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Considers why U.S. society is believed to be less healthy in spite of disproportionate spending on health care, identifying a lack of social services, outdated care allocations, and a resistance to government programs as the problem.
This volume is a revised edition of The Institute for Contemporary Study's report on national health insurance. It includes an analysis of legislation currently before Congress; an examination of hos-pital cost increases and cost containment; an in-vestigation of the politics of the National Health Insurance which asks if any major interest group involved in health care wants increased competi-tion; new research on both the NHS in Britain and Canada's relatively recent experiments with full NHI; an update on public health care; a considera-tion of the relationship between health and health care; a discussion of the subsidy of health care; and an analysis of the market for medical care and the effects of an NHI on the market for physicians.
During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases.
This book presents the most recent comparable data on the performance of health systems in OECD and certain partner countries. It includes a dashboard of health indicators, a special focus chapter on the pharmaceutical sector, and indicators on health workforce migration and health care quality.