January 03, 2011
1:03 pm
The Baby Boom generation – defined by the Census Bureau as those Americans born between 1946 and 1964 – is often referred to as a ‘demographic tidal wave.’ That’s because the sheer number of citizens in this generation, approximately 75 million in all, have had and will have an enormous impact on the economy, the nation’s infrastructure and, increasingly as the Baby Boomers age, social services.
This year, the leading edge of this tidal wave will become eligible for Medicare benefits. Those born in 1946 will turn 65 in 2011 and start a trend that will see the Medicare population (and costs) expand rapidly with each passing year.
Policymakers are faced with several daunting challenges, including:
• How to ensure access to quality healthcare for these new Medicare beneficiaries, considering that 40 percent of the nation’s physician population is approaching retirement age and experts say we already don’t have a sufficient supply of medical professionals to treat the millions of newly-insured as a result of health reform.
• How to confront chronic disease, which is affecting the new generation of Medicare beneficiaries to a much greater degree than it did their parents and grandparents. Escalating incidences of diabetes and heart disease are pushing healthcare costs skyward.
• The costs associated with a greater demand for healthcare services such as knee and hip replacements that are desired by a more active generation of retirees.
We’re reaching the point, if we haven’t already, in which defending the status quo is an indefensible position. The longer we go without addressing the challenges posed by the retirement of the Baby Boomers will mean having to choose between unpalatable draconian policy options.
It’s time for creative thinking and a national dialogue on how to reform Medicare to simultaneously strengthen quality and cost-efficient. Some important work is already being done in this arena by a number of private sector healthcare organizations, and the new Center for Medicare and Medicaid Innovation – created as part of health reform – will also have a mandate to address both cost and quality.
Deficit reduction commissions and leaders have also focused on this issue and have proposed a number of ideas, including the use of premium support models to increase value through greater consumer engagement.
In the coming year, we need more of this discussion, not less. How we address the challenges presented by the Baby Boom generation will be the dominant healthcare and economic issue of the 21st century.
December 16, 2010
11:16 am
A new study released this week offers the encouraging news that death rates from cardiovascular disease have declined 28 percent since the late 1990s. That speaks well for the strides made by various health industry sectors in developing improved treatments, drugs and technologies to help those with heart disease live longer lives.
The news isn’t all good, however. According to the study’s lead author, Dr. Veronique L. Roger of the Mayo Clinic, “there are also more costs in terms of dollars and in terms of the cost to individuals who are living with heart disease instead of disease-free lives.”
Dr. Roger’s research shows that the cost of preventing and treating heart disease in 2007 was an estimated $286 billion, more than was spent to treat cancer cases or any other diagnostic group.
This drives home the point that no matter what the United States does in health reform to expand coverage and encourage more cost-efficient medical practice, it will be a very difficult task to get healthcare costs under control if we don’t take bold steps to attack the rising incidences of chronic disease.
The rising cost to treat heart disease has many factors, not the least of which are the facts that two-thirds of American adults are overweight or obese, more than 36 percent have prediabetes and approximately one in every five individuals still smokes. A number of workplaces are having tremendous success with various fitness and wellness incentive programs, achieving healthier labor forces. More than ever, we need to implement the best of the wellness lessons we’ve learned in our communities, our schools and our workplaces. This new study further reaffirms the link between healthcare costs and preventable chronic disease.
November 11, 2010
4:37 pm
The Washington Post and New York Times are ablaze today with top-of-the-page headlines about the proposals being made by the co-chairs of President Obama’s bipartisan commission on deficit reduction. There may be a bit of an overreaction to the draft report since there’s no assurance it will receive the necessary support of 14 (out of 18) commission members, and Congress is under no obligation whatsoever to adopt the proposals.
Nonetheless, the commission co-chairs Erskine Bowles, former chief of staff to President Clinton, and former U.S. Senator Alan Simpson deserve credit for taking on the tough task of trying to curb the nation’s burgeoning red ink. Their report doesn’t hesitate to put some political sacred cows on the chopping block in the name of deficit reduction.
