Currently, here in Grand Junction and at the state Legislature, talk of hospital and pharmaceutical costs remain center stage as policymakers and employers work to contain health care costs. However, the health-care cost problem transcends hospital and pharmacy prices. The largest factor in the health of the population and the resulting cost of caring for that population has nothing to do with hospital and drug prices. Indeed, the solution must include the individuals and the social factors that lead to chronic disease.

Our chronic disease epidemic is the proverbial elephant in the room. Despite $3 trillion spent per year, life expectancy in the United States has fallen for three out of the last four years. We have the most expensive health care system on the planet and our collective life expectancy is in decline. This is a mind-boggling failure and one rooted in an epidemic of chronic disease, a disproportionate focus on treatment versus prevention, and large discrepancies in social determinants of health. Remember, in the United States, zip code is the most powerful predictor of your life expectancy.

Hospitals and pharmaceuticals, while appropriate targets for our attention on health-care costs, do not have a causal relationship with epidemics and social determinants of health. If we are truly interested and honest with our endeavor to control health-care costs, we will boldly confront the most preventable elements of our chronic disease epidemic: tobacco, alcohol, obesity-related disease, and drug use. As per the Centers for Disease Control (CDC), the legal products at the root of much of the chronic disease are responsible for over $700 billion per year in added health-care costs.

Here in Mesa County, the health of our population is no different. Business owners, politicians, and citizens who are truly serious about controlling the cost of public and private health care must show leadership and disrupt the status quo.

Colorados physicians see the problems every day. As such, the Colorado Medical Society now supports taxing alcohol, tobacco and sugar-based beverages to directly address the sources of our chronic disease epidemic and the social determinants of health.

And now, I am helping to find sponsors for state legislation that builds on this policy such that we stop ignoring major elements of our health-care cost conundrum. We simply must address both sides of the health-care cost equation: delivery system reform and disease prevention. After all, the lowest price for a hospital or prescription drug is to not need one in the first place.

So heres a plan to change our current over-emphasis on treatment to more prevention:

Currently, our state ranks near the bottom with respect to consumption tax rates on alcohol and tobacco. Our alcohol taxes on spirits and beer rank about 46th in the country and our tobacco tax ranks 39th. Our obesity rates continue to climb triggering more diabetes, cancer, heart disease, and orthopedic problems. By simply increasing alcohol and tobacco consumption taxes to national medians and adding a one cent per ounce tax on beverages with added sugar, Colorado could pilot an innovative method to directly respond to our declining life expectancy and key drivers of increased cost.

Hospitals, places where chronic disease is often treated, are currently being taxed to help pay for Colorados new reinsurance program. Why would we not ask the commercial industries whose products cause the chronic disease to step up to the plate? Are we going to ignore this problem simply because it is unpopular to address the human behaviors that push us in the exact opposite direction that we need to go?

The proposed legislation would raise more than $400 million and the new revenue could not be used for the general fund. On the contrary, to successfully serve its purpose, the revenue must be used to address our chronic disease epidemic by addressing social determinants of health and by marketing healthy behavior.

Fifty percent of the funds would be delivered back to counties, indexed to poverty levels by zip code, for them to use on social determinants of health projects that each county would decide upon. The other 50% of the revenue would be directed back to individuals buying health insurance that meet healthy living parameters. Auto insurance appropriately rewards good drivers. Colorado, via this innovative design, could market and promote healthy living.

Your legislators need to hear the message. They need the political cover to support legislation that would bring this plan before the voters. Tell them its time to stop ignoring a large percentage of our health care cost problem with bold solutions that directly address our chronic disease epidemic.

Finally, if a statewide effort proves difficult at this time, Mesa County would benefit by leading the charge. Growing businesses, interested in moving to a healthy community, would take note of our comprehensive approach to solving the health care cost challenge. The problem requires innovation and bold policy otherwise we can continue to wallow in the expense of the status quo and our own denial.

Michael J. Pramenko, M.D., is the executive director of Primary Care Partners. He is chairman of the board of Monument Health and is a past president of the Colorado Medical Society.

See the original post here:
We need leadership to disrupt the status quo - The Grand Junction Daily Sentinel