Sunday, 27 January 2013

The Rising Cost of Healthcare

The BBC has an interesting article drawing on the discussions at the World Economic Forum at Davos.

Its main thrust is that healthcare costs are driving the current economic downturn in the West. It claims that healthcare costs in the US amount to 20% of all government spending, whilst most European countries are spending around half of that treating the sick, elderly and infirm.

There should be little that is surprising in the article, healthcare costs are high because of social and government failures in keeping the population well. Never more has the old axiom 'an ounce of prevention is worth more than a pound of cure' been more appropriate than today. More so when Government austerity measures are all but designed to increase the healthcare burden through their social impact.

The greatest part of healthcare spending goes to treating chronic care conditions - and many of those conditions are preventable, most at next to no cost, some at minimal cost. Take three of the more common non-congenital chronic conditions: COPD, Type 2 Diabetes (T2D) and Asthma. The first two are almost exclusively a result of poor lifestyle choices - smoking, lack of exercise, poor diet - whilst the third is usually a result of poor environment. Already its become apparent that the UK's ban on smoking indoors has had a positive effect on child asthma. Its likely that future COPD rates will also be reduced by the same change. More so if measures were extended to all public places. Better, integrated transport systems would further improve the future diagnosis of Asthma.

Its entirely possible that T2D could be significantly reduced in the long term by making changes in school life. As little as 30 minutes activity a day and a better diet at school ages could reduced the number of children and young adults being diagnosed with what used to be called late onset diabetes - an old persons disease.

However, the government's austerity budget has meant that school meals are being provided at cheaper and cheaper rates (and lower and lower quality) by local councils, there's no money for more playgrounds and out of school activities to encourage a healthy lifestyle and the results are being seen in more and more morbidly obese children.

The answer being proposed for the UK is more insurance based healthcare - which clearly hasn't had a positive effect in the US. Its the wrong answer, especially when the costs of all this prevention are minimal compared with the cost of paying the long term cost of treating a patient.

Perhaps because the payback is so far into the future no British government - so focused on the short term - would risk its implementation. Storing up more and more trouble for the future...

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