By W. Stephen Love, President/CEO, DFW Hospital Council

The U.S. healthcare delivery system is complex in that we provide care to patients with diverse values. In many cases, we tailor the delivery system to meet the patients’ social, cultural and linguistic needs.

A couple of days ago, the Commonwealth Fund released a publication citing the U.S. for spending more on healthcare than other high-income countries. We’ve heard this before and acknowledge healthcare expenditures consumed 17 percent of the nation’s gross domestic product (GDP) in 2013. The healthcare industry, through the “Triple Aim” of better health, better care and better value, is working to reduce costs and improve outcomes. With that said, let’s peel the onion a little more regarding comparisons with other countries.

The Commonwealth Fund did cite a 2013 study by Bradley and Taylor that found the U.S. spends a small amount on social programs like retirement, disability benefits, employment programs and housing when compared to other high-income nations. The U.S. spends 9 percent of GDP on social services and programs assisting the U.S. population. If we combine the healthcare percent of GDP with social services spending percent of GDP, the U.S. ranks in the middle of the pack of the 13 high-income countries reviewed in the study. Norway is 25 percent, Netherlands 27, Germany 29, Switzerland 31 and Sweden and France 33 percent. Maybe the lines are blurred as to what specific category we assign the dollars spent on healthcare and social programs.

We all agree we need to focus on better health and outcomes with expense reductions and efficiencies. Let’s also realize that physicians, hospitals, post-acute facilities and home care in the U.S. deliver more than medical treatment to our patients. The social needs of patients are frequently an integral part of the healthcare delivery system. For example, adequate nutrition and appropriate housing might prevent frequent asthma episodes in children and young adults. Therefore, we should look at investing more in social programs which should have a return on investment realized in lower healthcare expenditures. The Organization for Economic Cooperation and Development (OECD) data analysis of 34 industrialized nations demonstrates that social services focusing on helping individuals receive adequate nutrition, proper housing, and a subsistence income, produces a population with better health. The population health outcomes are much better, which lowers the overall cost of expensive medical treatment.

The next time you see a report on U.S. healthcare spending from a global perspective, please remember the social determinants of health.