Talking about the consequences of chronic disease

The Milken Institute released a report this week totaling the cost of preventable chronic disease in the US. The report's tally for 2003 was $1.3 trillion.* And when you float a number like that, people tend to notice. "Healthy living could save U.S. $1 trillion, study finds" is how the LA Times headlined its story about the report (others used similar headlines).

There are good reasons to trumpet this number -- it's an easy way to give people a sense of the scale of the problem and it certainly grabs attention. But there is another way to talk about this issue. The US is spending billions, if not trillions, on conditions such as diabetes and heart disease because millions of people are afflicted with them. And if you look at it that way, maybe the headlines are different, something along the lines of, "Millions in the US suffering unnecessarily from disease."

So? What difference does it make?

Well, if cost is the main descriptor we use for the size of this problem, maybe we look at the guy jamming french fries into his face and say, "Quit that! You're gonna cost all of us a ton of money!" Or, you could tell him, "Hey! Don't do that! You're setting yourself up for all sorts of avoidable pain and misery in the future!" Is it a problem of cost or suffering? And who's bearing the consequences, that guy or us?

The answer to those questions is: both. But the way we enter the process of tackling the problem could have a big impact on the solutions we develop. If we see preventable chronic disease as an economic problem -- caused by that guy shotgunning french fries -- maybe we hold health care budgets tight or slap a tax on unhealthy behaviors. Hey, someone else's french fry problem isn't going to cost us money! If we flip the situation around, though, and look at it as a problem of suffering, maybe we invest more in prevention programs and follow up care. People shouldn't have to suffer if we can prevent it. We should do something about that.

Of course, this doesn't have to be an either/or situation. And the way out of this problem will probably involve taking something from both perspectives. We just need to keep in mind that we'll all fare better in this discussion if we focus not only on what we're talking about, but how.

*About that $1.3 trillion... the Milken Institute figures that the US spent $277 billion on treatment and lost $1.05 trillion in productivity. It's almost always worth taking lost productivity numbers with a grain of salt (or even a whole shaker full) because it's awfully hard to figure how productive someone would have been if something else had happened. (Think about all those stories about lost productivity from the NCAA tournament -- just because the guy in the next cubicle spent an hour poring over his picks doesn't mean he would have been otherwise writing a report.) That said, even if the Milken people are off by half, it's still an enormous number... something like 5% of GDP.

-Greg Dahlmann

comments

After reviewing this passage, it was evident that both sides of the argument provide valid points. One side sees those people suffering from the diseases as a burden...Sigh, yet another reason for taxes to increase. The other side, however, has a perspective stating that they sympathize for the many citizens battling the chronic illnesses. This side believes that help needs to be provided to care for them, regardless of the amount of money it takes for research. If Americans view others suffering from chronic illnesses not as people, but as money-suckers, they appear to be self centered and shallow. However, it needs to be realized that by taking control of your own health can save you, and others, not only a bundle of cash, but "avoidable pain and misery in the future!" Although people should be more than aware of the dangers of tobacco use, obesity, and other major health concerns, Americans should always lend out a helping hand regardless. These people should not be viewed as tax increases but should, however, take responsibility and control of their own personal health the better themselves and the nation.

I agree that this is a really tough topic. It is so hard to choose one side because there are so many reasons why one would go for either side. Saying that a person with Diabetes basically brought it on themselves sounds so inhumane and ridiculous; but when you see things like “a guy shotgunning French fries in his mouth” (mentioned in the original post) it is hard not to want to point the blame on bad eating habits. Whether this epidemic is a disease or the result of multiple bad choices, I think that lack of education is the real battle behind this whole ordeal. If the public was just more aware of the consequences of their choices it would eliminate a lot of the problem. I can think of numerous times when I’ve talked to people about food choices and exercise and they had no idea of the most basic facts, i.e. one should only consume about 2000 calories a day, and it is recommended to get at least 30 minutes of exercise a day. If we start with kids and begin some sort of educational health program at a young age it is possible that in 20 or 30 years we will not be burdened with the problem of “trillions of dollars being spent on preventable chronic diseases.” But then again, we can not forget about the cost of those “educational health programs,” maybe as of right now we as Americans do not have an exact solution. However we can try to educate through word of mouth and as examples for the next generation to come.

Chronic diseases are diseases of long duration and generally slow progression. Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality in the world, representing 60% of all deaths. Out of the 35 million people who died from chronic disease in 2005, half were under 70 and half were women.

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