Tuesday, June 17, 2014

Personal Responsibility Can Lower Health Care Costs

By Elizabeth Torres, MD
President of the Harris County Medical Society
Internal Medicine Physician 

Personal responsibility is something we do every day, such as choosing to wear a helmet while bicycling or wearing a seat belt.

Studies estimate that 25 to 87 percent of health care costs are attributable to lifestyle choices, depending on how costs are measured. The $2.8 trillion in health care costs in 2012 is a lot of money. As a physician, I personally have seen many patients with genetic predispositions for diabetes, high blood pressure, obesity, heart disease, and the like, but by making healthy lifestyle choices, they have not succumbed to these diseases.

The Centers for Disease Control and Prevention (CDC) states that from 1935 to 2010, the primary cause of death has been heart disease, cancer, stroke, and chronic lung disease. It would seem that nothing has changed since 1935. However, the numbers tell a different story.  In 1983, 60 percent of deaths were caused by heart diseases and cancer, and in 2010 that percentage dropped to 47 percent. Several factors are key to this improvement, but none more so than the reduction of tobacco usage. Smoking cessation can decrease your risk of heart disease within two years of stopping and is associated with reduced risk of lung and other cancers. CDC states that starting in 2002, the number of former smokers has exceeded the number of current smokers.

Yes, there are genetic causes of cancer, but these account for only 5 to 10 percent of cancers, says the American Cancer Society. Also, getting older is associated with increased risk of illness, but we have seen a huge increase in people living well into their 90s. I have a 95-year-old patient who, until a recent fall, was driving and exercising daily, and volunteering regularly.

Some have pointed out that much of our health care cost is driven by addictive behavior. In 2005, federal and state governments spent $207.2 billion on health care costs relating to addiction. However, with the help of a physician, many of these patients can and will make necessary changes in their health. As these patients become healthier, there is also an immediate cost benefit. One study found that those who received treatment for their addictions had a 35-percent reduction in hospital stays, 39 percent fewer emergency room visits, and a 26-percent reduction in total medical costs.

Behavior can be modified. Just look at television’s The Biggest Loser, in which people are making a choice to improve their health. Obesity is responsible for 27 percent of the growth in health care spending. According to the Texas Comptroller’s Office, obesity cost Texas businesses an estimated $9.5 billion in 2009, and the cost is projected to rise to $32.5 billion in 2030.

Improving your health and lowering your health care costs are the ultimate goals of taking personal responsibility for your health. We know not everyone is willing to accept his or her role in health care, but any success in increasing the number of compliant patients will decrease health care costs and improve the quality of those individuals’ lives.

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