AN UNHEALTHY AMERICA: The Economic Burden of Chronic Disease

In October 2007, the Milken Institute published an eye-opening report authored by Ross DeVol and Armen Bedroussian. (You can find it in the Reports section of their website) It provides a comprehensive state-by-state look at the impact of chronic disease in America, what will happen if we continue our unhealthy behavior, and charts new courses to save lives and increase productivity and economic growth.

The authors don't waste any time pointing out the magnitude of the problem we face. Here is an excerpt from their introduction to the report: "More than half of Americans suffer from one or more chronic diseases. Each year millions of people are diagnosed with chronic disease, and millions more die from their condition. By our calculations, the most common chronic diseases are costing the economy more than $1 trillion annually—and that figure threatens to reach $6 trillion by the middle of the century. Yet much of this cost is avoidable. This failure to contain the containable is undermining prospects for extending health insurance coverage and for coping with the medical costs of an aging population. The rising rate of chronic disease is a crucial but frequently ignored contributor to growth in medical expenditures."

To quantify the potential savings from healthier lifestyles and plausible but modest advances in treatment, the authors compared a“business-as-usual” baseline scenario with an optimistic scenario that assumes reasonable improvements in health-related behavior and treatment. The major changes contemplated here are weight control combined with improved nutrition, exercise, further reductions in smoking, more aggressive early disease detection, slightly faster adoption of improved therapies, and less-invasive treatments. The impacts of these factors vary widely by condition—gains against diabetes depend largely on reductions in obesity, while colon cancer advances depend heavily on wider early screening. A complete description of the assumptions on which these scenarios are based can be found in the full report.

Across the seven diseases, the optimistic scenario would cut treatment (direct) costs in 2023 by $217 billion (figure ES-1). And the cumulative avoidable treatment costs from now through
2023 would total a whopping $1.6 trillion. Note that this would be a gift that keeps on giving, saving hundreds of billions annually in the years beyond 2023.