The healthcare provisions of the co-chairs’ proposals illustrate the difficulty in trying to reconcile two very important goals Americans want to see achieved – reducing deficit spending and improving our U.S. healthcare system. The Bowles-Simpson report illustrates how difficult it is to achieve one without potentially undermining the other.
For example, the draft report calls for the creation of a public health insurance option, a policy notion that Congress soundly rejected in the health reform debate. As we’ve discussed ad nauseum, a public option will certainly drive down payment rates to physicians and hospitals, but those costs would then be shifted to private payers. And a public option with arbitrarily-low costs would reduce the amount of competition in the insurance marketplace, a development that wouldn’t serve consumers well.
The report calls for strengthening the Independent Payment Advisory Board to an even greater degree than called for in the new health reform law. This would create an even more potent entity in terms of simply axing healthcare spending, but without a focus on how to elevate healthcare value.
The report says doctors and other health providers will have to be paid less. At the same time, we’re faced with the need to recruit more people into the medical profession to deal with the tens of millions of newly-insured Americans entering the system.
Yes, there is an urgent need to address the nation’s rising deficits, and the health sector has to do its part. But, understanding the challenges we’re facing in the years ahead, with one in every three Americans expected to have diabetes by the year 2040 and other chronic diseases on the rise, we have to look at the healthcare system as more than just numbers on a balance sheet.
Work needs to accelerate on delivery reform, on payment reform, on changing the tort system (which, to their credit, the commission co-chairs recommend) to reduce defensive medicine costs, on attacking the chronic diseases that account for 75 cents of every health dollar we spend.
But deficit reduction and quality healthcare should not be treated as an either-or choice. The commission’s work is an essential exercise in numbers, but we can’t forget the real patients and consumers who would be affected.
September 22, 2010
12:26 pm
It’s become one of the frequently-quoted axioms of American healthcare that 75 cents of every healthcare dollar we spend in this country is for treatment of chronic disease.
But now, thanks to a new study released yesterday, we know how much one of the leading causes of chronic disease, obesity, is costing individuals.
The study, conducted by a number of academic researchers, found that obesity is costing women who have the condition an average $4879 annually and men $2646. These are costs resulting from disability, absenteeism and lost wages. This study documents that obesity is not only causing chronic disease in millions of people, but also economic hardship for many.
One of the study’s authors, Christine Ferguson, said, “Being able to quantify the individual’s economic burden of excess weight may give new urgency to public policy discussions regarding solutions to the obesity epidemic.”
Dr. Ferguson is right. No matter how success the new health reform law is in getting Americans off the uninsured rolls, creating a sustainable healthcare system and a healthier populace must include a successful attack on chronic disease. Both the private and public sectors have an imperative need to engage in outreach to the public to emphasize healthier lifestyles and preventive care. If we don’t take on this challenge, too many people are going to be suffering, as we can now quantify, both economic pain and shorter lifespans.
July 01, 2010
12:15 pm
The new health reform law mandated that, by July 1, 2010, the federal government create a website to help consumers better understand their health coverage options. That site, healthcare.gov, went live on the Internet this morning.
The site is structured so that people in every state can answer some basic questions about themselves and their healthcare needs and then receive a list of potential options for acquiring some form of health coverage. The Department of Health and Human Services collected information from over 1,000 insurers as well as the Medicaid and Children’s Health Insurance Program in each state in order to create the site’s database. Healthcare.gov also has information on wellness and prevention as well as basic facts about the new health reform law.
HHS has also set up a Twitter feed at @healthcaregov as well as a YouTube site with information videos.
More on the site is found in this story on Politics Daily.
I haven’t had the opportunity to try out the site long enough to test its easy of usage or the breadth of its information, but I applaud HHS for getting the website up and running in such relatively quick time after the passage of health reform legislation. We know from experience with the Medicare Part D planfinder website that it takes time to work out the kinks and create a Web platform that the public can easily understand and access. The federal government has plenty of time to make these improvements before the new health insurance exchanges start in 2014.
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