Falling Short of What’s Needed

Saturday’s Wall Street Journal editorial does an excellent job explaining the obesity epidemic in the U.S. and how it’s driving much of the cost increases in health care.

The Journal cites many statistics that illustrate the scope of this problem, but let me add two more: The doubling of obesity between 1987 and today accounts for nearly a third of the rise in health care spending, and if the prevalence of obesity was the same today as in 1987, health care spending would be 10% lower per person, or about $220 billion less. That’s a significant chunk of money that could be spent on important reforms.

The Journal lists several of the policy solutions proposed by Congress to address this crisis, and rightly points out that these efforts don’t receive nearly enough funding or emphasis to do the job they’re meant to do—reduce costs and improve health outcomes. In fact, CBO Director Douglas Elmendorf said last month the current proposals will increase health care spending, not reduce it.

Congress needs bolder action when it comes to reducing obesity and chronic diseases, which account for 75 percent of health care spending (99 percent in Medicare), and this action should come in the form of investment in areas like care coordination, prevention and a stronger primary care network, all of which have been proven to improve health, control costs and increase quality of care. Efforts like community health teams (CHTs) are good examples of how we can make smart, cost-effective investments that improve the quality of care: by investing $25 billion over 10 years in a CHT infrastructure, we could save $100 billion over 10 years due to reductions hospital readmissions and improving existing care management protocols.

As the Journal rightly points out, we shouldn’t attempt to reduce obesity rates through punishment. Instead, we should create a system that helps people get and stay healthy, and rewards them for doing so. Unfortunately, the current health reform bills don’t include measures large enough in scope to sustain the type of comprehensive delivery system and payment system reforms necessary to create this type of system.

Check out these other weekend reads:

National Journal –“The Next Health Care System" by Ronald Brownstein – August 1, 2009
The New York Times –“Curbing Runaway Health Inflation" Editorial – August 1, 2009