Virtually everyone agrees that the U.S. health system is far too expensive. The root of this predicament may not be in how much we spend, but rather in where we invest.
Comparisons with other industrialized countries suggest that changing the balance of our investments across health and social spheres (i.e., by combining efforts to protect and sustain health with those to deliver higher-value care when and where it is needed) could generate profound improvements in the health of our people, and of our economy.
While the U.S. spends more on personal health care than any other country in the world, our results are worse. We pay more for shorter lives, with higher levels of infant mortality and premature deaths. We also lag on indicators of equity and efficiency.
Yet if we look at total spending on all the factors that affect people’s health, the U.S. total is not that exceptional—it is our decision where to allocate our resources that is so different. Research shows that the list of factors that shape our health is far longer, and the role that health care services play is far smaller, than most people realize.
In the U.S., we choose to pay for an excessively expensive medical industry rather than doing what every other country does: balance healthcare spending with investments in wider priorities—like affordable housing, high-quality education, and economic opportunity—that do even more to produce and sustain health over time. Without more equitable investments across all of these priority areas, our health will likely continue to suffer and medical costs may continue to escalate.
The next section draws on data from within the U.S. to explore where the greatest opportunities are and just how much better our health and economic futures could be if we began to invest differently right now.