The Best Kept Secret of Campaign '08: A Bipartisan Consensus on Health Reform

The Health Care Blog
February 5, 2008

The presidential candidates are doing a disservice to the voters and to themselves when they emphasize their differences over how to fix the broken health care system.  They can argue all they want about the likes of universal coverage, tax incentives, and employer mandates, but that cacophony obscures the fact that the candidates, regardless of party, actually share a major position on health reform.  Though little-noticed to date, there is a breakthrough bipartisan consensus that the key to health reform is to redirect the system to prevention and management of chronic illnesses.

This unanimity is huge.  Chronic diseases -- including conditions such as diabetes, asthma and hypertension -- are a major threat to both our health and our economy.  More than half of all Americans already suffer from one or more chronic ailments, and the rate is rising as the population ages.

And the price tag is staggering.  Some 80 percent of the more than $2 trillion in annual health expenditures already goes to taking care of patients with chronic diseases.   A recent Milken Institute study found that in 2003, chronic care cost the country $277 billion for treatment and another $1 trillion in lost worker productivity.  If nothing is done to halt the rise of chronic illness, the  Milken Institute projects that treatment and lost economic output will rise to $4.2 trillion by 2023.

And yet much of this cost is completely avoidable.

With preventive programs such as an early screening and health counseling, many chronic conditions can be delayed or prevented.  But sadly, our  health care is geared to sick care -- providing costly treatments rather than keeping patients healthy... It's as clear as day that better prevention and management of chronic conditions are absolutely key to health reform.  Keeping people healthy will save money and save lives.  So where in the din of disagreement over health reform are the presidential candidates on this? You wouldn't know it from the headlines, but they are in sync, Democrats and Republicans alike.  The bipartisan consensus around health reform emerged last fall at a forum in Boston sponsored by the New England Healthcare Institute.   The forum featured a panel of health policy experts from the presidential campaigns, and they all agreed that increasing health care coverage and controlling health care costs was necessary but not sufficient.  The real key, they agreed, was to constrain costs by tackling the chronic disease epidemic with prevention and management programs.

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