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Bad health hurts U.S. productivity

The rapid rise in preventable chronic diseases – such as obesity and heart disease – over the past 20 years is hurting U.S. economic productivity, escalating treatment costs and causing unnecessary suffering, a new report released Tuesday says.

That’s the bad news.

The good news, according to the report by the Santa Monica, Calif .-based Milken Institute, is that the trend can be turned around with healthy doses of prevention and early detection.

The report comes amid a national debate over health care, what it should include and who should pay for it – including government, private insurers, individuals and employers.

The Milken report is part of growing pressure at the same time to allocate more health dollars for prevention and early detection – rather than just treatment.

Currently, Medicare, the government’s health insurance program for seniors, and private insurers tend to pay more for surgeries and treatment procedures than for prevention counseling in a physician’s office. Such payment schemes are rooted in the health care needs of the population when the payment plans began decades ago.

The Milken Institute, a private economic think-tank, joins a growing chorus of researchers and public health experts arguing that such a system no longer serves the nation because the population is aging and because the incidence of obesity and preventable diseases among Americans of all ages, including children, has risen alarmingly in recent years.

The Milken report is one of the most ambitious attempts to quantify what is at stake in economic terms. It says that a reorientation toward prevention could avert 40 million cases of seven chronic diseases – cancers, diabetes, heart disease, hypertension, stroke, mental disorders and pulmonary conditions – in the year 2023.

That would reduce anticipated treatment expenses associated with seven chronic diseases and improve productivity by $1.1 trillion that year, it says.

The report does not put a price tag on prevention and early detection efforts. But the authors suggest that the economic gains and reduced treatment costs would more than pay for such efforts.

“Good health is an investment in economic growth,” said Ross DeVol, director of the Milken Institute’s Center for Health Economics and the lead author of the report titled “An Unhealthy America: The Economic Burden of Chronic Disease.”

The report recommends making rewards for prevention a part of any health care overhaul, and it urges a renewed commitment by policymakers to achieving a “healthy body weight.”

Reducing obesity to reasonable and achievable levels, the report says, could trim the incidence of disease by 14.8 million cases in 2023, saving $60 billion in treatment costs and improving the nation’s economic output by $254 billion.

Institute founder Michael Milken said the nation has made great strides in improving cancer death rates but was failing to avert preventable diseases.

Milken, a cancer survivor, pointed the finger at high-calorie, high-fat foods, and he noted the rapid advance of obesity, which is linked to many escalating diseases, including diabetes and hypertension.

He called for a moon-launch-type mission to fight disease through prevention efforts, such as diet and exercise, and to improve outcomes with early detection.

“We have not contained the containable,” Milken said at a Washington, D.C., news conference. This “doesn’t take new medical breakthroughs or new Nobel prizes to solve.”

The report was released at a Washington, D.C., news conference hosted by the Partnership to Fight Chronic Disease. Former U.S. Surgeon General Richard Carmona, who chairs the coalition, said the report helped by identifying the “cost burden” of chronic disease.

Public health experts said the report should help focus the attention of presidential candidates and policymakers to the need to emphasize and encourage prevention, early detection and effective disease management.


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