PUBLIC HEALTH

Get Healthy Campaign

The Centers for Disease Control and Prevention recently launched the "Healthiest Nation Campaign," which seeks to promote efforts to improve the health of U.S. residents. The goal is to ensure that health is included in social policies at all levels of government, CDC director Julie Gerberding told USA Today. “We put way too much emphasis on treating disease rather than protecting health in the first place,” said Gerberding. “People are talking about health-care reform, but they're not really talking about health.” Disease management and prevention programs receive about five cents of every dollar spent on health care in the U.S., much less than many other countries spend on health promotion. Gerberding stressed that disease prevention programs should focus on the “things we need to do before we get to the doctor's office,” such as additional lanes for bicyclists and walking paths for pedestrians, more nutritious meal options in schools and public smoking bans. In addition, she said that expansion of health insurance to all residents would not necessarily ensure their health. “If you solve the problem of access, it at best would account for 25 percent of the health disparities we're seeing.” Most of the fix she said, is at the community, family and personal level.

SUBSTANCE ABUSE

Under-Treatment of Addiction

The Johns Hopkins University Hospital spent close to $50 million in 2002 to treat people who abused one or more drugs, according to a new study in the Journal of Substance Abuse Treatment. The study followed admissions from 1994-2002 for patients with co-occurring alcohol and drug addiction. Four usage patterns were reported: 49% used a combination of two or more drugs, 25% used alcohol only, 11.8% used opioids only, and 6.5% used cocaine only. Patients on Medicaid or Medicare represented 70 percent of these admissions. The cost of treating those abusing two or more drugs rose 119 percent over the course of the study while treating those using only opioids rose 482 percent over the eight-year period. The study also noted that both public and private insurers spend very little on addiction treatment, accounting for less than 1 percent of private claims and 2 percent of Medicaid claims.

HEALTH-CARE COSTS

Mandated Benefits and Premiums

Total spending on the health benefits mandated by Massachusetts accounted for 12 percent of health insurance premiums in the state, or $1.32 billion in 2005, says a report recently released by the state's Division of Health Care Finance and Policy. The review of mandated health benefits, required under the 2006 Massachusetts health reform law, covered the one-year study period from July 1, 2004, through June 30, 2005. "Although mandated benefits provide protections for insured populations, they may also impact the ability of health insurers to offer affordable health-care coverage options," the report stated. Five of the state's 26 mandates—maternity, mental health, home health, preventive care for children and infertility services—accounted for 80 percent of the total cost of the mandated benefits ($1.07 billion or 10 percent of premiums), according to the division report. The study noted that the federal government mandates some of the same benefits as Massachusetts, such as maternity coverage, which accounts for one-third of all spending on Massachusetts mandates. It is unlikely that insurers would choose not to cover popular benefits such as mental health or diabetes care, even in the absence of a state mandate. While most of the state's mandates appear to be cost-effective, state officials said, it may be appropriate to consider removing mandates for benefits that no longer are the standard of care, such as bone marrow transplants for breast cancer.