1. Running head: HOW MONEY INFLUENCES HEALTHCARE
How Money Influences Healthcare
Cheri Labrador
University of San Francisco
Introduction to the CNL Role
N613

2. HOW MONEY INFLUENCES HEALTHCARE
The United States spends approximately 17.2% of the gross domestic product on
healthcare. Spending per person increased from $147 in 1960 to $8,915 in 2012. In any given
year, substantial differences exist in spending among geographic regions and the states.
(Thornton & Beilfuss, 2016). As a nation, the United States spends the most on healthcare
compared to other countries and yet our health outcomes rank 25th for maternal mortality, 26th
for life expectancy, 28th for low birth weight, and 31st for infant mortality. (Bradley & Taylor,
2015). Some of the reasons for this are healthcare fragmentation, fee-for-services payments,
social and economic policies controlled by lobbyists.
Our healthcare system is fragmented with respect to services provided, payments made
to pay for services and physicians and specialist providing care. Family care clinics and local
hospitals do not always share information on patients. Duplicate diagnostic tests may be
ordered. Many patients take multiple medications that are ordered by several providers.
Frequently, lab and x-ray results are not shared across all providers. Payments for these
services come from private insurance, Medicare or Medicaid and sometimes state funding. The
lack of communication and collaboration often results in duplication of services and increased
costs for services and providers.
The method in which dollars are spent in healthcare is called a “fee-for-service”
payment system. That means that a physician will be paid based on the number of patients
seen and the number of procedures done by that physician. This is why a physician will only
have about 15 minutes to spend with any one patient. The more patients they see, the more
they get paid. If a visit takes too long, they will ask to have a patient return for a follow-up visit
so that they may go to the next patient waiting. Hospitals bill based on procedures and services

3. HOW MONEY INFLUENCES HEALTHCARE
provided. Healthcare is the only industry that will bill for services and providers without first
giving an estimated cost to the patient. The increase in costs gets passed down to the
consumer in the form of higher insurance premiums and taxes.
In any industry, the people who control the money also make the policy. This is also
true of the healthcare industry. The US drug industry spends more than any other sector on
lobbying each year: $234 million in 2012, according to the Center for Responsive Politics. The
second was Insurers with $152 million. The reasons for this are 1) drugs are highly regulated
and 2) the government is the biggest payer. (Senior, 2013) The companies that are making the
big profits are the ones spending the money on Capitol Hill in order to ensure that the laws and
regulations remain in their favor. There is no money to be made in Public Health and in Social
services for the public. We already know how to fix the rising cost of healthcare. But it would
take a complete shift on how healthcare is provided. A five year randomized controlled trial
was able to demonstrate that when participants with moderate to severe congestive heart
disease changed their diet to primarily plant-based diet, in conjunction with lifestyle changes,
angina decreased 91% over the course of a single year and maintained a 72% reduction over
baseline by year five. (Smith, 2016) These changes require everyone to think differently about
how and where we deliver healthcare. Our community clinics and family physicians are under-
funded and under paid. And yet they are able to make the most impact if they have the
resources to help support and educate the public. Promoting a healthy lifestyle and preventing
chronic diseases would be a better way to spend our healthcare dollars. But that means
changing the way we currently provide care.

4. HOW MONEY INFLUENCES HEALTHCARE
The biggest influence in the US healthcare system is money. This concept was shown in
the movie Escape Fire. As long as we continue to allow that to happen, then our healthcare
system will not be changed. It will take consumers, politicians, drug companies, physicians,
nurses, the government and many other people to change the way healthcare is provided and
how it is paid for.

5. HOW MONEY INFLUENCES HEALTHCARE
References
Morgan, L. (2015). US healthcare annual spending estimated to rise by 5.8% on average through
2024. American Health & Drug Benefits, 8(5), 272
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Senior, M. (2013). Spreading biotech dollars around Washington. Nature Biotechnology 31,
673-675. DOI:10.1038/nbt.2651
Smith, K. E. (2016). Improving Cardiac Outcomes and Decreasing Health Care Costs. Journal of
The New York State Nurses Association, 44(2), 32-39.
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eds.b.ebscohost.com.ignacio.usfca.edu/eds/pdfviewer/pdfviewer?vid=9&sid=9707873d-be47-
4e8a-8e77-b47513620600%40sessionmgr120&hid=119
Thornton, J. A. & Beilfuss, S. N. (2016). New evidence on factors affecting the level
and growth of US health care spending. Applied Economics Letters, 23(1), 15-18,
DOI: 10.1080/13504851.2015.1044644