Daily on Healthcare: Study: Don’t blame underinvestment in social services for high US healthcare spending

By | August 15, 2019

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HIGH US SPENDING ON HEALTHCARE NOT DRIVEN BY UNDERINVESTMENT IN SOCIAL SERVICES: A new study undermines the conventional wisdom that the United States spends so much on healthcare because it under-invests in social services that help keep people healthy in the first place.

The study, published in the journal Health Affairs, instead finds that U.S. spending on social services as a percentage of gross domestic product is greater than the average of other developed countries. Countries that spent more on social services also tended to spend more on healthcare, and countries with the greatest increases in social spending also had larger increases in healthcare spending.

“Do countries that spend less on social services end up spending more on healthcare? Does the US have low social spending? Is that why we have high healthcare spending? Short answers: No, no, & no,” tweeted Ashish Jha, one of the study’s authors and director of the Harvard Global Health Institute.

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When education is included, the U.S. in 2015 spent 19.7% of GDP on social services while other countries on average spend 17.7%. In the U.S., a greater proportion of social spending comes from private sources and is particularly concentrated on spending for older residents, the authors found.

On healthcare, other countries averaged 8.8% of GDP, but the U.S. was an outlier, spending 16.8% of its GDP on healthcare. The prices of healthcare goods and services are instead what is driving the large portion of healthcare spending here.

The authors cautioned that their findings “should not be interpreted as suggesting that social spending might not be effective at lowering healthcare costs for subpopulations.”

The study used data from 35 countries in the Organization for Economic Cooperation and Development from 1980-2015.

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at dailyonhealthcare@washingtonexaminer.com. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.

FDA PROPOSES NEW REQUIREMENT FOR GRAPHIC LABELS ON CIGARETTE PACKS: The Food and Drug Administration proposed a rule Thursday morning to require cigarette packages to include realistic images showing the health consequences of smoking. The packaging will include warnings including: “tobacco smoke causes fatal lung disease in nonsmokers” and “smoking can cause heart disease and strokes by clogging arteries.”

Some suggested images, from the FDA:


PLANNED PARENTHOOD WILL DROP OUT OF TITLE X IF TRUMP ADMINISTRATION RULES AREN’T BLOCKED BY MONDAY: The organization told the 9th Circuit Court of Appeals that if it doesn’t intervene, then it will have to turn down Title X funds, which pay for birth control, testing for sexually transmitted diseases, and cancer screenings for low-income people. Under Trump administration rules set to go into effect, doctors who receive the funds aren’t allowed to directly refer for abortions. Planned Parenthood receives about $ 50 million from Title X every year.

TRUMP’S LATEST JUDICIAL NOMINEE INVOLVED IN FETAL TISSUE DEBATE: The president on Wednesday nominated Sarah Pitlyk to the U.S. District Court for the Eastern District of Missouri. Pitlyk represented David Daleiden, the Center for Medical Progress founder who secretly taped Planned Parenthood employees. The tapes led to more Republican backlash against Planned Parenthood and calls for ending the use of fetal tissue from abortions in medical research. The Trump administration has banned its scientists from acquiring new tissue, in part as a result of the tapes.

13 STATES SUE THE TRUMP ADMINISTRATION OVER PUBLIC CHARGE RULE: Following the lead of Washington Attorney General Bob Ferguson, a Democrat, 13 states have filed suit against the Trump administration over the “public charge rule” Wednesday. The updated rule, set to go into action October 15, will allow the Department of Homeland Security to deny more immigrants entry to the U.S. or citizenship based on their use of food stamps and Medicaid.

Ferguson wrote that the new definition of a “public charge” is “arbitrary, capricious, and an abuse of discretion” that will cause “irreparable harm to the working families and children who live in the Plaintiffs States, as well as the states themselves.” The plaintiff states, including Michigan, New Mexico, Illinois, and Rhode Island, are led by Democratic attorneys general.

