Chronic conditions: Attacking our wallets

Jan Hudson

The Center for Healthcare Research and Transformation (CHRT) recently released a brief on the high cost of treating chronic conditions in Michigan. 

Annual spending for someone with a chronic condition can range from $3,800 to $38,000 more than for someone without a chronic condition. 

The brief reports that nationally 5 percent of the people with the most complex conditions account for 49 percent of U.S. health care spending, while 20 percent of the population account for 80 percent of total health care spending. 

Heart disease was by far the most costly chronic condition both nationally and in Michigan. Total annual spending per patient by Blue Cross Blue Shield of Michigan in 2008 for heart disease ranged from $16,900 to $41,000.

These costs document the importance of good public policy and strategies to address chronic diseases – both their prevention and their effective management. Prevention programs have certainly not been a priority for Michigan policymakers in the last several years as funding for programs has been dramatically reduced and programs have been eliminated.

In FY2008, the Healthy Michigan Fund, a key funding source for prevention and health education programs, provided $26 million for programs.  By FY2010, the amount had been reduced to $11 million, and the FY2011 Senate-passed budget further reduces program funding to $5.9 million. 

Many of these programs are considered ‘nice, but not essential.’ Cardiovascular health programs have been cut by nearly 50 percent, diabetes programs have been cut by more than 60 percent, and smoking prevention programs have been cut by 30 percent. Michigan needs to reverse this trend in disinvestment. 

Fortunately, the Affordable Care Act provides many opportunities to develop new strategies and demonstration projects to determine what works best. Policymakers must be encouraged to fund these opportunities and to make these critical investments.

In addition, the Affordable Care Act requires new health plans, beginning on or after September 23, to provide recommended prevention services (e.g., screenings for high cholesterol, high blood pressure, or diabetes) without any cost sharing by the patient.  In January, Medicare beneficiaries will have access to these recommended prevention services without any cost sharing.

Policymakers often talk about the need for personal responsibility in health matters, but people need the tools to be successful.  We cannot wait any longer to address the impacts of chronic disease.  As the CHRT brief notes, “chronic conditions are attacking our wallets,” particularly the state and the business community that pay for much of Michigan residents’ health care.

— Jan Hudson