Research and Innovation Can Address Health Care Challenges, Experts
Say
SOURCE: The Heartland Institute, IL  /  Health Care News
WWWeb: http://tinyurl.com/3jv4d

Written By: Susan Konig
Published In: Health Care News
Publication Date: December 1, 2004
Publisher: The Heartland Institute

Medical research and innovative service ideas are already helping to
alleviate health care problems caused by the aging of the American
population and rising prices, according to a panel of experts who
gathered in Washington just before the November election.

Given the opportunity, scientists and health care providers can meet
these and other new challenges, according to speakers at the
conference, which set aside immediate political controversies and
focused instead on the long-term challenges and opportunities facing
the nation's health care system.

Co-hosted by the Alliance for Aging Research and the American
Pharmacists Association Foundation, the conference, "Beyond the
Election: America's Health Care Issues," focused on the cost of
disease in the United States, the costs and utilization of drugs, and
programs that have demonstrated cost savings, including prevention
efforts and lowering or elimination of copays.

The symposium's featured speakers laid out the realities of health
care costs in the coming years and paired the sobering numbers with
real-life innovations on the business and community levels that have
achieved a measure of success.

Moderator Grace-Marie Turner, president of the Galen Institute,
invited participants at the National Press Club to study the major
problems of the country's health care system--such as rising
insurance costs, the numbers of uninsured, and regulations and
penalties that govern the system--and then to look at opportunities
to improve the system through information technologies, care
management, and prevention.

Costly Tsunami Approaching

Dan Perry, executive director of the Alliance for Aging Research,
described the looming challenge of an aging population as a "tsunami
of health care costs."

He noted that although the debate over health care typically narrows
during an election season, Americans must look to the decades ahead.
"Seventy-seven million baby boomers are aging, with the first wave
eligible for Medicare in six years. Promoting health and independence
for older Americans must be a priority."

Mortality rates continue to drop, said Perry, in response to new
health care technology and better awareness of personal actions that
can sustain good health. The actual number of disabled elderly was
significantly lower than projected over the past 20 years, he noted,
which resulted in lower costs than expected.

But Perry warned that $26 billion in hidden health care costs can be
expected to arise from a coming decrease in the ability of older
Americans to care for themselves--an ability that declines quickly
after age 80. By 2030, he said, nursing home costs could reach
$190,600 per bed per year.

Meanwhile, care for people with chronic conditions already consumes
78 percent of U.S. health care spending, and conditions such as heart
disease, neurological disease, cancer, and diabetes are costing $814
billion a year. Diabetes alone accounts for more than one-third of
all Medicare spending. Currently, 4.5 million Americans suffer from
Alzheimer's disease, at a cost of $100 million a year, and as many as
16 million people in the United States could be affected by this
disease by 2030.

Those numbers point to one imperative: "We have to control these
diseases," Perry stressed. "Shifting costs won't solve this problem."

Research Expenditures Rising

The good news, Perry said, is that Americans have high expectations
for medical research. "They value it and are willing to pay for it.
Medical schools and research universities are often the pride of
their communities. We must energize our best minds, reduce the impact
of disease, and make the U.S. the engine of innovation for the
world."

Money spent on technology and research is considered well spent by
the American public because it works to avert the impact of numerous
diseases. Whether the innovation is as simple as the benefit of
taking a daily aspirin, or an advanced product breakthrough such as
cholesterol-lowering drugs, ACE inhibitors, and cancer medications,
the success of such research is tangible.

In 2000, the United States invested $634 billion in breakthrough
treatments. Without that investment, Perry contended, the U.S. would
have seen:

470,000 more deaths;

2.3 million more disabled individuals; and

206 million more days in the hospital.

Using newer drugs and therapies could lower overall health expenses
by as much as $111 per person, per year, per condition, for the
general population and $155 for Medicare beneficiaries, Perry said.

Perry believes the rest of this century will bring a series of
medical breakthroughs. For example, he expects researchers to find
ways to control and possibly reverse Alzheimer's and Parkinson's
diseases, with 20 drugs currently in development for each of those
ailments. Cures for many cancers will become available, he said, and
risks for cardiovascular disease will be identified and targeted for
specific preventative interventions.

Business Helps Employees Manage Health

The speakers who followed Perry discussed breakthroughs in new health
care models that are succeeding in business and within entire
communities.

In 2002, for example, the mail document business Pitney Bowes
undertook a health plan redesign to increase compliance with
prescribed medication and disease management among employees with
chronic conditions. David Hom, who as Pitney Bowes' vice president of
employment brand total rewards is responsible for the benefits and
compensation package the company offers to its employees, discussed
how his firm helped employees manage their health.

