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U.S. health reform estimates need long view: study

By Susan Heavey
/ Source: Reuters

By Susan Heavey

The Congressional Budget Office may be missing potential savings from various health reform proposals by not looking at efforts to manage or prevent expensive, chronic conditions such as diabetes and heart disease, researchers said in a study released on Tuesday.

The study, published in the Tuesday edition of the Health Affairs journal, comes as members of the U.S. Congress prepare to return to Washington next week and again take up legislation to revamp the U.S. healthcare system.

President Barack Obama has made the overhaul a top priority this year, but debate has swelled in both parties in part over the CBO's early projections the Democratic plan could cost nearly $1 trillion.

Obama and other Democrats have argued the CBO does not factor in how improvements to care such as primary doctor visits, although costly at first, could improve people's health and lower costs over time.

The nonpartisan CBO, charged by Congress to estimate the cost of various programs, now uses a 10-year forecast that cannot look at the cost of programs aimed at diseases that can last for decades, researchers at the University of Chicago said.

Instead, the CBO should use methods that would weigh savings from earlier treatment and other intervention that could help reduce costly complications from conditions that arise when left untreated or improperly treated, they said.

Lawmakers need cost estimates that look at a period of 25 years for healthcare legislation, they said in their study, which was sponsored by diabetes drug maker Novo Nordisk A/S and looked at a scientific model to help estimate such costs for long-term diseases.

"Although this would not be necessary for the vast majority of cost estimates produced by the CBO, it would improve the information available when Congress considers health legislation with implications for the treatment of a relatively small number of costly chronic illnesses," they wrote.

In the study, researchers at the University of Chicago's National Opinion Research Center said new longer-term estimates would also help legislators and others estimate how having healthier, longer-living patients would affect costs.

In their model, the researchers used the example of diabetes, which affects nearly 8 percent of the U.S. population, or 24 million Americans, and factored in the costs of complications such as blindness, kidney failure and stroke.

They projected the disease would cost $336 billion a year 25 years from now. They then factored in the costs of prevention programs that would include medication and routine testing and how they could save money over time.

While such methods would need to be adjusted as treatments change, it could provide the CBO a starting point to look more long term, they said.