Social Medicine and Public Health

[chickenfeet2003]

What follows was triggered by a debate with arcana_mundiWe were discussing, inter alia, the relatively poor showing of the US on many population health indicators despite the US spending more on health than the rest of the OECD and whether the US healthcare financing and delivery model was responsible for that.  She argued that there are many factors affecting

Comments

[f4f3]

...speaking from the heart disease and stroke leaders of the Western World, I'm not sure that the NHS has been interventionist enough in this socialised health care market. However, there have been a couple of early studies on the smoking ban in Scotland which do show astonishing (and therefore suspect) results.

[gramarye1971]

That particular Yes, Prime Minister episode also had a classic bit of Sir Humphrey cynicism where he remarked that if smokers stopped dying off early, then the government would not only lose the tobacco revenue but also would end up having to pay out more in pensions and benefits as a result of increased life expectancy. ^^;;

[chickenfeet2003]

I remember. I had the same problem myself once trying to write a business case for investment in IT for cancer care. Improving health care invariably drives up otal health spending however efficiently one does it.

[kittenexploring]

Is that just considering the total spending on health or does it include the increased earnings of the healthy (or even some way of measuring quality of life for the individual or community)?

With a change of federal government here I'm hoping for less of a focus on political gain/sweeping ideology and more on effective and efficient health care. Australia has some bizarre funding arrangements with little relation to the eventual health care. It will be interesting to see if anything is done with the opportunity to improve that.

[chickenfeet2003]

Cost benefit analysis is brutally difficult in healthcare as I have found on many occasions. Ultimately it's all about boundaries. That said, using reasonable boundary conditions it can be shown that things like smoking cessation programs and clean needle programs reduce the direct cost of treating smoking related diseases or HIV respectively by many times the program cost. Unfortunately, as with all successful health interventions, the total lifetime cost to the system probably increases since the 20 year old who doesn't die of HIV ends up needing a coronary bypass 60 years later.

[a_d_medievalist]

I think I would have to catch up on the original discussion to offer an informed opinion!

[arcana_mundi]

I'm very curious to find out what you conclude - I volunteer to be assistant research monkey! I've got access to JSTOR. If you tell me what searches you want run, I can email you the PDFs of the articles that result.

[chickenfeet2003]

That would be great.