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

Bradley, faculty director of Yale University’s Global Health Leadership Institute, and Taylor, the institute’s former program manager, contrast American healthcare models with the much more successful models in Denmark, Norway, and Sweden. The Scandinavian model, a dramatically more holistic approach envisioning citizen health as inextricably linked to national welfare, views greater spending on housing, education, employment, and nutrition as necessary components of healthcare outcomes, resulting in less overall spending with far greater results. The authors assemble an expansive study of representatives from the health-care and social sectors, including hospital administrators, social workers, physicians, police, emergency service personnel, nurses, educators, and pharmacists to demonstrate the need for integration between medicine and social welfare in the U.S. The disconnect between social services and health care, and the deeper historical schism between public and private interests, emerges as the reason why the U.S., which ranks first in healthcare spending, is mired in disappointing health outcomes. Admirably presented as an apolitical examination of an urgent situation, Bradley and Taylor’s carefully researched and lucidly reported findings, including innovative approaches in Connecticut, Oregon, and California, offer what appears to be an easily rendered fix, but their equally striking depiction of uniquely American hostility to government involvement in private matters, exposes a daunting uphill battle. (Nov.)