According to the Centers for Disease Control and Prevention (CDC) 75% of U.S. healthcare costs goes to the treatment of chronic diseases. The most common of these chronic diseases include heart disease, stroke, cancer, diabetes, obesity and arthritis. In fact, each year 7 out of 10 deaths among U.S. citizens are caused by chronic diseases. Heart disease, cancer and stroke account for half of all deaths annually.
Four Behaviors can lead to Chronic Disease
Chronic diseases are among the most preventable health challenges in the U.S. Consider, there are four modifiable health risk behaviors that are attributable to much of these illnesses:
- lack of physical activity,
- poor nutrition,
- tobacco use, and
- excessive alcohol consumption.
Fortunately Congress understands that investing in personal and preventative healthcare is a wise choice. As the chart shows below, the FY 2014 Omnibus Appropriations bill, H.R. 3547, provides $711.65 million in discretionary appropriations, and $446 million from available amounts in the Prevention and Public Health (PPH) Fund. This brings the program level near the previous FY 2012 level.
Chronic Disease Costs $2.5 Trillion!
For some perspective, CDC estimates the medical care cost of chronic diseases in the U.S. is $2.5 trillion. The funds Congress provided in the FY 2014 omnibus Appropriations bill account for .00046 of this amount. While comparatively small, Congress understands their investment is the ounce of prevention that will render the pound of cure.
CDC uses the funds provided by Congress to
- conduct epidemiology and surveillance,
- promote and reinforce health,
- improve effective & efficient delivery and use of clinical and other preventive services to prevent disease,
- detect diseases early, and reduce or eliminate risk factors and mitigate or manage complications, and
- improve clinical links ensuring those with, or those highly at risk of developing, chronic diseases have access to resources to best manage their conditions.
Yet given the enormity of the current and future healthcare challenges in the U.S., Congress’ investment and CDC’s efforts must be met with paradigm shifts from the healthcare industry and individuals. The U.S. has little choice in the near future but to engage in a debate on how to contain rapidly growing health care costs. In the upcoming decade, if not sooner, there will be a shift in the accountability of an individual’s own health care. For instance, if an individual chooses to smoke or continue to excessively overeat then the individual must pay related and associated health care costs and higher health insurance premiums for those behaviors. Simply put, individuals must accept personal responsibility for their health conditions.
Healthcare Industry Must Focus on Preventative & Predictive Medicine
Moreover, the healthcare industry must focus more on preventative & predictive medicine that render: 1. better patient outcomes, 2. reduce healthcare costs and 3. spur the U.S. economy. With an economy that continues to struggle under the weight of a high unemployment rate, jittery investors and budget deficits for the foreseeable future, lawmakers are looking for solutions to improve health and energize the U.S. economy. But some recent ideas have not proven to be successful. For instance, Congress was promised that stem cells would be a cure for numerous diseases like Parkinson disease and diabetes. Today, proteomics and microbiomes are being promised as technologies that will help treat diseases. But neither of these new health interventions or research achievements facilitate future congressional objectives of reducing healthcare costs.
Also, while American ingenuity and technological advancements typically render increased efficiencies and effectiveness in most industries, it seems such advances in medical technology lead the U.S. to spend more per person on health care. According to MIT Technology Review (Sept. 2013), “Health care accounts for one in five dollars spent in the United States. It’s 17.9 percent of the gross domestic product, up from 4 percent in 1950. And technology has been the main driver of this spending: new drugs that cost more, new tests that find more diseases to treat, new surgical implants and techniques.” The need for new technologies is recognized, but future innovations in healthcare must maintain ways to reduce current and future costs.
Under the Government Performance and Results Modernization Act (P.L. 111-352), federal agencies are required to make available a strategic plan that provides:
- a comprehensive mission statement covering the major functions and operations of the agency;
- oriented goals, for the major functions and operations of the agency;
- a description of how any goals and objectives contribute to the Federal Government priority goals;
- a description of how the goals and objectives are to be achieved;
- a description of the operational processes, skills, technology, human capital, information, and other resources required to achieve those goals and objectives;
- a description of how the agency is working with other agencies to achieve its goals and objectives as well as relevant Federal Government priority goals.
Like all federal agencies, every 4 years the Department of Health and Human Services (HHS) updates its strategic plan. HHS asked for public comments on their Strategic Plan for FY 2014-2018 and the comment period closed on October 13, 2013. HHS will soon release their new strategic plan. Let’s hope they recognize the continued financial investment from Congress targeted toward more preventative healthcare delivery in the U.S.