The company created a model for a healthy corporation, encompassing
culture and values, benefit plans, management practices, and employee
resources. That foundation was combined with a healthy work
environment consisting of onsite medical facilities, fitness centers,
ergonomic workspaces, stretch breaks, non-smoking worksites, healthy
food options in cafeterias, and even lactation rooms. The third
component was to require personal responsibility for wellness,
disease prevention, and condition management.

According to Hom, employees with chronic conditions such as diabetes
became more compliant in their own treatments, increased the
appropriate use of prescription drugs, and visited the emergency room
less frequently.

City Encourages Citizens to Stay Healthy

John Miall, risk manager for the city of Asheville, North Carolina,
talked about applying such a model to an entire community. He
observed that the incentives in the heath care industry all have to
do with someone being sick. He suggested aligning the incentives with
the well, encouraging people to stay healthy.

The citizens of Asheville, he said, know something about this idea.
In an undertaking called the Asheville Project, the community
collaborated to improve the conditions of people with chronic
diseases.

Using diabetes as a chronic condition that needed attention,
pharmacists in Asheville were offered a curriculum and certificate to
learn hands-on care--foot exams, eye exams, and blood pressure tests--
for their customers with diabetes. The state waived copays for drugs
and glucose testing materials. This established a relationship
between the patients, the pharmacists, and the physicians, a constant
feedback loop that improved the level of care, Miall said.

In the eight years since the Asheville Project began, costs for
diabetic care decreased greatly, from $6,127 to $4,651 per patient
per year.

The project has grown to include many more participants and other
chronic diseases. "Sometimes," Miall concluded, "you have to build
systems that don't exist."

Local, Personal Care Essential

Dan Garrett, senior director of the medication adherence program for
the American Pharmacists Association Foundation, helped implement the
Asheville Project. To manage chronic care effectively, he said,
health care must be local, and there must be self-management. The
person with the condition has to manage the disease.

Fifty percent of all prescriptions written are not filled or not
taken, according to Garrett. People with a "silent disease" such as
diabetes or heart disease need to understand the importance of taking
care of the condition. Local networks of pharmacists need the
motivation, training, and time to help patients manage their care.

"Align the incentives," he urged, "improve the outcomes, and control
the costs."

Public-Private Partnership to Help 31 Million

Dr. Martin J. Murphy, Jr., told the conference that cancer will
overtake cardiovascular disease as a cause of death in the United
States because of the availability of improved medications to
mitigate heart disease.

The good news, he said, is that two-thirds of all cancer is
preventable, and preventative measures and early treatment will
change the outcome for patients with those diseases.

Murphy, founding chairman and CEO of AlphaMed Consulting, Inc., a
corporation that provides strategic support for academic cancer
centers and cancer drug development programs of global pharmaceutical
and top-tier biotechnology companies, worked to develop, at the
request of President George H.W. Bush, the CEO Roundtable, which in
turn spawned the Cancer Gold Standard project.

Partnering with the American Cancer Society, the Centers for Disease
Control and Prevention, and others, the Cancer Gold Standard project
engaged companies and states in a public-private partnership to aid
employees and their family members who are not receiving recommended
medical care. The participants target tobacco use, diet and
nutrition, physical activity, screening and early detection, access
to quality treatment, and clinical trials.

The 41 corporations, states, and organizations involved--including
Wachovia, Eli Lilly, Johnson & Johnson, Pfizer, Aventis, the Mayo
Clinic, and the states of Arkansas, North Carolina, and West Virginia-
-will roll out the program by the end of 2005, directly affecting 31
million Americans.

"It is this kind of entrepreneurship, innovation, and thinking
outside the box" that will solve the problems of health care in the
United States and let us move into the future," concluded Turner.

Susan Konig ([log in to unmask]) is managing editor of Health Care
News.

Reference:

The Heartland Institute
http://www.heartland.org/

Health Care News
http://www.heartland.org/IssueSuites.cfm?issId=9
http://www.heartland.org/Publications.cfm?pblId=2

The Alliance for Aging Research
http://www.agingresearch.org/
http://www.agingresearch.org/healthtopics.cfm
http://www.livingto100.com/

The American Pharmacists Association Foundation
http://www.aphafoundation.org/
http://www.aphafoundation.org/News/Releases.htm

The Asheville Project
http://tinyurl.com/4ub7z

C-Change - The Cancer Gold Standard Project
http://tinyurl.com/6kpwj

SOURCE: The Heartland Institute, IL
WWWeb: http://tinyurl.com/3jv4d

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