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Doctor Blog--Fighting Chronic Illness--The Key to Health Costs

Posted Oct 03 2008 3:05pm

Former Secretary for US Department of Health and Human Services, Tommy Thompson,
published this article as an editorial in the Milwaukee Journal Sentinel.
There is a lot to agree with and think about.

Fighting chronic illness is key to health costs


Posted: Sept. 27, 2008

These days, trouble on Wall Street and the housing crisis have Congress and the
presidential candidates scrambling for answers to fix our faltering economy.
However, there is one unexpected long-term option that can help our stalling
economy — reforming our health care system through enhanced prevention and

Time has shown us the impact that health care costs have on our nation's economy.
Our health care bill has grown faster than inflation and wages. Last year, we spent
more than $2.1 trillion on health care —16% of our gross domestic product and the
highest proportion in U.S. history. At the same time, the disease burden also has grown.
We are sicker than ever. Chronic illnesses, such as diabetes, cancer and heart disease
and related conditions, such as obesity, affect more than 130 million Americans
(more than voted in the 2004 presidential election).

This disease burden costs us in increased absences and lost productivity at work.
However, even during these belt-tightening times, health care is not something we
can do without — and so, we need to explore new ways to stem the rising costs.
We've heard many ideas on how to do this, from universal coverage to price regulation
and supply-side limits on capacity to demand-side proposals, such as health savings
accounts. The problem is that none of these enjoys broad political support nor
effectively limits costs in the long term. Rather, they simply shift costs from one
payer to another.

The main reason health care costs are so high in this country is our chronic disease
burden is high and rising, yet we pay our doctors and hospitals based on individual
incidences of illness. Our payment system is misaligned. We are focused on sickness
and illness when we need to be focused on wellness and prevention.

Our first step must be to arrest the unchecked growth in poorly prevented and mis-
managed chronic illness, which will reduce costs, improve productivity and improve
our health. Chronic diseases and obesity are at the heart of our health care problems,
but they also show the greatest potential for savings. For example, a Trust for
America's Health report found that spending $10 a year per person on chronic disease
prevention programs would save the United States more than $16 billion annually
within five years.

Wellness programs run by employers across the country have shown that prevention
can make a significant impact on the bottom line. Here are some examples from
companies whose investment in prevention is paying off:

• Utilizing health and wellness programs, IBM has driven more than $175 million in
savings to the company, resulting in health care premiums that are 6% to 15% lower
than industry averages, with employees paying 26% to 60% less than industry average.

• In the city of Ashville, N.C., health care costs were reduced by thousands of dollars
per year per employee through an employee education program.

• With a long commitment to the wellness of its employees, the Pitney Bowes Health
Care University program has led to a 5% decrease in costs for participants over three
years vs. a 2% increase for non-participants over the same time period.

This is the direction we need to move; this is our compass. We need to continue and
increase our education of the American people about not only the health benefits
but also the economic benefits of eating healthy, exercising and not smoking. We pay
too little attention to the lifestyle choices we make, and the consequences are
catching up to us. But we can't tell Americans to "get healthy" when healthy food
and fitness options are unavailable, unaffordable or not readily accessible. As a nation,
we need to make sure that we have policies and practices in place that encourage
Americans to make better decisions for their health.

In my roles as governor of Wisconsin and secretary for Health and Human Services,
I have been at the center of a number of important health care debates. In each instance,
while faced with a great challenge, politicians from both sides of the aisle came together
to do what was right.

Instead of retreating in the face of adversity, my experience tells me that we have an
opportunity to advance and help both our economy and our health. By making changes
to how we deliver health care, we can lower costs and improve quality for all while also
improving job productivity and, ultimately, helping our economy.

Tommy Thompson is former Wisconsin governor and former U.S. secretary for Health and
Human Services. He is co-chairman of the Wisconsin chapter of the Partnership to Fight
Chronic Disease (

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