Spiritual_Wellness_Holistic_Health_and_the_Practic

Health Care Reform 307
MEDICAL EXPENDITURES AND HEALTH STATUS
It would be one thing if it could be shown that increased medical care expenditures
resulted in improved health status as measured by crude indicators such as infant mortality
and longevity. Such is not the case. Research fails to show any clear relationship
between the resources countries spend on medical care and the health of their populations.
For this article a correlation was run on medical care expenditures and health status indicators
for twenty - nine Organization for Economic Cooperation and Development (OECD)
countries (Anderson & Poullier, 1999). Results indicated an insignificant negative correlation
of –.32 between expenditures and infant mortality, suggesting not only wasn ’t there
a positive relationship, but also that if anything, it showed that higher spending was
inversely and insignificantly related. For longevity, the relationship was an insignificant
.24 for men and an insignificant .33 for women.
The United States is an excellent case study for the lack of any relationship. In
1998 the United States spent far more (13.6 percent of the gross domestic product
[GDP]) than most other OECD industrialized countries, where spending is about
8 percent of GDP. U.S. per capita health care expenditures in 1998 were $ 4,178 or
134 percent higher than the OECD median of $ 1,783. Per capita U.S. expenditures
were 50 percent higher than the next highest country, Switzerland, where per capita
cost was $ 2,794 (Anderson & Hussey, 2001). Meanwhile U.S. health status indicators
historically have been and continue to be poorer (Anderson, Hurst, Hussey, &
Jee - Hughes, 2000). In the midst of an increased rate of medical care spending compared
with other OECD countries, the relative position of the United States continues
to decline. If there were a relationship between medical care spending and
health status indicators, one might expect that the United States would have the
best health status in the world by far, for we not only spend the highest GNP but
also have the largest economy from where that percentage is derived. Again, such
is not the case.
Another way of noting the absence of a positive relationship between medical
care and health is the relative ranking expressed as the percentile rank of the United
States compared with other OECD countries; Anderson and Hussy (2001) report interesting
findings over a nearly forty - year period in Table 26.1 . In reviewing these data, a
percentile rank of 100 is given to the country with the highest value for each indicator,
except for infant mortality, potential years of life lost, and alcohol consumption, where
a percentile rank of 100 is given to the country with the lowest value.
Results of Table 26.1 evidence that for no indicator did the relative performance
of the United States improve from 1960 to 1998. Although the relative ranking of
health status indices worsened, health spending per capita and as a percentage of GDP
remained consistently highest. During that period medical expenditures as a percentage
of GDP nearly tripled from 5.2 to 13.6 percent.
One might argue that U.S. spending of considerably more on medical care than any
other country — more than double the amount spent by the median OECD country in
1998 — is explained by the average wealth of the country as measured by GDP per capita.