authors, as well as an accompanying editorial, emphasize that fully grasping where Americans spend for their health care is just a start. It does suggest targets where experts might seek to decrease costs, improve efficiencies, and eliminate waste, especially through reductions in overtreatment or needless or less effective therapies.

What else can we do about this giant challenge? Those who wish to delve deeper into health spending may want to check out the nifty interactive visualization tool put up by the Kaiser Health Foundation. It lets users explore and graph spending changes, by source and expenditure.

There also are individual actions to be considered. I’ve written, for example, on back pain and what sufferers might do to improve their lot with it. In my practice, I’ve seen the challenges of diabetes care, especially when delivered inappropriately, and I’ve written about the concern about the disease’s epidemic growth. I’ve written about the importance of taking care and means to avoid falls and their harms.

I also find a lot of common sense in a growing body of research that concludes that to combat major, common killers like heart disease and cancer some basic, individual steps may produce improved outcomes over time: We need to eat more healthful foods in appropriate quantities, while reducing fats, refined sugars, and salt in our diet. We need to manage our weight better and avoid becoming overweight or obese. We need to exercise in moderation. We need to cut out smoking, reduce stress, and increase our sleep. These all sound like little measures, I know. But our gigantic, ever growing spending on health care is unsustainable, and we all need to do what we can to reduce it.

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