Chronic

Pat Hynes sent me an e-mail message:

Would love it if you could attend and blog about it ...
Where "it" was a lunchtime forum on the UNH campus devoted to a recent study of the economic burden of chronic disease on the United States and on the state of New Hampshire.

So, I'm like: "Really? Me?" But a good rule of thumb for bloggers is: when Pat Hynes invites you, go. Besides, there was a free lunch.

The main speaker was Ross DeVol of the Milken Institute, an economic think tank founded by Michael Milken. He was introduced by Mil Duncan of UNH's Carsey Institute; after his talk, Ned Helms of UNH's New Hampshire Institute for Health Policy and Practice, and UNH econ prof Bob Woodward offered their comments. (Update: Please note that Ross DeVol was the only participant speaking on behalf of the Milken Institute; Mil, Ned, and Bob were speaking for themselves or, as appropriate, their respective organizations.)

DeVol presented a massive Milken-funded study of how chronic diseases impact economic growth and health care spending. It was clear that a lot of money was, and is, devoted to running and promoting this study: we got a slick brochure describing the results of the research, and there's even a very professional website devoted to it.

The chronic diseases the researchers looked at were: (1) cancer; (2) diabetes; (3) heart disease; (4) hypertension; (5) stroke; (6) mental disorders; and (7) pulmonary conditions (mostly asthma). They estimated both direct costs due to the medical care of these conditions, and also indirect costs due to lost economic productivity; it turns out that the lost-productivity costs were greater than the treatment costs, and, for most of the considered diseases, much greater.

The study also broke things down by state, and we got a (again, slick and professional) handout showing how New Hampshire compared, chronic-diseasewise, against other states and the US generally.

There are a lot of reasons to be pessimistic about trends. As baby boomers age, they are—we are—projected to cause chronic disease cases to rise faster than population growth. Obesity drives a number of chronic diseases; since we're getting fatter, that also tends to make the rates go up. (Increased occurrence of Type 2 diabetes in our tubby youth was mentioned a number of times.)

The study contrasted their gloomy "if trends continue" scenario with what they called their "optimistic scenario": that (somehow) obesity, smoking, alcohol abuse, and illicit drug use all decline, while people exercise more, air quality improves, and medical care gets more effective at early intervention and medical costs decrease. This causes a significant improvement in the numbers; the savings run into the trillions of dollars.

This is where we verged into social engineering territory, because much of the underlying problem is due to what are euphemistically termed individual "lifestyle choices": diet, exercise, etc. Frankly, nobody seemed to have "solutions" that didn't involve a lot of massive, intrusive, and fundamentally obnoxious government action: varying combinations of nagging, taxation, and regulation. Twinkie taxes? Portion restrictions in restaurants? Outlawing the Hungry Man meal? Mandatory phys-ed in K-12? Given the massive, well-funded push behind this effort, I wouldn't be surprised by any proposal.

Unsurprisingly, the Milken Institute also funds the "activist" side of this coin: at the website for the Partnership to Fight Chronic Disease, you can sign the "Petition to the 2008 Presidential Candidates", which basically demands: Do Something, where the "Something" is left pretty vague.

In short, the forum was both educational and depressing. And it reminded me that I really should get to the gym more. Thanks to Pat for the invitation.


Last Modified 2007-11-09 11:31 AM EST