Even people who decry European social policies as socialism or welfarism admit that countries like Sweden, France or Germany provide their citizens with benefits not commonly available in the United States in terms of access to health care, job security, unemployment aid, maternity leave, child day care, paid vacations and more.
While it is true that the U.S. spends more than most countries on health care, the average life expectancy is lower and infant mortality is higher here than in many other industrialized nations. Why the discrepancy?
Our Band Aid Approach to Health Care
Leaves Many Social Needs Unfulfilled
Based on a study that compared the various health care policies of the 30 most developed countries in the world, researchers found that spending on health care combined with spending on social services made the most significant difference. The study report, which was published in the journal BMJ Quality and Safety, concluded that spending on social services can extend and improve people’s lives in ways that health care alone cannot achieve.
“We studied 10 years’ worth of data and found that if you counted the combined investment in health care and social services, the United States no longer spent the most money – far from it,” wrote Elizabeth H. Bradley, a professor for public health at Yale University, and Lauren Taylor, a program manager at Yale’s Global Health Leadership Institute, in a co-authored op-ed article in the New York Times (12/9/2011).
“America is one of only three industrialized countries to spend the majority of its health and social service budget on health care itself. For every dollar we spend on health care, we spend an additional 90 cents on social services. In our peer countries [mostly in Europe], for every dollar spent on health care, an additional $2 is spent on social services. So not only are we spending less, we’re allocating our resources disproportionately on health care,” they added.
Health experts agree that unmet social needs often lead to an increase in acute health problems. Like actual diseases, lack of health insurance, job insecurity and poverty contribute heavily to the worsening of our public health. For millions of Americans, the hospital emergency room is the only option left in an otherwise broken system, a last resort that is not really sustainable.
“It’s time to think more broadly about where to find leverage for achieving a healthier society,” wrote Bradley and Taylor. The simplest way would be to invest more in social services, like the Europeans do. But this would mean an extended role of government and probably higher taxes, both of which are considered non-starters in the current political climate.
Still, the authors insist that introducing variations of the European model may be possible at some point in the future. As an example where this is already happening they cite a program called “Stand Downs” by the Department of Veterans Affairs, which addresses a number of social needs of retired service members as part of their health care plan.
So, what can be done in the meantime for the rest of us? For once, we need a better understanding of the importance of pro-active instead of strictly re-active health care. While it is common knowledge that “an ounce of prevention is worth a pound of cure,” we have yet to turn these insights into action. Health education and counseling should be considered as important as drug prescriptions and surgery – and appropriately funded. The fact that many of today’s common diseases are caused by poor lifestyle choices, bad eating habits, stress and sleep disorders should make us rethink our health care priorities.
Furthermore, studies have shown how access to basic health care can give people peace of mind and improve their overall well-being and quality of life (as I have reported earlier in an article titled “Health Insurance Shown to Make a Big Difference in Quality of Life”). It is part of a safety net nobody should have to be without. Seeing so many people in our midst deprived of some of the most elementary social services is intolerable. We can and must do better.