Most spending on Health Care in the United States views health care as a private consumer good. If you break you leg, you pay a doctor to have your problem fixed.
But, this is not the only approach to health care. Health care can also be viewed from the perspective of the systems we put in place as a society as a whole. Despite the fact that Public Health measures are among the least expensive part of modern health care, the bulk of the increased life expectency, improved infant mortality rates, and major reductions in disease in the United States are attributable to public health measures, rather than an increased quality of private care. For example:
- Malaria and yellow fever can be controlled, not just by treating individuals who are infected, but also by community wide mosquito control efforts.
- Food borne diseases can be controlled with instructions about cooking and better health inspections. Trichinosis cases have fallen by 93% since 1950 as a result of these public health measures.
- Basic sanitation measures, like community wide treatment of drinking water and widespread use of sanitary sewers and toilets, can dramaticly reduce infectious disease. Cholera (caused by ingestion of fecal material and uncooked food)was once a regular cause of pandemics that killed more than 200,000 people in the 1800s and now affects only two to nine people a year in the entire United States.
- Vaccinations, which have trival costs, can dramatically reduce the effect of, or even wipe out, major killer illnesses, such as small pox and polio. These vaccinations help not just the person vaccinated, but the society as a whole, because even incomplete vaccination of a population disrupts the spread of the illness if vaccination is widespread. Consider some diseases now immunized against (a requirement enforced by public schools and in the case of polio vaccination no longer even necessary): Whooping cough is down 94% from 1950; mumps is down 99.7% from 1970; there were 33,300 polio cases (a crippling disease) in the U.S. in 1950, but there were none in 2000; rubella is down 99.96% since 1970; tetanus is down 92% since 1950.
- Widely alerting the public to health risks, like the dangers of smoking or the dangers of unprotected non-monogamous sex, can cause significant changes in behavior that greatly reduce the number of individuals who fall ill to certain diseases. For example, public health campaigns have reduced per capita cigarette consumption by a little more than 50% between 1960 and 2000. A side effect of the campaign against AIDS has been an 88% reduction in syphilis and a 48% reduction in gonorrhea cases since 1990.
- Epidemiology (i.e. the systematic study of where and why illnesses arise) can determine the causes of diseases and how they spread, making them preventable. For example, epidemiology allowed public health officials to identify AIDS in the United States as a disease and determine which steps would be most effective in preventing it. If this action had not been taken, the United States might have a far worse epidemic. Instead, the growth of the disease in the United States population has been seriously checked. Newly diagnosed cases are now less than a third as common as they were in the peak year of 1993.
- In 1900, the leading causes of death were pneumonia and influenza, tuberculosis, and diarrhea, diseases that have been dramatically reduced in incidence with public health measures.
- The 60% decline in accidental deaths rates in the U.S. from 1910 to 2000 is largely a result of public health and safety measures.
- The 85% reduction in infant mortality since 1940 (most recently with the "put your baby to sleep on its back" campaign which has reduced sudden infant death syndrom deaths by 40% in just a few years) is largely a result of better public health measures.
Much of the extent to which the United States lags behind other developed nations in life expectency, infant mortality and other common measures of societal health are a result of an underinvestment in public health. Most recently, the United States's inadequate public health commitment has been evidenced by a shortage of Flu vaccine.