The Value of Public Health Expenditures

While most of the $3.5 trillion the US spends on health care annually goes to personal medical care, a few tens of billions go to public health expenditures (think of all those health-related public service announcements you see and hear).  Do they do any good?  A question which a study in Health Affairs attempts to answer.   (HA Article)   The authors used data on public health spending from Census bureau files, mortality data from the Centers for Disease Control and census demographic data to shed some light on this admittedly hard-to-research topic.  They looked at a long period, 1972 to 2012, and used a broad definition of what would be considered public health spending.  Notwithstanding this expansive reach, they found little impact on their primary outcome variable, mortality.  Except in the very last few years of the study (during the recession) public health spending rose steadily, from $22 per person in 2012 on average to $108, in constant dollars, a massive 411% rise.  What do you get for all this spending?  A somewhat less massive decline in mortality of .006% to .01%.  That’s right, about one-one hundredth of a percent decrease.  But at least its statistically significant!!  In areas with high minority and low-income populations, the effect was slightly higher, but even there it took $7.7 million in spending to delay a death (you don’t ever prevent death).  The authors try to defend that as cost-effective, but that is pure BS.  Be better to give the money to the needy to use for actual health care or healthier food.  Waste of taxpayer dollars.