For most in Washington, healthcare reform has taken a back seat to the economy. But the truth is that the two are intimately connected--ignoring one problem exacerbates the other. Righting the economy is understandably President Obama's first priority. He can make great strides in that effort by addressing one of the fundamental causes of higher healthcare costs in this country: chronic disease.
In a recent Kaiser Family Foundation poll, nearly four in ten people surveyed reported experiencing a serious financial burden caused by healthcare costs. Worries about paying medical bills ranked higher than those for rent, mortgage, debt, food, and even losing money in the stock market.
Chronic illness is the number-one culprit for the national healthcare burden. Chronic illness affects 45 percent of the population. And it accounts for 75 percent of overall healthcare spending.
Fortunately, treatments to control and even cure many chronic illnesses are emerging. And such treatments can save money over the long run by mitigating the need for expensive emergency treatments. For instance, a cholesterol-lowering drug like Lipitor or Zocor might mean you won't need quadruple-bypass heart surgery.
According to a study published in the Journal of Medical Care, for every $1 spent on prescription drugs for diabetes and cholesterol, the healthcare system saves $7.10 and $5.10 on other medical services for each respective disease.
Unfortunately, prescription drugs are one of the most underinsured medical treatments in the country, and account for the largest share of out-of-pocket patient spending nationally. High co-pays and sparse coverage cause millions of patients to forgo their prescribed drug regime.
This is especially true in Alabama, my home state, where 14 percent of the population lacks health insurance, as does nearly a fifth of working adults aged 18 to 64.
This contributes to the epidemic of "non-adherence," where people either don't take their medicines or take the wrong amount. The Johns Hopkins Center for Adherence Research estimates that this problem increases national healthcare costs by $100 to $300 billion annually.
To address this problem and cut down on healthcare costs, employers should reduce or eliminate cost-sharing for prescription drugs in their employee insurance plans. Public insurance programs should expand their contributions to patient drug expenses. And lawmakers and business leaders alike should encourage patients to follow their drug prescriptions in full.
Individual Americans need to do their part, as well. Weight problems make it much likelier that a person will develop diabetes, heart disease, cancer, and other chronic conditions. Small improvements in one's daily routine--like regular exercise and good nutrition--lead to a lower waist size and a reduced medical bill.
Lawmakers can encourage insurance companies to provide incentives to individuals by rewarding healthy lifestyle choices, for example, with lower premiums. They could in turn increase health insurance premiums for those who actively engage in unhealthy behaviors, such as smoking, even after being advised by a medical doctor to stop.
This is difficult but critical step toward revamping our healthcare system and generating long-term cost-savings.
(Dr. R. Randolph Brinson is a practicing gastroenterologist in Montgomery, Alabama. He is also is a clinical assistant professor of medicine at the University of Alabama School of Medicine and founder and chairman of Redeem the Vote.)