Chronic diseases such as high blood pressure and diabetes account for over 85% of the $2.3 trillion annual healthcare expenditure. This includes dealing with the acute complications of these diseases. A recent article in Health Affairs directs attention to the need for reorganizing our healthcare delivery system to better handle the management of chronic diseases. Pointing out that “it takes nearly eleven hours per day for a lone clinician to provide good chronic care to the average panel of patients—a time commitment made impossible by shortages of primary care doctors,” the article highlights the benefits of the Chronic Care Model (CCM) where multidisciplinary teams use evidence-based protocols to manage patients with chronic diseases.

Moving the Chronic Care Model from a theoretical framework to a reality that can be replicated on the ground by healthcare providers can be a great challenge and a potentially expensive undertaking. Will the benefits outweigh the costs of care delivery reorganization? What is the goal exactly? Is it to reduce healthcare costs or pain and suffering? Is it to prolong life or increase quality of life? How do you measure quality of life anyway?

I think answering the above questions requires a little soul searching and introspection for patients, policy experts, and healthcare providers but trying to address them can set a more realistic tone when mulling over the current swarm of healthcare reform proposals. The realists are beginning to realize that there may be no perfect solution that can make everyone happy but for some, to quote Neil Peart, “the future does not have to contain any flaws until it becomes the present.”

Filed under: Health Policy