This article, slated for publication in SSM-Population Health in December, analyses 25 years of fiscal data from California and exposes the crowding out of non-medical social spending (K-12 and higher education, social services, housing, community development et al.) by rapidly increasing health care costs.
The researchers wanted to provide a point estimate of the tradeoffs of high medical spending with spending in social and public health areas:
There is, in American medicine, a misleading narrative about hard tradeoffs: that reducing spending requires depriving people of coverage, that expanding coverage to new populations requires reducing the benefits of those with existing coverage; that enhancing the benefits will bankrupt the system; and that reducing prices will cost lives. In fact, none of these suggested tradeoffs is confirmed by empirical evidence.
Their paper shows how investments in education and social programs have not kept pace with increases in healthcare spending. The authors argue the potential gains of shifting spending from low-value activities to high-value interventions, and conclude thus:
Reducing waste and unnecessary cost increases in the US healthcare system is politically difficult. Yet precisely for this reason it is essential to be clear-eyed about the costs of doing nothing. Making progress politically will require an energized coalition of those who could benefit from change and all who care about good governance. Creating this energy requires careful articulation of the true opportunity costs of unnecessary medical spending.
You can read the full article here on ScienceDirect.com.