The American Health Care Paradox: Why Spending More Is Getting Us Less

By Neff, LaVonne | The Christian Century, November 13, 2013 | Go to article overview

The American Health Care Paradox: Why Spending More Is Getting Us Less


Neff, LaVonne, The Christian Century


The American Health Care Paradox: Why Spending More Is Getting Us Less

By Elizabeth H. Bradley and Lauren A. Taylor

Public Affairs, 272 pp., $26.99

This may be one of the three most important books your member of Congress will probably never read.

The first is journalist T. R. Reid's The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care (2009). A couple of hours with this book and Republican legislators might finally discover that most other economically advanced nations have systems that cost less than America's, give better results and (shocker!) aren't socialist.

The second is David Goldhill's Catastrophic Care: How American Health Care Killed My Father--and How We Can Fix It (2013). Goldhill, who is both a CEO and a Democrat, offers a health-care proposal combining free market business principles, personal responsibility and concern for the common good. A couple of hours with this book and Democratic legislators might realize that although the U.S. health-care system desperately needs fixing, Obamacare may not be the solution.

The third book is neither as entertaining as Reid's nor as concrete as Goldhill's. But if the goal is to keep Americans as healthy as possible while spending no more than necessary, it may be the most important of the three, because it completely reframes the usual (and by now tedious) discussion. The American Health Care Paradox is a paradigm shifter.

Americans spend more on health care and get poorer results, say Elizabeth H. Bradley and Lauren A. Taylor, because we are coming at health care backward. Instead of investing in social services that help people stay healthy, America spends vast amounts trying to fix people after they have fallen ill. Until the U.S. reunites social and medical services as health-care partners, all the health-care legislation in the world will accomplish little.

The authors are well credentialed: Bradley is a professor of public health at Yale, and Taylor is a presidential scholar studying public health and medical ethics at Harvard Divinity School. Two years ago they attracted national attention with a New York Times article arguing that, contrary to popular opinion, America does not spend more than any other nation on health. If health care and social service expenditures--"like rent subsidies, employment-training programs, unemployment benefits, old-age pensions, family support and other services that can extend and improve life"--are looked at together, America's total outlay is in tenth place (it has since fallen to 13th). And although most other industrialized nations spend two dollars on social services for every dollar spent on health care, America spends just 90 cents (now only 60 cents).

Sadly, the American tendency to medicalize health care seems not to be working so well. Bradley and Taylor tally the results of the U.S. approach:

   Americans have lower life expectancy
   and higher rates of infant mortality,
   low weight birth, injuries and homicides,
   adolescent pregnancy and sexually
   transmitted diseases, HIV/AIDS,
   drug-related deaths, obesity, diabetes,
   heart disease, chronic lung disease,
   and disability than people in other
   industrialized countries.

Bradley and Taylor's message, repeated in one form or another in every chapter, is that Americans need to start thinking seriously not just about how much money they are spending on health, but on how effectively they are spending it.

Readers hoping for a political way out of America's health-care impasse (or for ammunition to support their partisan preferences) will be disappointed in this book, which is much more about why than how. The authors say they grimaced when they saw the title on the New York Times article presenting their position: "To Fix Health Care, Help the Poor." They are not politically motivated, they say; nor are they advocating social justice. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

The American Health Care Paradox: Why Spending More Is Getting Us Less
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.