Health Care Public Sector Share and the U.S. Life Expectancy Lag: A Country-level Longitudinal Study

Area of Science:

• Political economy of health
• Comparative health policy
• Population health disparities

Background:

• Sociopolitical factors increasingly influence population health differences across nations.
• Research often focuses on overall health care spending (health care effort) but neglects spending distribution (public sector share).
• The U.S. exhibits a growing life expectancy disadvantage compared to peer nations.

Purpose of the Study:

• To assess the impact of health care effort, public sector share, and GDP on U.S. life expectancy relative to peer nations.
• To determine the independent contribution of public sector health care spending to longevity.
• To inform policy discussions, including the U.S. Affordable Care Act.

Main Methods:

• Utilized fixed effects models for robust analysis.
• Analyzed data from 16 wealthy democratic nations spanning 1960-2010.
• Compared the predictive power of health care effort, public sector share, and GDP per capita.

Main Results:

• Public sector share positively impacts life expectancy, independent of health care effort.
• The beneficial effect of public sector share on longevity is nonlinear, diminishing at higher levels.
• Public sector share is a stronger predictor of life expectancy than GDP per capita.

Conclusions:

• The distribution of health care spending, particularly the public sector share, is crucial for population health outcomes.
• Policies promoting public health care investment may be more effective for improving longevity than solely focusing on economic growth.
• Findings challenge the growth consensus and offer insights into the American life expectancy lag.