The Missing Link In Healthcare Reform
I recently attended a half day conference, “Fighting Chronic Disease: The Missing Link In Health Care Reform” sponsored by Emory University and the Partnership to Fight Chronic Disease (PFCD). It was an extremely well run event with an all-star political cast: Tom Daschle, Dick Gephardt, Dr. Mark McClellan, and Nancy Johnson were present. The key medical players included Dr. Nancy Nielson, president-elect of the AMA, and Dr. Otis Brawley, CMO of the American Cancer Society.
The purpose of the conference was to raise awareness about the cost of chronic disease – it accounts for at least 75% of healthcare spending, and 80% of that could be avoided with lifestyle interventions. Shocking, isn’t it? Any discussion of reducing medical costs needs to begin at ground zero – getting Americans to adopt healthy diet and exercise habits.
One of the most entertaining panelists was Chris Viehbacher, the president of North American Pharmaceuticals at GlaxoSmithKline (GSK). Chris is a gifted speaker with a charming Canadian accent - and could probably be the head of a debate team. We had the chance to speak about lobster fishing in Nova Scotia during one of the breaks since we share a common Maritime heritage. He offered some amusing analogies about our healthcare system, and made some points that bear repeating here:
“Half of the people in the US have some sort of chronic illness. Health insurance is like having car insurance when 50% of people are having accidents. Of course nobody can afford it.”
“We need to keep employer-based healthcare because when employers have ‘skin in the game’ they have the incentive to promote healthy behavior at a local level. Monolithic government programs aren’t good at influencing people at the individual level. Employers know each of their employees by name, they are invested in their lives, they provide childcare services and other benefits to them, and each employee’s health affects their bottom line. Employers are a critical force for promoting and facilitating healthy behaviors.”
“Alternative energy sources aren’t that interesting when gas is $1/gallon. But when gas hits $4/gallon suddenly everyone is very interested in alternative energy. The same goes for healthcare. It takes a cost crisis to bring it to everyone’s attention. And now the audience is listening.”
I’ll be cherry picking some other interesting tidbits from the conference in my next few blog posts. I hope they bring you some good food for thought.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
Yes, I could not agree more on the chronic illness issue. To have any balance in health care spending, we need to manage chronic illness well and cost effectively. We need to remember that most people are not innocent victims of their chronic illness. Most chronic illness happens because of lifestyle behaviors. The obesity epidemic causing the diabetes epidemic is the most obvious example. Treatment early, prevention and early intervention, is less costly than the later treatment of the complications. In every community, we need to attack the roots of the most common chronic illnesses and manage them. Five chronic illnesses make of the bulk of the costs: hypertension, diabetes, obesity, asthma and depression. Manage them well and we will have a healthier society and lower health care costs.
It seems to me that we as a society could make changes that would improve health. However, as long as fast food is cheaper than fresh vegetables, fear of crime keeps people indoors, and both parents have to work 12 hour days to provide food and shelter, we are likely to have little success promoting diet and exercise. I believe that true healthcare improvements will only occur if we start with the basics.
People definitely need to take more responsibility with making lifestyle changes, but Gardnersgate has a really good point – it can be hard to find time to exercise when people are working long hours and still have to find time to spend with spouses and kids too.