Turning the page on America’s chronic disease crisis


By Kenneth Thorpe



After rising steadily for decades, U.S. life expectancy has flat lined for three consecutive years, according to a new report from the Centers for Disease Control and Prevention. The study also finds that chronic conditions like heart disease, cancer, stroke, and kidney disease remain among the leading causes of death in the United States.

Our country requires a new strategy for improving the health and longevity of Americans. In particular, our leaders need to focus on reforms aimed at combatting chronic diseases through prevention, medical innovation, and improved access to care.

By elevating these three priorities, policymakers can help make 2016 the beginning of the end of America’s chronic-disease crisis.

Chronic conditions represent the single largest threat to health in America. According to the CDC’s latest statistics, roughly half of all adults suffer from at least one chronic disease. In 2014, seven chronic conditions were responsible for nearly 65 percent of all deaths.

Not surprisingly, these diseases also are the main driver of our nation’s rising health spending. About 86 percent of all healthcare spending goes towards treating patients with chronic conditions.

The good news is that policy strategies for reducing the death, suffering, and cost associated with chronic disease are within reach. What’s required is a renewed emphasis on three core principles.

First, policies must incentivize all actors in our health sector — from insurance providers to physicians, employers, and individuals — to focus on prevention.

For instance, individuals suffering from a chronic illness — or at risk of developing one — could receive tax deductions for healthy behaviors like joining a gym, just as they would for owning a home.

Similarly, employers could receive tax credits for establishing wellness programs for their workers. While the Affordable Care Act established a grant program that helps small businesses set-up wellness initiatives, a permanent federal tax break doesn’t yet exist.

Policymakers must also work to promote the development of better treatments, like the recently released hepatitis C medications that boast cure rates of 90 percent or more. More innovative treatments like these could be a game changer in the battle against chronic disease. But that depends on a policy environment that fosters innovation by protecting the incentives research scientists need to develop the next series of breakthroughs.

Finally, expanding access to care is essential to any chronic-disease policy strategy. Lawmakers can start by addressing the lack of physicians across the country. According to one recent analysis the nation could face a shortage of 90,000 doctors by 2025, making it even more difficult for chronic-disease patients to manage their illnesses.

On this front, economic incentives could go a long way. New doctors who practice in underserved areas or who go into less popular specialties might be eligible for student-loan-repayment packages or other financial benefits.

Just as important, leaders need to help preserve programs like Medicare Part D, which are already providing chronic disease patients with access to the care they need.

By making it easier for seniors to adhere to their drug regimens, Part D has dramatically reduced hospitalization rates among enrollees. Research shows this effect is especially prevalent among patients with congestive heart failure and chronic obstructive pulmonary disease.

Chronic disease is a massive problem — but a solvable one. Through policies that promote prevention, innovation, and access, our political leaders can turn the page on a chronic disease epidemic that has plagued our nation for too long.

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Kenneth Thorpe is professor of health policy at Emory University and chairman of the Partnership to Fight Chronic Disease.

By Kenneth Thorpe

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