The U.S. spends more than $10,000 per person on health care per year, approximately twice as much as the average spent by comparable high-income countries. There is ample evidence we aren’t getting our money’s worth. The rate of amenable mortality — premature deaths that could have been avoided with effective and timely health care — is higher in the U.S. than in any comparable high-income country, and more than 50 percent higher than in France, Australia, Japan and Sweden.
“We’re spending a huge amount on the provision of medical care and not nearly enough on the social, organizational and economic factors that can lead to better population health in a more cost-effective manner,” says Dr. Thomas Rice, professor in the UCLA Fielding School of Public Health’s department of health policy and management.
For more than 25 years, the FSPH-based Los Angeles Area Health Services Research Training Program, funded by the federal Agency for Healthcare Research and Quality, has trained doctoral students and postdoctoral fellows who become leaders in evaluating the costs, benefits, outcomes and financing of health care. The program provides two years of funding to five Fielding School PhD students at any one time, and for two new postdoctoral fellows each year who are trained in a collaboration among FSPH; the USC Schaeffer Center for Health Policy and Economics; the Veterans Administration (VA) Greater Los Angeles Center for the Study of Healthcare Innovation, Implementation and Policy; and RAND Health.
Highly trained health services researchers have contributed significantly to recent positive steps in both the quality of U.S. health care and access to it, notes Rice, the program’s director. But major challenges remain. Health outcomes continue to lag behind those of poorer countries that spend far less. Wide health disparities persist, to the detriment of disadvantaged populations. Despite significant gains in access to care since the passage of the Affordable Care Act (ACA) in 2010, the law faces an uncertain future amid legal and political challenges.
The FSPH-based program prepares trainees for these challenges by exposing them to all of the disciplines of public health and beyond — including economics, management, political science and the social determinants of health.