April 14, 2011
8:01 am
Sure, the topical thing to do in this space today would be to comment on the President’s deficit reduction speech and the contrast between the Obama budget plan and the one put forward by Congressman Paul Ryan (R-WI).
But there will be plenty of time to do that. This debate over our nation’s priorities and how best to reduce the debt will be going on for months to come.
Instead, I wanted to share an item that caught my eye because I found it fascinating that it took someone other than a political or economics journalist to put the current budget wars into a proper perspective. Mark Bittman, the food columnist for The New York Times Magazine, pointed out in an online commentary this week that, by the year 2030, the cost of treating heart disease in the United States will escalate to $800 billion. And incidences of diabetes, according to the Centers for Disease Control and Prevention, are projected to reach a point at which every other American will have either Type 1 or Type 2 diabetes, which will cause cumulative treatment costs to rise to $500 billion.
So that’s over $1 trillion in future costs connected to just two chronic diseases. By comparison, the recent congressional budget fight that almost resulted in the federal government shutting down was over a small fraction of that, $38 billion.
Bittman’s point is that many of our healthcare costs – and, subsequently, costs to taxpayers because of the number of Americans receiving care through Medicare or Medicaid – can be addressed through better diet. He’s right, but the point is bigger and broader than that.
It is going to be impossible to get a grip on future healthcare costs unless our nation makes wellness and disease prevention an urgent priority. Today, the treatment of chronic disease is responsible for 75 cents of every healthcare dollar we spend in this country. And if projections are correct on the significant increases in heart disease, diabetes, pulmonary illness and various cancers, huge budgetary outlays in both the public and private sectors are going to be unavoidable simply to treat a less healthy populace.
Many employers and communities have made tremendous progress in developing incentive programs to encourage individuals to live healthier lifestyles and seek diagnostic tests and preventive care. We need to take these success stories and expand them so they can benefit a nation.
Now, I don’t expect the upcoming budget debates to focus on how we can get more Americans to quit smoking, eat healthier, get exercise and see their doctor for regular exams and blood tests, but if we don’t give wellness and prevention at least as much attention as, say, appropriations for public radio, then aren’t we missing the point?
March 25, 2011
12:21 pm
The one year anniversary of the Affordable Care Act wasn’t the only significant healthcare news this week. Here are links to some interesting and important reports you may have missed.
A study published in Health Affairs documents the savings generated by a major employer, Johnson & Johnson, as a result of employee wellness programs.
A new blood test is in development that can diagnose the risk of diabetes a decade before symptoms begin to appear.
On the subject of diabetes, Novo Nordisk and race car driver Charlie Kimball have teamed to launch a campaign urging patients to speak to their physicians about improved insulin delivery methods.
Could video games have a healthcare value? Experts say they may help discover whether children have vision problems.
The Cleveland Clinic is taking advanced healthcare delivery concepts far beyond U.S. borders, bringing its expertise to Abu Dhabi.
Meet “Sammons Says,” Baylor’s new blog on cancer prevention, treatment & research.
February 15, 2011
11:35 am
Now that gasoline is over three dollars a gallon, I wince a little every time I fill up my car. It would be nice to have the power to simply decree that gas prices be 50 cents lower, but I understand that my pocketbook preferences do not take precedence over basic marketplace factors that range from the cost of oil exploration to rising energy demand in China and India.
There is still an insistence on the part of some, though, that governments should set healthcare prices (more than is already the case in Medicare and Medicaid), regardless of actual cost of producing and delivering healthcare goods and services.
This issue arises because of a report from Boston’s National Public Radio affiliate, WBUR-FM, that the Massachusetts Governor may ask the state legislature for the authority to set the rates that hospitals can charge. That authority would kick in if, after three years, hospitals are requesting increases of more than two percent.
This idea of government setting prices is, of course, neither new nor limited to the Bay State. During the debate over health reform, proponents of a government-run health insurance option cited Medicare as a model of “efficiency” because it establishes the payment levels that physicians and hospitals can receive. That’s fiat, not efficiency. Similarly, there are constantly proposals bandied about to affix price ceilings to virtually every healthcare sector from insurers to pharmaceuticals to medical devices. That’s also the problem with the Independent Payment Advisory Board, scheduled to be implemented as part of the Affordable Care Act. It’s an entity empowered to slash healthcare spending without regard to achieving greater quality or value.
The problem with having government simply decree what any one sector may charge for its services is that this approach ignores the interrelationship between insurers, providers, manufacturers and consumers in determining the value of healthcare services. It also undermines the ability of health system participants to provide greater value through innovation.
There’s no question that we do need to focus on improving healthcare’s affordability. The way to do that, though, is through new, innovative health delivery mechanisms, a greater reliance on evidence-based medicine, a more intense focus on wellness and prevention and strengthening the ability of consumers to be discerning healthcare shoppers.
For government to simply declare that certain prices must be lower may bring a measure of short-term relief, but there’s a price to be paid, whether it’s in the form of cost-shifting, reduced access, impaired quality or less innovation. Just saying a cost is lower isn’t the same as actually making it lower through marketplace mechanisms or greater ingenuity.
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.
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