Chronic Disease and Costs

There once was a time that people got sick and died. One of the major achievements of modern medicine is that we can now keep many of these people alive for a very long time and at a very high cost. Thus one of the drivers for the ever increasing health care costs is the ever increasing prevalence of chronic disease and the ever increasing ability of medicine to keep these people alive longer yet at an ever increasing cost. Yet these are preventable chronic diseases which for the most part are preventable as we had shown in our book on Health Care.

Science states today:

Diabetes, heart disease, and cancer now cause more deaths worldwide than all other diseases combined, according to the first global status report on noncommunicable diseases (NCDs) released at the WHO Global Forum in Moscow today. Communicable diseases such as malaria and AIDS are now outpaced by NCDs in every region except Africa. Chronic diseases, many of which are preventable, accounted for 63% of the 57 million deaths worldwide in 2008. Of those 36 million deaths, 80% occurred in low- or middle-income countries. 

Health leaders from around the world are continuing to meet in Moscow the rest of this week to prepare for the United Nations summit on NCDs in September. It will be only the second U.N. summit convened to address a health issue; the first, held in 2001, focused on AIDS and led to the creation of the Global Fund. 

The 100-page report aims to establish a baseline for the risks of NCDs, measure their prevalence, examine the progress various countries are making in dealing with NCDs, and outline what steps countries can take to both prevent and combat NCDs. 

"The good news," WHO Director-General Margaret Chan said in a press conference today, "is that these diseases are preventable." The report identified smoking, alcohol use, insufficient physical activity, and poor diet as the major risk factors. The report predicts that even African countries will suffer more deaths from NCDs by 2020 than from transmissible diseases and poverty-related issues such as malnutrition and maternal deaths. A 15% increase in mortality from NCDs is expected worldwide in the next decade. 

We have argued quantitatively that if we treat and prevent then we can almost half our current health care expenditures. One wonders why no one in the current Administration has raised this issue.