Patients tell me all the time that our health care infrastructure needs reformation. Many people, including myself, would agree with that statement, but reformed to what? As a Patient Access Specialist at Beaumont Health and public health student at Wayne State University, I have the opportunity of studying the United States (U.S.) health care system both in and out of the classroom. This piece will look at U.S. health care expenditures and access to care through a public health lens.
The Centers for Disease Control and Prevention (CDC) reported that within the last century, human life expectancy increased by 30 years, with twenty-five years attributed to public health prevention measures and five years attributed to medical advancements. Meanwhile, the U.S. allocated only 2.5% of the roughly 3.5 trillion spent on health care in 2017 to public health intervention and prevention programs. Looking at health care spending amongst the Organization for Economic Co-operation and Development (OECD) nations, the U.S. spent more than two times as much of its GDP on health care than the average OECD nation in 2018. Even though the U.S. spends the most on health care, we rank 28th in human life expectancy amongst the 37 OECD countries. A significant contributor to the low ranking in life expectancy is the structural inequality in the U.S. Such structural inequality is evident in recent reports from the World Bank which show that from 2000-2017 the U.S. ranked the highest in income inequality and the worst on health and social problems. This is a significant statistic, considering that social and economic factors comprise 40% of our health determination. It is worth investigating how the U.S. could better incorporate preventative health frameworks within health care. Based on my professional background in patient health care access and my academic involvement in public health, I propose the following recommendations to address community care management, wasted health care spending, and health inequity:I. Use place-based public health and collaborative health networks to foster transdisciplinary health care delivery approaches.
II. Invest more in health care accountability and reallocate wasted funds.
Beyond data: collective action for future development
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Kamali Clora is a senior public health student at Wayne State University and an aspiring health administrator. Prior to his work at Beaumont Health, he served as a Certified Pharmacy Technician at CVS Pharmacy where he helped administer COVID-19 vaccinations. Kamali’s passions include alleviating health inequities, social justice, and legal epidemiology.