Table 1.

Summary of Expected Returns on Investment for Three Health Dividend Options. One year of excess health care expenditures worth $6.14 billion fully funds programs in each of the sectors below.

Sector	Social investment	Years funded	Impact on mortality	Other health and social outcomes	Financial return
Education	Hire 8,443 additional secondary school counselors starting 2016–2017 for 10 years. This would reduce the ratio of students to counselors from 467 to 139.	10 years	126 deaths averted annually by 2028 (10 years after initial hires).	418,000 additional high school graduates by 2028. Graduation rate would increase from 84.3% to 93.7%.	$153-$313 billion lifetime return to society. $81-$104 billion return to government. Benefits include productivity loss averted, and health care, crime, and public assistance costs averted. Benefit to cost ratio=29–60.
Public health	Fund comprehensive state tobacco control program at CDC recommended levels ($9.15 per capita) for 13 years (through 2031).	13 years	10,500 annual deaths averted in 2028 (end of funding period).	2.42 percentage point reduction in smoking prevalence from 10.8% in 2014 to 8.4%. (Additional reduction in cigarette consumption per smoker not quantitatively estimated).	$65 billion return to society at end of funding period. Cumulative savings of $11 billion in health care costs from 2016–2028 due to reduction in smoking prevalence & fewer pack years smoked. $2.5 billion savings for CA state in health care costs. Benefit to cost ratio=12.4.
Child development	Fund 55,032 additional State Preschool full-day slots for 10 years. This would increase the fraction of income eligible children served from 26% to 35%.	10 years	372 deaths averted saved by 2056 (40 years after end of funding period).	2,036 additional high school graduates per year by 2036-37 (20 years after implementation). Among additional children served by the program, 3.7 percentage point increase in proportion of adults 18–24 with high school degrees. 29% reduction in proportion with less than a high school education.	$25 billion lifetime return to society. $7 billion savings for taxpayers. Benefit to cost ratio=4.8.