Study: Prevention saves lives, money

The Milken Institute says chronic disease is hurting the economy.

October 03, 2007|Lisa Girion | Times Staff Writer

The rapid rise in preventable chronic diseases -- such as obesity and heart disease -- over the last 20 years is hurting U.S. economic productivity, escalating treatment costs and causing unnecessary suffering, a new report says.

That's the bad news.

The good news, according to the report by the Santa Monica-based Milken Institute, is that the trend can be turned around with healthy doses of prevention and early detection.

The report comes amid a national debate over healthcare, what it should include, and who should pay for it -- including government, private insurers, individuals and employers.

The Milken report is part of growing pressure at the same time to allocate more health dollars for prevention and early detection -- rather than just treatment.

Currently Medicare, the government's health insurance program for seniors, and private insurers tend to pay more for surgeries and treatment procedures than for prevention counseling in a physician's office.

Such payments are rooted in the healthcare needs of the population when the payment plans began decades ago.

The Milken Institute, a private economic think tank, joins a growing chorus of researchers and public health experts contending that such a system no longer serves the nation because the population is aging and because the incidence of obesity and preventable diseases among Americans of all ages, including children, has risen alarmingly in recent years.

The Milken report is one of the most ambitious attempts to quantify what is at stake in economic terms.

It says a reorientation toward prevention could avert 40 million cases of seven chronic diseases -- cancers, diabetes, heart disease, hypertension, stroke, mental disorders and pulmonary conditions -- in the year 2023.

That would reduce anticipated treatment expenses associated with the seven diseases and improve productivity by $1.1 trillion that year, it says.

The report does not put a price tag on prevention and early detection efforts.

But the authors suggest that the economic gains and reduced treatment costs would more than pay for such efforts.

"Good health is an investment in economic growth," said Ross DeVol, director of the Milken Institute's Center for Health Economics and the lead author of the report, titled "An Unhealthy America: The Economic Burden of Chronic Disease."

The report recommends making rewards for prevention a part of any healthcare overhaul, and it urges a renewed commitment by policymakers to achieving a "healthy body weight."

Reducing obesity alone to reasonable and achievable levels, the report says, could trim the incidence of disease by 14.8 million case in 2023, saving $60 billion in treatment costs and improving the nation's economic output by $254 billion.

Institute founder Michael Milken said the nation had made great strides in improving cancer death rates but was failing to avert preventable diseases.

Milken, himself a cancer survivor, pointed the finger at high-calorie, high-fat foods, and he noted the rapid advance of obesity, which is linked to many escalating diseases, including diabetes and hypertension.

He called for a moon-launch-type mission to fight disease through prevention efforts, such as diet and exercise, and to improve outcomes with early detection.

"We have not contained the containable," Milken said at a Washington news conference.

This "doesn't take new medical breakthroughs or new Nobel Prizes to solve."

The report was released at the news conference, held by the Partnership to Fight Chronic Disease. Former U.S. Surgeon General Richard Carmona, who serves as chairman of the coalition, said the report helped by identifying the "cost burden" of chronic disease.

"It's truly staggering," he said. "If we are unable to reduce the rate of chronic disease, the potential economic damage to our nation could be devastating."

Carmona said the biggest problem with the current system was that it waits for people to get sick and then treats them at high cost.

"The system we have is archaic," he said. "It really doesn't work."

Public health experts said the report should help focus the attention of presidential candidates and policymakers to the need to emphasize and encourage prevention, early detection and effective disease management.

"Most of the national policy discussion on healthcare is about financing mechanisms," said Kenneth Thorpe, a public health professor at Emory University in Atlanta and executive director of the Partnership to Fight Chronic Disease.

This report "suggests that the urgent need to act now to reduce the amount of preventable illness as the country ages deserves equal focus," he said.

Thorpe said the magnitude and growing burden of disease required new approaches.

"Solving the problem is not going to be done the way we've done things in the past -- dialing up co-pays and deductibles," he said.

The Milken research builds on a study by Thorpe that was released this week that found higher rates of cancer and chronic diseases among Americans age 50 and older compared with their European counterparts.

Thorpe blamed Americans' diet and sedentary lifestyle.


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