We can help people now, or ponder later what we could have done for them

It is no secret that this country spends more money per person on medical care than any other country in the world. In the past 15 years since last time we tried to enact comprehensive healthcare reform, I have witnessed small and large businesses crumble under the cost of rising healthcare premiums. I have seen the percentage of GDP spent on healthcare skyrocket to 17 percent. And I have watched old and young alike lose their houses due to exorbitant medical costs. Yet despite all this, we continue to rank near the bottom in quality of care of any industrialized country. To me, this is unacceptable.

The problems with our health system are extremely complex and the solutions are no less complicated. But one thing is clear: While we are spending more money than other nations, we are not providing the American public with the right kind of care: preventive care. Studies have shown that citizens in our country do not have the same easy access to preventive care that citizens of other nations enjoy. This lack of access definitely impacts our spending. Think about it: If we spent our dollars on the kind of care that prevents us from getting sick in the first place, from ever getting diabetes or from suffering the effects of heart disease, we could save billions.

This month, the Partnership to Fight Chronic Disease reported that money spent each year in the U.S. treating patients with one or more chronic diseases is nearly identical to the nation’s federal deficit of $1.65 trillion. For every dollar we spend on Medicare, 96 cents goes to treating chronic disease. The numbers are similar for Medicaid, where 83 cents per dollar is spent on the treatment of chronic disease. According to the Centers for Disease Control and Prevention, 1.7 million Americans die due to a chronic disease every year. That is 70 percent of all deaths in the United States. It is no surprise, therefore, that there is not a day that has gone by where I have not heard from a health professional who demands more and better prevention efforts.

I’m not going to say we haven’t stressed prevention at all. In fact, we have some of the best cancer screening programs in the world and the lowest smoking rate. I don’t think it’s a coincidence that from the pink ribbon movement to the anti-smoking campaigns we have invested time and money in prevention and seen a great result. While these efforts are on the right track, we still have much more work to do.

In stark contrast to those successes, for example, is our performance on indicators including asthma mortality rates and survival after kidney and liver transplants. Only the United States has seen asthma mortality rates increase over time; they are now higher than in the United Kingdom and Australia. The survival rate after kidney transplants in the United States was 11 percentage points lower than the country with the highest survival rate.

But perhaps the most alarming epidemic that our nation is facing is the obesity epidemic. In my home state of New Jersey, 14 percent of our children are clinically overweight. A report conducted by Trust for Americas Health in 2008 highlighted all the potential problems these children will have to face during the course of their lifetime. Childhood obesity can lead to a myriad of health problems including high blood pressure, Type 2 diabetes, joint problems and depression, just to name a few. This epidemic alone has the potential to cripple our healthcare system if we do not take measures to address it.

That is why in the America’s Affordable Health Choices Act (H.R. 3200) I helped author, I made it my mission to realign incentives for both primary prevention — encouraging individuals and communities to avoid disease through evidence-based interventions — and secondary prevention, which involves helping chronically ill patients more effectively manage their disease to avoid costly complications.

In H.R. 3200 we propose achieving this goal through incentive programs, such as eliminating co-pays for preventive services for those on Medicare. We increase the reimbursements to doctors who provide preventive services so they have the financial ability to sustain high-quality care practices. And we eliminate the donut hole for prescription drug coverage for those on Medicare Part D, because we know that being able to afford your medication means better compliance and prevents more serious consequences and complications down the road.

Finally, we establish a wellness and prevention fund that aims to promote prevention and wellness programs. Communities will be able to apply for grants to implement evidence-based prevention programs that have been proven in the past to be successful. With this funding, we will be able to reach areas of the country that have very little access to preventive services and will start moving the ball forward on creating a healthier nation.

The reality of our failing healthcare system is staggering and goes to the core of my mission in Congress to pass comprehensive healthcare reform and improve our ability as a society to live healthier and more productive lives. But health reform is not just about improving our healthcare delivery system. It is also about making our nation healthier and I for one am done saying to myself “Had I only ...” The time to act is now. Our constituents — the citizens of this great nation — can wait no longer. 

Pallone chairs the Energy and Commerce Committee’s health subcommittee.