October 28th, 2009 by Happy Hospitalist in Better Health Network, Opinion
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What we need is health reform, not health insurance reform. If we do nothing about health care inflation, we are all doomed. Every last one of us. Taking care of sick people is expensive. The only way to get rid of health care inflation is to stop spending money. At some point we will either have to
- decrease illness
- decrease treatment and/or
- decrease the cost of treatment
There are no alternatives. As an American which action plan would you rather see take hold? Realize that every cost action has a reaction. You can decrease disease by prevention. You can decrease treatment by bundling. And you can decrease the cost of treatment by making it more efficient or simply paying less until access becomes an issue. I am certain that keeping the financial stability of America will require all three. But the only one you as a patient have control over is #1. As a country, we can prevent 80% of diabetes, heart disease, stroke and cancer by taking care of ourselves with lifestyle modification. Read more »
*This blog post was originally published at A Happy Hospitalist*
January 27th, 2009 by Dr. Val Jones in Announcements, Audio, Expert Interviews
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Better Health’s policy writer, Gwen Mayes, caught wind of an interesting new conference being held tomorrow in Miami. She interviewed Ken Thorpe, Ph.D., one of the conference organizers, to get the scoop. You may listen to a podcast of their discussion or read the highlights below. I may get the chance to interview Billy Tauzin and Donna Shalala later on this week to get their take on healthcare reform initiatives likely to advance in 2009. Stay tuned…
[Audio:http://blog.getbetterhealth.com/wp-content/uploads/2009/01/gwenken2127.mp3]
Mayes: Tell us about the upcoming conference in Miami on January 28th called “America’s Agenda: Health Care Policy Summit Conversation.”
Thorpe: The conference will start a conversation on the different elements of health care reform such as making health care more affordable and less expensive, finding ways to improve the quality of care and ways to expand coverage to the uninsured. The conference is unique in that we’ve brought together a wide range of participants including government, labor, and industry for the discussion, many of whom have been combatants over this issue in the past.
Mayes: Will there be other meetings?
Thorpe: This is the first of several. There will others in other parts of country over next several months. President Obama and HHS Secretary Designee Tom Daschle have talked about engaging the public in the discussion this time around. So part of this is an educational mission and part of it is to reach consensus among different groups that have not always agreed in the past.
Mayes: What encourages you that these groups will be more likely to reach consensus now when they haven’t in the past?
Thorpe: The main difference is that the cost of health care has gotten to the point that many businesses and most workers are finding it unaffordable. In the past, most businesses felt that, left to their own devices, they could do a better job of controlling health costs by focusing on innovated approaches internally. What we’ve found, despite our best efforts, working individually we haven’t done anything to control the growth of health care spending. The problems go beyond the reach of any individual business or payer and we need to work collectively.
Mayes: How will health care reform remain a priority in this economy?
Thorpe: The two go hand in hand. As part of our ability to improve the economy we’re going we have to find a way to get health care costs down. Spiraling costs are a major impediment to doing business and hiring workers. To the extent we can find new ways to afford health care it will be good for business and workers.
Mayes: Health information technology is also an important aspect. What are the common stumbling blocks to moving forward?
Thorpe: There are three issues we have to deal with. First, we have to have a common set of standards for how the information flows between physicians and physicians, and with payers and hospitals. What we call interoperability standards. Second, we have to safeguard the information. Finally, cost is the biggest challenge because most small physician practices of 3 or 4 physicians don’t have electronic record systems in place. To put in a state-of-the-art system can cost $40,000 per physician and most cannot afford this expense. I think the stimulus bill will provide funds to help with these costs.
Mayes: There’s always growing interest in the patient’s role. How will this be addressed?
Thorpe: We have to find a better way to engage patients in doing better job of reducing weight, improving diet and those with chronic disease to follow their care plan they worked out with their physician. We also want to make it more cost effective for patients to comply with the plan. Patients who comply with health plans will have better outcomes at lower costs.
Mayes: Who’s on the agenda in Miami?
Thorpe: It’s at the University of Miami so it will be hosted by President Donna Shalala who was Secretary of HHS under the Clinton administration so she is well versed on health policy. Also attending is the head of PhRMA, Billy Tauzin, a former Congressman and former majority leader of the House, Dick Gephart. There will be some lay people as well for a nice cross section of consumers, labor, providers, business and others.
Mayes: How can people learn more about American’s Agenda and the conference?
Thorpe: The executive director of American’s Agenda is Mark Blum. He can be reached at 202-262-0700 or at America’s Agenda.org.
November 27th, 2008 by Dr. Val Jones in Expert Interviews
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Happy Thanksgiving everyone – I thought I’d blog about food today, and to try to persuade you to trade that pumpkin pie for a glass of milk…
I learned some interesting things at the Dairy Science Forum on November 13th in DC. Dr. David McCarron presented some compelling data on the effects of the DASH diet on reducing blood pressure. The DASH diet is fairly high in dairy products (2-4 servings/day), fruits, and vegetables. In comparison with a low-salt diet (which reduces systolic blood pressure by an average of 1 point), the DASH diet can cause an average reduction in systolic blood pressure of ten points. If you have high blood pressure (and your kidneys are functioning normally) you probably shouldn’t worry all that much about the salt. It’s more important to stick with the DASH diet.
I interviewed Dr. McCarron about the role of dairy in blood pressure management. Here’s what he had to say:
Dr. Val: If salt isn’t the real enemy, and dairy can help to reduce blood pressure, why isn’t that message getting out?