THE COST TO FAMILIES FOR HEALTH COVERAGE HAS GROWN TWO TIMES FASTER THAN WAGES IN TEN YEARS: Families with large employer insurance paid 67% more for benefits and care in 2018 than they did in 2008, according to the Kaiser Family Foundation. By 2018, families were spending about $ 7,700 on coverage, up from about $ 4,600 ten years earlier. While families spent more for care between 2008 and 2018, wages only increased by 26% during that time.

VAPING ADVOCACY GROUP SUES FDA OVER ‘UNREASONABLE’ DEADLINE TO FILE MARKET APPLICATIONS: The Vapor Technology Association, which advocates for e-cigarette and vaping manufacturers, along with vaping company Vapor Stockroom, filed suit against the FDA for moving up the deadline to file applications for their products to be sold. The FDA requires vaping manufacturers to complete a Pre-Market Tobacco Application, which must include scientific evidence that the companies’ products won’t cause any public harm, and often includes lengthy lab and scientific testing on the part of manufacturers. Without the FDA’s approval, the company cannot bring their products to market.

The PMTA deadline has been moved several times already as worries over health risks of vaping have mounted. When the FDA finally got regulation control over vape products, the deadline was moved to 2018, then to 2022, to 2021, and finally is now May 2020. Tony Abboud, executive director of the Vapor Technology Association, said the latest deadline is not only “unreasonable and arbitrary,” but nearly impossible for small manufacturers to meet given the amount of resources needed to conduct scientific testing.

FDA APPROVES DRUG FOR THE HARDEST-TO-TREAT CASES OF TUBERCULOSIS: The FDA approved a new medication to work alongside two others to treat drug-resistant tuberculosis cases. Newly approved Pretomanid Tablets work with two other drugs to treat TB, and cured 89% of people in clinical trials. There were about 490,000 new cases of drug-resistant TB. Very few people who contract this drug-resistant strain of TB survive it, and treatment often requires upwards of 40 pills daily for up to two years, with no guarantee of a cure. Mostly TB-related deaths occur in eight countries: India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa.

ISRAELI FLIGHT ATTENDANT DIES AFTER FOUR MONTHS IN A MEASLES-INDUCED COMA: An El Al flight attendant, Rotem Amitai, 43, died Wednesday after contracting measles in March at some point during a flight from New York to Tel Aviv, Israel. While it is not clear whether she contracted the virus during the flight, the Israeli health ministry issued a warning for all those who were on the flight that a confirmed measles patient was on board and all those on the flight should see a doctor immediately. Amitai, a mother of three, landed in Israel March 26, developed a fever on March 31, and fell into a coma due to brain swelling a week after.

HOSPITAL-BASED PHARMACIES PROVIDE GREATER ACCESS TO CANCER DRUGS: Hospital- and clinic-based pharmacies will get cancer patients the medications they need faster than external pharmacies like CVS or Walgreens will, according to TrellisRx, a company that helps health systems build and operate specialty pharmacies.

MORE THAN THREE QUARTERS OF AMERICANS EXPERIENCE ANXIETY ABOUT THE POSSIBILITY OF A MASS SHOOTING: POLL: Most U.S. adults, 79%, experience stress about being in public out of fear of another mass shooting, and about one in three adults will avoid certain events or places where they think a mass shooting is more likely to occur. The American Psychological Association commissioned a study to see how much fear affects Americans’ daily lives, finding that almost a quarter of adults change their behaviors out of anxiety. Adults surveyed said they most fear going to schools, malls, and public events like concerts.

The Rundown

Stateline Kids with lead poisoning will get early help in these states

NPR Most kids on Medicaid who are prescribed ADHD drugs don’t get proper follow-up

North Carolina Health News Pittsboro agrees to notify residents of drinking water contamination

The Wall Street Journal States adopt ‘baby boxes’ in effort to protect unwanted infants


THURSDAY | Aug. 15

Congress in August recess.

FRIDAY | Aug. 16

2 p.m. Substance Abuse and Mental Health Services Administration-sponsored webinar on “Best Practices for Employment for People with Serious Mental Illness.” Details.

MONDAY | Aug. 19

Aug. 19-20. Atlanta. Centers for Disease Control and Prevention Advisory Committee on Breast Cancer in Young Women. Details.