Guest Opinion: Initiatives can help combat rising cost of medical care in the U.S.


April 13, 2014 

Nearly 2 1/2 centuries into the grand American experiment, the declining health status of significant cross-sections of the U.S. population reflects and contributes to a growing fiscal, moral and governance crisis that places the entire enterprise at risk.

Illustrative of this unsustainable arrangement is the rapid growth over recent decades of the medical care sector. As national spending approaches $3 trillion, health care consumes nearly one in every five dollars.

Fully 75 percent of this spending is for treatment of preventable chronic and related diseases, whose primary antidotes are eating better, moving more, eliminating tobacco, and moderating alcohol - and by changing the environments and incentives that encourage unhealthy behaviors.

Notwithstanding debates about the Affordable Care Act, in any scenario there will be increasing demand, and we are wise to concurrently address the social, cultural and economic drivers of our ever-sicker population, which will require ever more care on the "demand side" of the equation.

We will likely find that the most powerful long-term lever for assuring affordable and equitable access to care for all and the ultimate contributor to cost containment is to invest first and foremost in the drivers of the determinants of health and the factors that reduce health disparities.

We are seeing the emergence of thousands of independent, community-based, multisector, collaborative partnerships serving as innovation labs, working systemically to improve the health and vitality of people and places. One such partnership is the Creating Healthy Communities Summit, planned for next week in Boise and presented by St. Luke's Children's Hospital and the Blue Cross of Idaho Foundation's High Five Children's Health Collaborative with support from Saint Alphonsus, Boise Parks and Recreation, Valley Regional Transit, Idaho Smart Growth, Treasure Valley YMCA, COMPASS and others.

The credibility and power of these sorts of initiatives is to a great extent derived from the collaborative approach of participants. This body of work for the common good presents a powerful force capable of delivering the will to set good priorities, mobilize diverse assets, change practices and policies and make the investments that are critical for population health and American renewal.

As with the upcoming collaboration in Boise, leaders of the healthy community movement come from diverse backgrounds. They are locally focused innovators who value and engage participation across lines of politics, issue and generation.

Their initiatives, to get more people walking and to create more walkable communities, for example, appeal to very diverse groups, given the potential to prevent disease, promote health and reduce costs; improve workforce productivity; and drive economic development.

Solve for walkability, and you solve for many other issues. A walkable city is a resilient city.

We have an unprecedented opportunity to set the stage for a more robust economic future and to revitalize the processes of civic engagement necessary for a healthy democracy. What will be the legacy that is passed to our children and generations to come? How do we create communities that work for everyone?

Tyler Norris is vice president of Total Health Partnerships at Kaiser Permanente and will be a guest speaker at the Creating Healthy Communities Summit Thursday and Friday in Boise.

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