REFORM: Bringing Down Chronic Disease

When asked why he robbed banks, Willie Sutton supposedly said "because that's where the money is." Ask health reform advocate Ken Thorpe why he spends so much of his time on chronic disease and he'll probably tell you the same thing: that's where the money is—about $1.58 trillion according to the CDC.

Thorpe is the executive director of the Partnership to Fight Chronic Disease, and we heard him speak alongside former Senate majority leader Tom Daschle and a variety of health policy experts, at the organization's symposium last week.

Chronic disease can be a useful prism to examine health reform because it touches on so many issues cost, quality, and coverage driving the health reform debate. It also makes clear the need for better primary care, more health IT and general delivery system and payment reform. Later this week, we'll discuss in greater depth some of the major points from the day's panel, but first we'd like set the tone with some of the illustrative facts Thorpe emphasized from the Partnership's work on chronic disease. (For more information see their 2008 "Almanac of Chronic Disease") In the U.S., chronic disease:

• Effects more than 133 million Americans
• Causes 7 out of 10 deaths each year
• Makes up 75 cents of every dollar spent on health care in the U.S.
• Accounts for two-thirds of health care cost growth over the past two decades (because of both increased prevalence and intensity of treatment)
• Costs the U.S. economy $1 trillion a year in lost productivity.

Thorpe and the Partnership focus primarily on the need to reform our current system to better address the issues of cost and quality that arise in the treatment and management of chronic disease. Certainly we need a system better able to treat and manage chronic disease—one that focuses on primary care and pays doctors for their real work managing complex conditions and diseases. But we also need to reach out to those 47 million American's whose access to any primary care is limited by their lack of insurance. After all, nearly a third of chronic disease is not diagnosed, and it's hard to manage hypertension if you don't know you have it.

Willie Sutton robbed banks for a living, but our current health care system's inability to properly address chronic disease robs all of us of years of health and substantial wealth. The police caught Sutton in 1952, and sustainable health reform must take down chronic disease.