The Acute Nature of Chronic Problems

  • by: |
  • 10/06/2005

A new WHO study reports that India, China and Russia will suffer losses of billions of dollars in national income over the next decade unless investments are made to prevent rising levels of chronic diseases. A March 2005 research synthesis from HHS’ Agency for Healthcare Research and Quality estimates that the United States could save nearly $2.5 billion a year by preventing hospitalizations due to severe diabetes complications. But the global debate shouldn’t be primarily about the money — it should (indeed must!) be about saving lives. And the debate needs to begin at home.

In 1979, 31,691 Americans had a foot amputated because of undiagnosed and untreated diabetes. Last year that number grew to over 80,000. And hundreds of thousands of heart attacks and strokes, caused by high blood pressure and high cholesterol, cost the American health care system billions of dollars. The cost in terms of human suffering cannot even begin to be measured.

The argument that health care is “too expensive” is too broad. The proper argument is that waiting for Americans to get seriously ill and then intervening is too expensive. Earlier diagnosis and earlier, continuing care is crucial to the future health of both Americans and of the American health care system.

We cannot afford, in terms of either dollars or lives, to continue playing the health care “blame game” — because disease is the enemy and the cost of disease is staggering. One part of the blame game is about health care prices — for hospitals, insurance, drugs, and doctors. Rather than looking for a villain, it’s time to start asking the hard questions and finding the right answers — and focusing on how to reduce the price of a diabetic amputation is the wrong approach. We need to do the things that can be done to prevent it in the first place, because that’s the best way to save money and improve lives. And we need to do this now, because we also want to be able to invest in and afford better treatments for other conditions — cancer, Parkinson’s, etc. that are so desperately needed and that hold so much promise.

The first step in this process is an honest, broad-based dialogue. In order to revitalize our health care system we must refocus the debate about health care. In order to save lives, reduce costs, enhance quality and deliver on the promise of robust health to all groups of Americans, all of the players in the health care debate — including government must work together as a team, as a unit, as a public health defense force armed and ready to advance the pubic health.


Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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