How much does “healthcare” really matter?

For a long time I’ve railed that politicos and pundits confuse “healthcare” with “health insurance” – trying to fix health insurance (by throwing money at it) … rather than getting to the efficacy and efficiency roots of healthcare delivery.

Here’s another twist to the story.

I stumbled on a report from the Kaiser Foundation: Beyond Health Care: The Role of Social Determinants.

It’s punch line:

“Though health care is essential to health, research demonstrates that it is a relatively weak health determinant.”

More specifically, Kaiser concludes that healthcare has only about a 10% impact on the risk of premature death … dwarfed by genetics (30%) and individual behavior (40%).

Said differently, health behaviors, such as smoking and diet and exercise, are the most important determinants of premature death


And, as the title of the article’s title suggest, there’s a social component (20%) that’s double the impact of healthcare per se …


To that point, the Kaiser study concludes:

Social determinants have a significant impact on health outcomes.

These are “the structural determinants and conditions in which people are born, grow, live, work and age.”

They include factors like income, neighborhood, education, and nutrition as well as access to health care.


Boiling it down:

Children born to parents who have not completed high school are more likely to live in an environment that poses barriers to health.

For them, zip code may be a stronger predictor of their health than their genetic code.

So, if social factors and and individual behavior matter more than healthcare delivery, what to do?

Obvious answer: work on health insurance.

Say, what?



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One Response to “How much does “healthcare” really matter?”

  1. Will Yang Says:

    Prof. Homa, I’d invite you to seek insight from someone who understands the state of healthcare. It sounds like you believe that there are obvious answers and that no one has considered how to incentivize health and wellness rather than expensive care. Maybe look at examples of value-based players like Kaiser, or startups like Chenmed, who know full well the benefits of social determinants and thus experiment with providing their patients with social programs and food prescriptions. I wonder if you enjoy thoughtful discussion and building deeper insight or if you just like posting superficial talking points that end by questioning the common sense of people whose actions you know sparingly about.

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