NR 552 Week 1 Discussion, Macroeconomics National Health and Wealth

Relationship of health, wealth, and healthcare in the United States NAME Chamberlain College of Nursing NR 552: Economics of Healthcare Policy Professor Poirier DATE Review Figure 1.3, 1.4, 1.5, 1.6, and Table 1.2 from Chapter 1: Economics and Efficiency, from the Olsen text (2009). Discuss the relationship between health, wealth, and healthcare in the United States. Individuals or countries with greater income usually have a lower likelihood of diseases and subsequently premature death (Woolf, Aron, Dubay, Simon, Zimmerman, & Luk, 2015). Individuals in the middle class are healthier than those in the lower class but also less healthy than those in the upper class. Similarly, poor countries have poor healthcare systems due to low income hence the poor health of their citizens (Woolf et al., 2015). Therefore, the greater the income, the greater the wealth hence better healthcare and subsequently, improved, health. According to Olsen (2017), health basically deals with the social, physical, and mental dimensions. Healthcare comprises rehabilitation, prevention, care and cure (Olsen, 2017). The expected increase in quantity and quality of life are used to measure health gains (Olsen, 2017). Health care has positive effects on health hence the reason for its consumption (Olsen, 2017). Bringing in wealth, poverty reduction significantly improves life expectancy. Based on figure 1.3 and 1.4, increased resources on health care has significant effects on longevity. However, beyond a certain point, a further increase in wealth does not positively affect longevity (Olsen, 2017). This is because healthcare is not the only measure of longevity (Olsen, 2017). Figure 1.5 denotes that healthcare spending would increase with an increase in GDP. Similarly, figure 1.6 shows that health care becomes more tax-financed when a country becomes richer (Olsen, 2017) To conclude, the US being a rich country would spend more of its taxes and GDP on healthcare. This explains the reason for the introduction of Obama Care and Medicaid to provide universal access to healthcare. A greater portion of healthcare is not financed directly by individuals but by public finance and private insurance, hence, the greater health gains in the US. Reference Olsen, J. A. (2017). Principles in health economics and policy. Oxford: Oxford University Press Woolf, S. H., Aron, L., Dubay, L., Simon, S. M., Zimmerman, E., & Luk, K. X. (2015). How are income and wealth linked to health and longevity? Washington, DC: Urban Institute Publications. PROFESSOR RESPONSE: Thank you, Carole. How can we reconcile the US wealth and spending on healthcare with our less than stellar outcomes? The US frequently ranks low on preventable causes of death and infant mortality. Are there identifiable reasons for this? Dr. Poirier, Thank you for your response. After researching several articles and websites, I learned the United States along with 35 other countries make up the Organization for Economic Co-operation and Development (OECD) (Organization for Economic Co-operation and Development, n.d.). The U.S. has much room for improvement when it comes to healthcare. According to Papanicolas, Woskie, & Jha (2018), in the year 2016, the U.S. spent 17.8% of its gross domestic product on health care and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The United States spends more money per person on health care than any other nation in the world. Health spending per person in the U.S. was $10,348 in 2016, 31% higher than Switzerland at $7,919, the next highest per capita spender (Sawyer & Cox, 2018). Despite the U.S. government investing heavily in healthcare, Americans still live shorter unhealthy lives with poor health outcomes compared to other high-income countries. In 2016, Japan spent $4,519 per person on healthcare (Sawyer & Cox, 2018). Japan provides universal access to everyone allowing them to receive care at any institution at any time, subject to a co-payment at the time of service, thus allowing for cost containment in healthcare expenditure (Jones, 2009). They are flexible in responding if they think certain costs are exceeding what they budgeted for. In Japan, if spending in a specific area seems to be growing faster than projected, they lower fees for that area (Jones, 2009). The U.S. spends more on healthcare but continues to rank at or near the bottom in indicators of mortality and life expectancy. In 2015, the United States ranks 29th in infant mortality among the 35 OECD countries, only six countries have higher rates (WHO, 2015). Maternity leave benefits have been associated with lower rates of infant mortality. Currently, the