Crack cost containment through chronic care

We need a strategic war on chronic care in America to address spiralling health costs in the nation.

In 2007, $1.7 trillion was spent on chronic health conditions in the U.S. This consumed about 75 percent of the total $2.2 trillion spent on health care in America that year. To crack the code of health costs in the U.S., target chronic disease.

The cost of diabetes in 2007 in the U.S. was $174 billion according to the American Diabetes Association. The cost of heart disaese in America is even more staggering: $475 billion in 2009, based on calculations from the Centers for Disease Control. These are conditions largely borne out of everyday health behaviors such as food choices, decisions to take stairs at the workplace, and sedentary lifestyles.

Public policy and private health plans through employer-sponsored health insurance programs should be designed to move the public toward healthier behaviors. According to the Obesity Society's press release kicking off the group's annual meeting in September 2009, obesity is "driving America's health care to a tipping point." A current example of a public policy that's working was initiated by Mayor Bloomberg and the New York City Department of Health and Mental Hygiene. Since menu labelling laws were implemented in March 2008, calories of items ordered in four fast food chains in Manhattan decreased at the point-of-purchase.

The U.S. allocated $700 billion to the banking bailout (TARP) in 2008. The Federal Medicare and Medicaid programs spent $568 billion on chronic disease in 2008. These Federal programs should be designed to provide incentives that pay for providers to manage health citizens' care on a continuous, and not episodic basis -- and motivate enrollees to make sound health decisions on a daily basis.

By staging a strategic war on chronic disease and the personal health behaviors that contribute to them -- in particular, obesity, diabetes and heart disease -- the U.S. will slow down the inexorable rise of health costs in America. This approach will not only bolster the nation's public health -- it will help to restore the nation's long-term fiscal health.

By Jane Sarasohn-Kahn  |  October 27, 2009; 6:10 AM ET
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