Chronic diseases poised for national attention

Washington -- A bipartisan coalition of health care, business and labor organizations intends to bring several unhealthy truths about chronic disease out of the shadows and into the spotlight of presidential politics.

The newly formed Partnership to Fight Chronic Disease made up of nearly 60 groups, including the American Academy of Family Physicians, the American Hospital Assn., the National Medical Assn. and the Pharmaceutical Research and Manufacturers of America, would like to see the fight against chronic diseases become the nation's No. 1 health care issue.

"Our goal is to restructure and reframe the debate on health care reform," said the group's executive director, Ken Thorpe, PhD, chair of the Rollins School of Public Health at Emory University in Atlanta and a health policy adviser during the Clinton administration.

Among the unhealthy truths noted at the group's May 15 Washington, D.C., debut was the fact that chronic diseases such as asthma, diabetes, heart disease and cancer are the primary cause of death and disability in the U.S. Chronic diseases are responsible for seven out of 10 deaths each year, according to the group.

"We have a 'sick care' system, not a health care system in this country," said former U.S. Surgeon General Richard H. Carmona, MD, MPH, in a statement. Dr. Carmona is the coalition's chair. "Despite any differences we may have on other issues, we all agree on a single, undeniable fact: 130 million people suffer from chronic diseases in our nation, and costs are skyrocketing because of preventable and poorly managed chronic diseases," he added.

"Most people are not aware of the key role played by chronic disease in driving up health care costs," Dr. Thorpe said. Nor are they aware that obesity is also a major factor in the increase in health care spending, he noted. "If the prevalence of obesity was the same today as it was in 1987, health care spending in the U.S. would be 10% lower per person -- or about $200 billion less."

Seeking a shift to disease management

The vast majority of cases of chronic disease could be prevented, said former Centers for Medicare & Medicaid Services Administrator Mark McClellan, MD, PhD, a member of the group's advisory board.

Citing Centers for Disease Control and Prevention statistics, Dr. McClellan noted that 80% of heart attacks and strokes, 80% of type 2 diabetes and 40% of cancer could be prevented if Americans did just three things: stopped smoking, ate more healthy food and exercised regularly. "A regular exercise regimen could change the course of this trend in obesity."

There is also a huge amount of improvement needed in the treatment of chronic diseases, Dr. McClelland said. "Only about half the time do people get recommended treatment." High blood pressure and diabetes are among those undertreated diseases.

"We don't have to put up with the fact that three out of 10 kids in school today are going to get diabetes," said Billy Tauzin, president and CEO of PhRMA, a trade group that represents large pharmaceutical and biotechnology firms in Washington. "For the most part, our health care system won't deal with them until they need an amputation or their organs start failing.

"We don't have to put up with the fact that we misspend our health care dollars dealing with the damage done by diseases we could have prevented or managed more effectively," he said.

Warren Jones, MD, executive director of the Mississippi Institute for the Improvement of Geographic Minority Health, explained that his group is working to improve health care for rural and minority populations that bear a disproportionate amount of chronic disease.

Dr. Jones said he believes the coalition can drive changes to make those improvements by making sure hospitals work better, communities have the resources they need and that the physicians and other health care workers are available.

Rick Kellerman, MD, president of the American Academy of Family Physicians, said 80% of patients older than 65 have at least one chronic disease, 66% have two chronic diseases and "an astounding 20% ... have five or more concurrent chronic diseases."

Combine this information with child obesity rates and there is likely to be an increase in diabetes, blood pressure and arthritis in the future, he said. Plus, teens are picking up the cigarette habit. "You can see we have a lot of work to do."