Family and Medical Leave Act (FMLA) of 1993 provides eligible workers 12 weeks of job-protected unpaid leave to care for a new child (United States Department of Labor, n.d.). The catch is only half of women are eligible and many can’t afford to stop working, However, research establishes that mothers and children benefit from paid maternity leave. Yet, the United States remains the only country in the developed world that does not mandate employers to offer paid leave to new mothers. New parents are faced with the choice between economic hardship or returning to work prematurely. In Canada, new mothers can take pregnancy leave of up to 17 weeks of unpaid time off work (Ministry of Labour, n.d.). Next, new parents have the right to take parental leave. This is unpaid time off work when a baby or child is born or first comes into their care. Birth mothers who take pregnancy leave are entitled to up to 61 weeks’ leave (Ministry of Labour, n.d.). Birth mothers who do not take pregnancy leave and all other new parents are entitled to up to 63 weeks’ parental leave (Ministry of Labour, n.d.). Employers are required to give them their jobs back when they return. This is mandated by the government. I also discovered that new mothers in Finland, for instance, are entitled to up to three years’ worth of paid leave, Norwegian moms get up to 91 weeks, and The U.K. grants new mothers up to 39 weeks. Reference Jones, R. (2009). Health-care reform in Japan: controlling costs, improving quality and ensuring equity. OECD Economic Surveys: Japan, 2009(18), 99-133. Ministry of Labour. (n.d.). Pregnancy and parental leave. Retrieved from Organization for Economic Co-operation and Development. (n.d.). About the OECD. Retrieved on July 12, 2018, from Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health Care Spending in the United States and Other High-Income Countries. Jama-Journal of The American Medical Association, 319(10), . Sawyer, B. & Cox, C. (2018, February 13). How does health spending in the U.S. compare to other countries? Retrieved on July 12, 2018, from United States Department of Labor. (n.d.). Wage and Hour Division (WHD). Retrieved from World Health Organization. (2015). Infant mortality rate (probability of dying in the first year after birth per 1,000 live births). Mortality and global health estimates. Retrieved on July 12, 2018, from PEER POST: There is a relationship between health, wealth, and healthcare in the United States. Of course, the more money one makes, the better their health is because of the access to healthcare. Wealthy individuals can afford the better insurance plans that come with the higher premiums. I have worked in a physician’s off and when there was a new patient, the first thing the provider did was look at the type of insurance if the patient had insurance. RESPONSE TO PEER: Rosalinda, There is broad evidence that Americans often do not get the care they need even though the United States spends more money per person on health care than any other nation in the world. Studies reveal that not only is income associated with better health, but wealth (net worth and assets) affects health as well (Pollack, C. E., C. Cubbin, A. Sania, M. Hayward, D. Vallone, B. Flaherty, and P. A. Braveman. (2013). Middle-class Americans are healthier than those living in or near poverty, but they are less healthy than the upper class. People with low incomes tend to have more restricted access to medical care, are more likely to be uninsured or underinsured, and face greater financial barriers to affording deductibles, copayments, and the costs of medicines and other healthcare expenses. Preventive care is underutilized in lower-income neighborhoods, resulting in higher spending on complex, advanced diseases. Thus, patients with chronic diseases such as hypertension, heart disease, and diabetes all too often do not receive proven and effective treatments such as drug therapies or self-management services to help them more effectively manage their conditions. Income and wealth directly support better health because affluent people can afford the resources that protect and improve health. Individuals with higher socioeconomic status have greater access to healthy nutritious meals; have access to recreational programs, and facilities for regular exercise and active living; and have opportunities to acquire assistance with lifestyle changes, such as smoking cessation programs. Reference Pollack, C. E., C. Cubbin, A. Sania, M. Hayward, D. Vallone, B. Flaherty, and P. A. Braveman. (2013). Do Wealth Disparities Contribute to Health Disparities within Racial/Ethnic Groups? Journal of Epidemiology and Community Health, 67(5), 439–45. .