On the Economic Burden of Health Inequities

The Joint Center for Economic and Political Studies, a leading think-tank on health inequities and the SDOH (they co-sponsored Unnatural Causes), commissioned a paper on the economic burden of health inequities. The paper, produced via a collaboration between researchers at Johns Hopkins University and the University of Michigan is available open-access here (PDF). Here is the delightfully succinct Executive Summary:

We estimated the economic burden of health disparities in the United States using three measures: (1) direct medical costs of health inequalities, (2) indirect costs of health inequalities, and (3) costs of premature death. Our analysis found:

Between 2003 and 2006 the combined costs of health inequalities and premature death in the United States were $1.24 trillion.

Eliminating health disparities for minorities would have reduced direct medical care expenditures by $229.4 billion for the years 2003-2006.

Between 2003 and 2006, 30.6% of direct medical care expenditures for African Americans, Asians, and Hispanics were excess costs due to health inequalities.

Eliminating health inequalities for minorities would have reduced indirect costs associated with illness and premature death by more than one trillion dollars between 2003 and 2006.

This kind of quantification is helpful for a variety of reasons, not least strategically, because issues of cost and waste are prime currency for political discourse on health inequities. However, I do want to sound a note of caution with these kinds of studies, because, as I have mentioned before here on MH Blog, the naturalistic fallacy looms large in discussions of public health policy. The mere fact that we expend a certain amount of money does in and of itself license a particular normative conclusion, because, while the presence of massive health inequities is an injustice to which I hope to center my life's work, the ethical deficiencies in the situation are assuredly not reducible to whether funds are saved or wasted. Even if health inequities were perfectly efficient, they would still be unethical.

Thoughts?