At a recent White House forum on health care, President Obama said that reforming the nation’s healthcare system is a key component of jumpstarting the economy. He also indicated that his administration would be open to different viewpoints.
“Health care reform cannot be achieved through ideas from Washington alone,” the president concluded. “You know what works and what doesn’t. I look forward to hearing your ideas.”
Since you’re asking, Mr. President, here’s one suggestion for improving American health care: improve American’s health by focused attention upon chronic disease.
The seven most common chronic illnesses — including diabetes, heart disease, and cancer — are responsible for $1.3 trillion in treatment costs and lost productivity each year, according to the Milken Institute, an economic think tank. Obesity alone, one of the causes of many chronic illnesses and which afflicts two-thirds of all Americans, costs the healthcare system more than $117 billion annually.
In my home state of California, chronic diseases exert a continuing heavy toll. For example, about 775,000 Californians suffer from cardiovascular disease, while an astonishing 2.5 million are afflicted with diabetes, and 57% are overweight.
Early diagnosis, monitoring, and regular treatment of chronic conditions can drastically bring down medical costs. Keeping a chronic disease in check with appropriate medical oversight and early intervention with noninvasive treatments such as prescription drugs can prevent the need for more expensive courses of action, such as emergency hospitalization, multiple ignored disease states, and surgery. In fact, for example, every dollar spent on appropriate diabetes medications saves the healthcare system more than seven dollars in other services, while every dollar spent on cholesterol drugs saves more than five dollars.
In addition, many of the patient and policy challenges associated with chronic diseases can be mitigated with appropriate education. Because chronic disease accounts for an increasing share of our nation’s healthcare spending, policymakers should also work to ensure that education of the public about the importance of taking preventative action is critical to preserve valuable healthcare dollars.
This effort should include activities to avoid contracting such conditions in the first place to preventive measures to maintain a healthy lifestyle that can help stem progression of the chronic disease state. And taking public health lessons on smoking reduction efforts, both adults and children should be included in this educational effort. This should be supported by savvy advertisement campaigns that focus on “truth” television commercials that have been shown to reduce teen smoking 22%.
To accomplish at least some of these goals, state and federal policymakers should grant tax incentives to businesses that offer wellness programs to their employees. It is crucial that workers have the tools and knowledge they need to exercise regularly, keep a balanced diet, and live healthy lifestyles. Further, employers are well-positioned to enroll their employees in medical screening programs, which can detect chronic disease risk factors before they develop into more serious conditions.
Importantly, wellness programs are a good investment. They often pay for themselves by increasing workplace productivity and reducing the number of sick days taken by employees. One survey found that 95% of businesses have experienced a positive or break-even return from their investments in wellness program. This is an outstanding return on investment for the patient, the private sector, and the public fisc.
Finally, Ad Council efforts targeting audience-relevant messaging should be created that mimics public health efforts to address smoking. Sustaining educational information dissemination is a critical resource to promote change in culture with regard to healthy lifestyles and actions.
As the Obama administration looks for ways to improve health care and rein in health spending, it should make preventing chronic diseases a priority. Otherwise, we doom the next generation to the high costs, poor health, and economic burdens associated with uncontrolled and unattended disease.
Bryan A. Liang is Executive Director, Institute of Health Law Studies, California Western School of Law; and Co-Director, San Diego Center for Patient Safety, University of California, San Diego School of Medicine.