The irony illuminated by the Health Affairs article is that there are "truly massive opportunities to improve the effectiveness and value and cost of health care, which are just not being pursued in public policy," said Henry E. Simmons, president of the National Coalition on Health Care, a nonpartisan group that promotes high-quality, universal care. "That's a very sad statement."
Simmons and others pointed to diabetes as the most obvious example of where the United States could drastically reduce costs and improve patients' health by following well-established treatment guidelines on diet, exercise and preventive measures, such as eye and foot exams.
Thorpe agreed that a stronger emphasis on prevention and following "best practices" guidelines would likely slow the growth rate in health spending and improve overall health.
"This is very much of a reactive system; we wait for somebody to get sick and show up" at a doctor's office, he said. "What's needed is a much more proactive approach."
Many of the 15 costliest maladies could be prevented or managed with simple, affordable steps.
However, the data also suggest that some medical procedures and prescription drugs have been worth the increased expense, Thorpe said.
Although the prevalence of heart disease has remained constant, 70 percent of the rise in cost per treated case was attributed to more expensive prescription drugs and procedures such as angioplasty and cardiac catheterization. At the same time, death rates associated with heart disease continue to go down, the article noted.
In many other areas, though, Thorpe found that "we do a substandard job of providing care" or identifying why certain maladies are on the rise. Two of the biggest mysteries, he said, were the "explosion" in patients reporting back pain and pulmonary cases, such as asthma and allergies.
