Health care, overconsumption and uneconomic growth: A conceptual framework

• Published in: Social science & medicine (1982) 2020-12, Vol.266, p.113420, Article 113420
• Main Authors: Hensher, Martin, Canny, Ben, Zimitat, Craig, Campbell, Julie, Palmer, Andrew
• Format: Article
• Language: English
• Subjects: Delivery of Health Care; Economic activity; Economic Development; Economic growth; Economics; Environmental harms; Failure demand; GDP; Gross Domestic Product; Health care; Health care expenditures; Health Expenditures; Health Facilities; Health services; Humans; Interdisciplinary aspects; Interdisciplinary research; Natural environment; Overconsumption; Right care; Social costs; Uneconomic growth; Well being
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2020.113420

Concerns have grown in recent decades that economic growth in many rich countries may, in fact, be uneconomic. Uneconomic growth occurs when expansion in economic activity causes environmental and social costs that are greater than the benefits of that additional activity. Health care has enjoyed a close historical relationship with economic growth, with health care spending consistently growing faster than GDP over the long term. This paper explores the possible relationship between health care and uneconomic growth. It summarises the rapidly growing evidence on the harms caused by poor quality health care and by the overuse of health care, and on the environmental harms caused by health care systems. Further, it develops a conceptual framework for considering the overconsumption of health care and the joint harms to human health and the natural environment that ensue. This framework illustrates how health-damaging overconsumption in the wider economy combines with unnecessary or low-quality health care to create a cycle of “failure demand” and defensive expenditure on health care services. Health care therefore provides important sectoral insights on the phenomenon of uneconomic growth. There are rich opportunities for interdisciplinary research to quantify the joint harms of overconsumption in health and health care, and to estimate the optimal scale of the health sector from novel perspectives that prioritise human and planetary health and well-being over GDP and profit. •Uneconomic growth costs society and the environment more than the benefit it brings.•Health care spending has consistently grown faster than GDP for many years.•Many patients suffer harm from poor quality health care, and overuse is prevalent.•The environmental impacts of health systems are increasingly well understood.•Health care is therefore a contributor to the phenomenon of uneconomic growth.