Preventive policy lacks performance

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Kaitlyn Dmyterko
Staff Writer

Over the past few decades, the rates of and costs associated with chronic conditions such as diabetes, hyperlipidemia and hypertension have soared. A study this week from Health Affairs found that chronic diseases have soaked up nearly half of the inflation of Medicare spending since 1987, and the authors argue that U.S. policy makers ignore this trend.

By 2018, Medicare expenditures will reach a towering $879 billion annually and surpass even the growth rates of our federal revenues and the economy overall. In a separate study evaluating the frequency of high blood pressure, researchers found that the direct and indirect costs related to the treatment of hypertension alone reached more than $70 billion last year.

In fact, during today's healthcare summit on Capitol Hill, Sen. Tom Coburn, R-Okla., who also happens to be an MD, said that Congress should focus healthcare reform first on preventive measures, offering rewards for effective management of chronic diseases.

“We absolutely do not incentivize prevention. We don’t pay rewards for great management of chronic disease,” Coburn said. He also called for a change in the school lunch program and the food stamp program, which he said are a cause of diabetes in the U.S.

Two chronic conditions that continue to increase in rate, diabetes and hypertension, can lead to heart disease, but also can be prevented. In fact, to curb the recent pandemic of hypertension, researchers found that reducing salt intake by 1,000 mg per day could reduce the rates and costs related to high blood pressure.

Conversely, the Centers for Disease Control & Prevention (CDC) found that while use and efficacy of drug-eluting stents, CT scanning and prescription drugs eat up costs, overall they have been effective in diagnosing and treating heart disease.

In other news, researchers confirmed that volume CT scanning with the newer 320-row scanner significantly reduced radiation dose -- by 91 percent -- compared with helical scanning with 64-slice machines. Findings like this could go a long way in informing public policy regarding the use of CT to triage chest pain patients.

While healthcare professionals, nonprofits and policy makers are concerned with heart disease and other chronic conditions by installing preventive programming and treatments, so far not enough is done to shrink the exorbitant number of patients diagnosed with chronic conditions.

Implementing lifestyle changes can help to win the fight before it enters the ring. A push for patients to lose 10 pounds, reduce salt intake, eat healthy and exercise can prevent diabetes, hypertension and heart disease.

Overall, better health and preventive measures could save patients from the tumultuous burden these chronic conditions have on them, their pockets and the economy.

On these or other topics, feel free to send me questions or comments.

Kaitlyn Dmyterko