Where's the money going?

After reading "It's the prices, stupid...other countries" by Anderson and Co., I was curious as to where the extra money spent, U.S. per capita spending more than double the OECD average, was going. My first thought: how much do the CEOs of key players in the health industry (insurance, biotech and hospital companies ) make? Well, here's a little taste (from http://www.forbes.com/lists/2008/12/lead_bestbosses08_CEO-Compensation-Health-Care-Equipment-Services_9CompTotDisp.html ):

Overall Rank (all industries)/Name/Company/Compensation in millions per year/5-year/Age/Efficiency

53 H Edward Hanway Cigna 30.16 120.51 44.4 56 162
75 David B Snow Jr Medco Health 21.76 36.29 19.0 53 NA
78 Dale B Wolf Coventry Health Care 20.86 61.91 9.1 52 NA
86 Michael B McCallister Humana 20.06 60.64 22.7 55 36
98 George Paz Express Scripts 18.37 26.85 16.8 53 NA
108 Jay M Gellert Health Net 16.65 47.39 26.1 54 157
199 Ronald A Williams Aetna 8.88 NA 10.2 59 NA

I would imagine that these CEOs wouldn't be making so much if the companies were in financial distress...so, to address the prompt, I do agree that administrative costs and excessive profits are contributors to the rising costs of health care, but are not the only reasons for rising costs. We now live in an era where the leading causes of death are due to chronic diseases, such as cancer and heart disease. Patients now have more treatment options than ever before thanks to vast advancements in medical technology, cutting edge treatments and innovative prescription drugs. As a result, our society has become reliant on procedures, treatments and technology. Our physicians upgrade their practices with new technology continually to attract more patients and increase their revenues, resulting in a positive feedback loop, reinforcing overutilization and passive, rather than active and preventive, health behaviors.

I believe the first step to slowing the growth of health care spending is to invest in public health efforts. An analysis written by Trust for America's Health (TFAH) provides financial justification for investment in preventive public health efforts. The report states a return of investment of $5.60 for every $1 spent on proven community-based programs in tobacco, nutrition, physical activity - a savings of $16 billion annually over five years. The rest of the report can be found here: http://healthyamericans.org/reports/prevention08/.

If we can encourage people to become more aware, more interested and more proactive with their own health, we will move towards a more efficient health care system WITH a healthier population.