A very small percentage of our population is consuming a very large percentage of our health care dollars. These patients with chronic conditions account for 83% of the $1.67 trillion spent on health care and cause two-thirds of the deaths in the U.S.
The major chronic conditions are: heart disease, stroke, cancer, diabetes and chronic lower respiratory diseases. These diseases are major killers and a major source of illness, hospitalization and health care costs. Not to mention the cost of long-term disability associated with them. And without aggressive intervention these costs are expected to worsen.
As mentioned earlier total national spending on healthcare rose to $1.67 trillion dollars. That is over $5,500 per person in the US. And that is a 7% increase over the year before.
Health care spending for a patient with a chronic condition is on average two and a half times greater than for a patient without a chronic condition. Or put another way the average cost for a patient with a chronic condition is over $13,000.
It is not surprising that many of those people with chronic conditions have less insurance requiring greater out of pocket expenses. Also they file for bankruptcy more often (51% of those that file for bankruptcy cite medical expenses as the cause). And the number of medical related bankruptcies has increased 30 times since 1980.
To make these figures more devastating one only need to factor in the aging population. By 2011 the first of the baby boomers will reach 65, the added strain that will put on these numbers cannot be doubted. Also due to medical technology, those with chronic conditions are living longer, requiring more services and additional costs.
For a more detailed look at how this relates lets look at one condition and see its impact. Diabetes is the body’s inability to utilize glucose. Some diabetes can be controlled with diet and/or oral medications while another type requires insulin injection and close monitoring of glucose levels. Diabetes can be linked to other illnesses such as neuropathy, glaucoma and heart disease to name a few. Over 18 million Americans have diabetes and roughly one third don’t even know they have the disease.
By the year 2050 it is estimated 29 million residents will be diagnosed with diabetes. It is now the sixth leading cause of death, with over 200,000 deaths each year from diabetes or related complications. The estimated cost in 2002 was $132 billion, of that $92 billion was for direct medical costs, $40 billion was for indirect costs such as lost work days, restricted activities and disability.
Heart disease and stroke amass similar numbers: 70 million of us or 1 in 4 live, with cardiovascular disease; and heart disease is responsible for 1 death every 34 seconds. It cost the U.S. $394 Billion in 2005 from direct and indirect costs.
You can see how quickly these chronic conditions can amass staggering numbers. You can also see how those few in the Medicare/Medicaid rolls can account for 83% of health care spending.
Many state governments are looking at this problem and possible solutions to ward off financial crises. Even the federal government is investigating cost saving measures. Disease management programs are one option. These programs not only help prevent chronically ill patients from further disease and costly treatments, it also involves patients in managing their own care. This frees scarce health care resources.
Disease management is used by insurance carriers and private industries. Those identified with diabetes for example are contacted and kept informed about the importance of healthy behaviors. Specifically, they are contacted by phone and asked how often they check their glucose and what the values are. Those without strict control are advised to visit their physicians.
Another method to limit chronic conditions and their enormous costs is through prevention. Several states have instituted these programs. Whether it be cancer screening procedures like mammograms or colonoscopies in Michigan or smoking cessation programs like Arizona and California, states are becoming more proactive.
It is vital to our nation that chronic conditions such as heart disease and stroke be limited. Not only for the direct costs each of us has to pay but the indirect costs to our workforce and nation. And as the population ages, more and more patients will be diagnoses with chronic conditions thus ballooning an already strapped system. We must find a solution now before the cost is beyond reach.
