Aging Options

Controlling diabetes can save everyone money (even those who don't have it)

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This blog has covered stories about Concierge doctors before (see storyhere), we’ve even posted a story by a Concierge doctor before (see story here) and of course Seattle Elder Law Attorney, Rajiv Nagaich often includes Dr. Mixon as a guest for client appreciation events, so I’m not unaware of boutique medicine or private practice medicine as they are called.  But a Forbes story talked about concierge medicine in a way I was completely unfamiliar with.  What interested me was that it wasn’t about doctors at all.  It was about a special group of community health care workers.

Why do we even need to be having a discussion about health care workers?  The United States spent almost $3 trillion on health care in 2012.  The statistics for that amount of money are staggering (the Forbes article is a good source for some of them) but what I as a tax payer am concerned about is that by one estimate we spend an extra half-trillion dollars each year and we get average results for that money.  That’s like buying a Volkswagen for the cost of a Lamborghini.

The problem according to Dr. Ezekiel Emmanuel is that 10 percent of the population accounts for approximately two-thirds of total health care costs (over $1 billion).  Some of these costs are the result of a single high-cost event such as cancer, a major accident, or an extremely premature birth and won’t be impacted for the most part by interventions.  Another third have severe diseases that are rarely altered by interventions.  Emmanuel’s focus was on the third level.  These individuals could benefit from interventions.  An example used in the article is an individual with diabetes.  Diabetic costs, while higher than average health care costs, don’t begin to soar out of sight until the individual has to have a leg amputated or experiences a heart attack, stroke or kidney failure.  These major complications cause costs to rise dramatically.

Diabetes can be effectively managed with low cost medicines but patients must follow treatment plans. Maybe the patient doesn’t do so because they haven’t been identified as having the disease, or they can’t get transportation to a health facility or someone needs to monitor them to ensure compliance with treatment.

Emmanuel suggests one option is to have community workers target individuals in that group.  The Centers for Disease Control and Prevention (CDC) says that there is “an emerging body of literature …to support the unique role of these community workers and advocates in strengthening existing community networks for care…”  The CDC seems to echo Emmanuel’s stand and views these community health care workers as a way to build a bridge between communities and the health care system and help reduce health care and personal costs.

Around 24.4 million Americans have diabetes according to the International Diabetes Federation (IDF).  About one in 10 individuals in the world have diabetes but in America it’s estimated that one in eight has it and due to our obesity problem, the number is expected to rise.

By some estimates, one in every three nursing home resident has diabetes.  Getting containment of diabetes can help save the government money, prevent diabetics from losing their assets due to long term care needs and keep them out of a nursing home.

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