Entries from March 2008 ↓

Health care is already a key topic for this upcoming presidential race. Hillary is staking most of here campaign on the notion that some how she has figured out how best to provide health care to everyone, even those who don’t want it. What will certainly come up is the gap between the rich and the poor with regard to life expectancy. Before this gets out of hand, a few thoughts.

Wealth is largely dependent upon some other variables, one could be born into it, build it through hard work and education, and or be provided with special talents as in musicians or sports figures. Either way, not all of these characteristics are directly under the control of the individual, less one: education.

In today’s New York Times piece “Gap in Life Expectancy Widens for the Nation” I fear that few will read the complete, well written piece, and instead gleam from that which suits them best. So I thought I might point to the core of the article: education matters. Cited also in the article is a quote from Ellen R. Meara, a health economist at Harvard Medical School, who found that in the 1980s and 1990s, “virtually all gains in life expectancy occurred among highly educated groups.” Note also that that same group, tends to earns more.

The growth in health care labor continues as again pointed out by Mike Mandel of Busienssweek. In the graph below I looked at non-seasonally adjusted growth within the three larger sub sectors of the health care provider market, and not to surprisingly that growth has been in the outpatient space. There can be many reasons for this shift and specific evidence is not all that clear, but permit me a guess. The outpatient health care provider environment is far less regulated than are hospitals. Operators of these facilities which include outpatient surgery centers, diagnostic centers and clinics, are far less encumbered by certifications and regulations of dubious value. Tasks and procedures performed by licensed personnel can be more easily performed by lesser trained individuals under supervision of licensed practitioners. In the end, patients get faster care, at a lower cost.

The graph below describes a unique condition in which we find ourselves, what are we to do in caring for an aging population. Mike Mandel of BusinessWeek pointed out in the fall of 2006 and followed up again with a piece in the summer of 2007 that health care is a growing labor sector, accounting for over 56% of labor growth from 2000 through 2006. If the health care labor sector is so robust, what is to be made of such a large gap in nursing? Ask any hospital administrator and right up there with indigent patient care is the constant lack of nurses willing to work in nursing.

It’s amazing to see this kind of evidence and not hear of the daily issues that must happen to those who continue to work in hospitals, and are forced to deal with on a daily basis.

There is plenty more behind this graph which I’ll be presenting over the following weeks and months. But first I need to hear from you. Is this a problem or is it not? What are the consequences and how are institutions trying to cope? What tactics or studies have you seen or done. Let us know.