Dr. McCarron: We have national nutrition policies in place that are old and out of date. The healthy eating paradigm – low fat, low sugar, low salt – was established 40+ years ago and when new evidence is obtained, it’s really hard to crack through that illusion of knowledge. There is excessive mistrust of new data because of the attitude that if it conflicts with our previous beliefs, it can’t be true. I believe that the Internet will be critical in allowing the evidence to bubble up. For example, a diet rich in dairy food is absolutely associated with a reduction in virtually all chronic medical conditions. We have data to support this for people of all ethnicities and from around the world. I think that consumers are looking for clarity and simplicity in their nutritional advice – and basically they need to know that a healthy diet requires 3-4 servings of dairy and 5-6 servings of fruits and vegetables/day. If you do that alone (along with regular exercise) you’ll be amazed by the results.
Dr. Val: What is the proposed mechanism by which dairy has all these positive effects?
Dr. McCarron: It’s almost impossible to nail down specific mechanisms because milk products contain so many ingredients (electrolytes, key vitamins, bioactive proteins, and essential fatty acids). Trying to understand which piece is impacting very complicated physiological control mechanisms within the body (that have 30-40 different vectors feeding into them) is extremely difficult. In fact, the permeatations make it almost impossible. We can’t come up with the proof that we do for drugs (which contain only one bioactive ingredient). What we do know, though, is that dairy is a vital component for chronic disease reduction and prevention. Unfortunately the policy people say, “you haven’t explained to me how this works, so I’m not going to consider it.”
Dr. Val: But what about the research suggesting that whey protein contains lactokinins that function similarly to ACE inhibitors (a type of blood pressure medicine)?
Dr. McCarron: That’s been known for over a decade. There’s no question that there are small peptides (proteins) in milk that have a positive impact on blood pressure, mood disorders, and weight reduction. The industry doesn’t want to talk about it because it makes milk sound like a drug, which isn’t effective marketing. Also the average consumer doesn’t have enough background to understand what that means (lactokinins have ACE inhibitor-like effects in vivo), so we need to simplify the message and disseminate it via the Internet.
References:
NEJM, 1998 Effects of Dietary Patterns On Blood Pressure
Am J Hyper, 2004 McCarron and Heaney
JAMA, 2002 Pereria et al
Science, 1984, McCarron et al
JAMA, 1996, Bucher et al
October 7th, 2008 by Dr. Val Jones in Expert Interviews, Medblogger Shout Outs
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Many thanks to my fellow blogger KevinMD who offered to host me during my period of blog homelessness. In this post, I interview Dr. Ken Thorpe about the real driver of healthcare costs:
About 75% of what we spend on healthcare is associated with chronically ill patients. That’s about 1.6 trillion dollars per year. Chronic disease accounts for the biggest source of spending in the healthcare economy, and it’s also the fastest growing – as more and more people are living with chronic illnesses. If we’re really serious about getting to the bottom of the healthcare affordability crisis, we’ll have to first address the chronic disease issue…
For the rest of the post, please click here.
September 14th, 2008 by Dr. Val Jones in Health Policy
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I posted this at Medpolitics.com today… but it is displaying some weird code, so I decided to repost it here.
***
For the first time in recent memory the Republicans and the Democrats are on the same page on a healthcare issue: the problem of chronic disease. Former Surgeon General Dr. Richard Carmona told me that chronic disease contributes more to healthcare costs than any other single issue, and that many chronic diseases are preventable through diet and lifestyle measures. Both political parties seem to agree that America must become a “wellness” culture. However, they don’t exactly agree on how that may be achieved. The Democrats would expand the government’s role in stimulating healthy behaviors while the Republicans would use market forces and grass roots efforts to encourage personal accountability.
WHAT THE DEMOCRATS SAY ABOUT CHRONIC DISEASE:
An Emphasis on Prevention and Wellness.
Chronic diseases account for 70 percent of the nation’s overall health care spending. We need to promote healthy lifestyles and disease prevention and management especially with health promotion programs at work and physical education in schools. All Americans should be empowered to promote wellness and have access to preventive services to impede the development of costly chronic conditions, such as obesity, diabetes, heart disease, and hypertension. Chronic-care and behavioral health management should be assured for all Americans who require care coordination. This includes assistance for those recovering from traumatic, life-altering injuries and illnesses as well as those with mental health and substance use disorders. We should promote additional tobacco and substance abuse prevention. (“Renewing America’s Promise,” pg. 10).
WHAT THE REPUBLICANS SAY ABOUT CHRONIC DISEASE:
Prevent Disease and End the “Sick Care” SystemChronic diseases — in many cases, preventable conditions — are driving health care costs, consuming three of every four health care dollars. We can reduce demand for medical care by fostering personal responsibility within a culture of wellness, while increasing access to preventive services, including improved nutrition and breakthrough medications that keep people healthy and out of the hospital. To reduce the incidence of diabetes, cancer, heart disease, and stroke, we call for a national grassroots campaign against obesity, especially among children. We call for continuation of efforts to decrease use of tobacco, especially among the young. (“2008 Republican Platform,” pg. 38).
Whichever party is elected this November, one thing is certain – more emphasis will be placed on encouraging Americans to adopt healthier lifestyles. The Partnership to Fight Chronic Disease is doing its part to coordinate these efforts and raise awareness of lifestyle modification programs that work. As for me, I’ve traded my car for a pedometer.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
