September 13, 2013
Spending on health care and education make up about one quarter of America’s economy. Despite spending more than other developed countries, however, our outcomes in both sectors lag behind our peer countries. Budget expert Isabel Sawhill’spost on Brookings asserted that “providers are paid based on what they deliver and not on the outcomes they produce.” Columnist Ezra Klein’s post on Bloomberg View discussed Sawhill’s claims in relation to President Obama’s recent speech on education. According to Klein, President Obama’s plan is to change these systems by rearranging how money is spent. Health care services are often paid on a fee for service basis. That is, providers are paid based on the amount rather than the quality of care. Many provisions of health care reform over the past several decades have had the aim of altering this incentive structure.
Both Sawhill and Klein detail the similarities in the U.S. education and health care sector and how the proposed solutions in each revolve around paying for quality. What they do not talk about is the connections between these two sectors and how improving educational outcomes in the United States may have a profound impact on our health and the amount we spend on health care. According to the County Health Calculator created by VCU’s Center on Society and Health, in Virginia alone, if just 5 percent more people attended college and 4 percent more had an income higher than twice the federal poverty level, 22,900 cases of diabetes could be prevented and yearly costs of diabetes could be reduced by $126 million.
Policy discussions are often siloed such that policy makers and thought leaders like Sawhill and Klein debate solutions focused on one area, either education or health care. The Center on Society and Health is dedicated to connecting the dots between the characteristics of where we live, work, and play with the public’s health. Our research illustrates that education policy, along with many other social policies, is health policy. In order for the U.S. to reduce health care expenses, policy makers need to recognize the linkages and address the implications of social factors such as education on health.