Presented By: Health Policy Students Association
Our own worst enemies: How we and our government created, exacerbated, and extended the health care mess
Lecture by Charles E. Phelps, University Professor and Provost Emeritus, University of Rochester
About the lecture
Compared with any other nation, the U.S. spends far more on medical care and seemingly gets far less in return than other nations (as measured by such things as infant mortality and longevity). We also have abundant evidence that much of our spending is wasteful, in the sense that regions within the U.S. differ by a factor of two or more (for example) in Medicare spending per enrollee, with no discernible differences in health outcomes.
Professor Phelps shows how the spending problem will inevitably get worse without intervention, mostly because of two inexorable forces – an aging population and the growth of new medical technologies (which improve well-being but cost more money in general).
The most promising focus for improving this dismal prospect comes from within ourselves. Large fractions of our nation's mortality, morbidity, and health care spending result from our own behavioral choices, most notably tobacco consumption (where things are improving over time), obesity (where things are rapidly getting worse over time), and (to a lesser extent) alcohol abuse and unsafe sexual practices. Changing these health behaviors represents the most promising way to improve health outcomes and health care costs.
Professor Phelps explores several ways to change public policy to improve future outcomes and costs. These changes come in two basic areas: incentives (for providers and consumers alike) and in improvements in education (both general education and disease-specific education). Incentive-improving changes would (a) include employer-paid health insurance premiums in the income tax base, (b) having individual Medicare premiums reflect regional costs of care (rather than a national average), and (c) link health care premiums – both public and private – to life style choices of individuals, most notably tobacco use and obesity. Implementing such changes would be controversial in many ways, but even moderate success in doing so would improve the health of our population and actually lower health care costs at the same time.
Professor Phelps will also discuss the Affordable Care and provide an analysis of the legal challenges to the core structure of the ACA – the mandate that individuals buy health insurance.
Compared with any other nation, the U.S. spends far more on medical care and seemingly gets far less in return than other nations (as measured by such things as infant mortality and longevity). We also have abundant evidence that much of our spending is wasteful, in the sense that regions within the U.S. differ by a factor of two or more (for example) in Medicare spending per enrollee, with no discernible differences in health outcomes.
Professor Phelps shows how the spending problem will inevitably get worse without intervention, mostly because of two inexorable forces – an aging population and the growth of new medical technologies (which improve well-being but cost more money in general).
The most promising focus for improving this dismal prospect comes from within ourselves. Large fractions of our nation's mortality, morbidity, and health care spending result from our own behavioral choices, most notably tobacco consumption (where things are improving over time), obesity (where things are rapidly getting worse over time), and (to a lesser extent) alcohol abuse and unsafe sexual practices. Changing these health behaviors represents the most promising way to improve health outcomes and health care costs.
Professor Phelps explores several ways to change public policy to improve future outcomes and costs. These changes come in two basic areas: incentives (for providers and consumers alike) and in improvements in education (both general education and disease-specific education). Incentive-improving changes would (a) include employer-paid health insurance premiums in the income tax base, (b) having individual Medicare premiums reflect regional costs of care (rather than a national average), and (c) link health care premiums – both public and private – to life style choices of individuals, most notably tobacco use and obesity. Implementing such changes would be controversial in many ways, but even moderate success in doing so would improve the health of our population and actually lower health care costs at the same time.
Professor Phelps will also discuss the Affordable Care and provide an analysis of the legal challenges to the core structure of the ACA – the mandate that individuals buy health insurance.
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