Mass. Town Takes Steps To Trim Fat (Really), Health Care Costs

“Kelle Shugrue's 7-year-old son eats fresh fruit and vegetables at his public school, rides his bike along neighborhood paths and walked to school last week as part of a community effort to get kids moving. The Shugrue family lives in Somerville, Mass., a Boston suburb hailed by health advocates for its seven-year investment in programs fighting childhood obesity and encouraging healthful living. The model program is beginning to be replicated around the country, a small start on a huge task: preventing the onset of chronic diseases such as diabetes and heart disease that now account for 75% of the nation's health care spending. As the Obama administration and Congress tackle an overhaul of the health care system, chronic disease looms as a major impediment to controlling costs. According to the Partnership to Fight Chronic Disease, 45% of Americans — 133 million people — suffer from at least one chronic disease such as asthma or hypertension. Because many of the conditions are brought on or exacerbated by obesity, which has doubled nationwide since 1987, experts say they can be prevented or at least better managed. ‘Improving the management of chronic disease is a critical component of our plan to drive down the skyrocketing cost of health care,’ says Nancy-Ann DeParle, director of the White House Office for Health Reform. ‘Two-thirds of Medicare spending is for beneficiaries with five or more chronic conditions.’ A down payment is coming. In February, as part of the $800 billion economic stimulus package, Congress approved $1 billion for disease prevention and wellness programs. A third of that money is slated for immunizations; two-thirds for new programs to prevent chronic diseases. The Department of Health and Human Services plans to announce early this summer how it will use that new money. ‘We want to help prevent disease and illness before Americans end up at the doctor's office or the emergency room,’ says Nick Papas, a department spokesman. Experts at the disease partnership and in Congress say controlling chronic disease requires a two-pronged approach: preventing diseases before they begin and doing a better job helping patients manage their chronic conditions once they develop. The issue will be up for discussion in the Senate on Tuesday when Finance Committee Chairman Max Baucus, D-Mont., holds the first of three roundtable discussions on health care reform. The subject of the session, which will include insurance company CEOs, doctors and nurses, and policy analysts, is how to make the health care delivery system more effective, including by better managing chronic care. Jeffrey Levi, director of the non-profit Trust for America's Health, is more focused on solving the problem before it begins. Levi says he's sure changes to the health-care system will include funding and programs to prevent chronic disease. That wasn't the case in 1993-94, during the last overhaul effort, when he said public health advocates were ‘banging at the door’ to get heard. ‘I am very confident (legislation) will include a serious commitment to public health and prevention,’ Levi says.”

http://www.usatoday.com/news/nation/2009-04-20-chronic_N.htm