Health Care Costs and the Weather

Last week I attended an excellent forum on understanding and controlling health care costs in our state. As the presenters discussed the causes of health care costs from their various perspectives within the system, I couldn't help but think of a comment attributed widely, but not totally sourced to Mark Twain: "Everybody talks about the weather, but nobody does anything about it."

And so it often seems, health care costs like the weather are driven by forces beyond our control. Yet several at the meeting challenged this assumption. Many touted the big "Ts" - technology, transparency and treatment controls ("you can't always get what you want...") as possible solutions. But the real message was delivered in stark numbers by Emory University professor and researcher Ken Thorpe.

According to Thorpe, we are not victims of our own successes in doubling our life expectancy over the past hundred years with new and better medicines and diagnostics; rather we are victims of our own behaviors, what the experts call "modifiable popuation risk factors" such as obesity and smoking. Keneth Thorpe presented data that indicated that 30% - or one in three Americans - is now characterized as obese, up from 15% in the late 1970's. The cost of care attributed to diseases associated with this increase (diabetes, hypertension,etc) has risen from about 2% of total health care in 1987 to over 11 %. "Most of what is going on now to try to control health care spending is missing the target," Thorpe says. "Companies are tweaking co-pays and talking about health care savings accounts when really they need to redirect their focus to reduce the prevalence of obesity among children and workers."

To return to the cosmos metaphor... the fault "lies not in our stars, but in ourselves."