WITH the acrimonious debate over healthcare reform poised to return to Washington following Congress鈥檚 summer break, two new studies carry a clear message: don鈥檛 expect an expansion of insurance coverage alone to improve Americans鈥� health.
The law-makers are trying to revamp a system that spends around twice as much per person on healthcare as most European countries, while achieving worse health outcomes overall.
The US lags on measures such as life expectancy at birth and infant mortality. Now two teams, one led by of the RAND Corporation in Santa Monica, California, the other by of the University of Pennsylvania in Philadelphia, have dug into international health statistics to ask why US citizens can expect to die earlier than their counterparts in many European countries.
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that the blame lies largely with chronic diseases caused by poor diet, lack of exercise and the lingering effects of tobacco use from a time when smoking was more prevalent in the US than in Europe. , and finds that in some other respects 鈥� screening and treatment of cancer and cardiovascular disease, for example 鈥� the US healthcare system is performing well.
鈥淔or the treatment of cancer and cardiovascular disease, the US healthcare system is performing well鈥�
These findings, while not a surprise, emphasise that eliminating profligate spending on ineffective medical interventions is only part of the solution to America鈥檚 health woes. Getting people to eat less and exercise more will be vital to improving health and cutting costs.
鈥淥ne of the main reasons US healthcare is so expensive is that we are sicker than other people,鈥� says Preston. The RAND team suggests that gradually moving the US towards the health status of Europe could save up to $1.1 trillion between now and 2050.
Politicians leading the reform effort stress the gains to be made by expanding preventive medicine. 鈥淚f we can use cost-effective screenings and other up-front interventions to prevent tens of millions of occurrences of cancer, diabetes and cardiovascular disease, then we are going to slash healthcare costs significantly,鈥� says Tom Harkin, Democratic senator for Iowa, in a statement .
Is this enough? 鈥淚t鈥檚 not going to fix the underlying problems of poverty, poor diet, lack of exercise and smoking, which are the biggest determinants of health,鈥� says of the New America Foundation in Washington DC. More widespread changes may be required, such as more sidewalks where it is hard to walk around, and greater availability of healthy food.