Date: October 10th, 2013
More than 133 million Americans live with a chronic condition like diabetes or heart disease. As the population ages, that number is expected to climb to 171 million by 2030. Advanced age is the single greatest risk factor for many chronic conditions. However, the illness, suffering, and premature death caused by chronic diseases are often accelerated by risk factors that can be prevented like a lack of physical activity, poor nutrition, and tobacco use.
As the chronic disease epidemic in the U.S. worsens, we need laws that will give Congress the information it needs to understand the true value of passing prevention-focused legislation. Preventing or delaying the start of new chronic disease cases, and slowing the progress of existing cases, will not only improve the health of many Americans but will also reduce healthcare costs.
Pulling back the curtains
We all hope that our representatives and senators have the data they need to make decisions on health polices, but you may be surprised to learn that the office in charge of providing that information does not currently give Congress a complete picture of the long-term savings of preventive interventions.
The Congressional Budget Office, or CBO, is responsible for economic forecasting, fiscal policy analysis, scoring, and cost projection. CBO’s purpose is to allow Congress to make informed choices regarding spending, taxation, and the handling of the federal deficit or surplus. CBO provides information to members of Congress and their staff through annual reports and other written estimates of the cost (score) of every bill approved by a Congressional committee and on its way to a vote. These scores show how a bill would impact spending or revenues.
However, these scores only look 5 and 10 years into the future. Research has shown that certain expenditures for preventive medicine produce savings when considered in the long-term, but those savings are not always obvious when only looking at 5 and 10 years out—as far as the CBO scoring goes. This makes it hard to pass bills that require substantial upfront investments in disease prevention, but that do not yield fairly immediate returns.
Mh2>Opening the Window Recognizing the need to focus our healthcare system on wellness and disease prevention in order to contain potentially skyrocketing healthcare costs, forward-looking members of the House of Representatives and the Senate took note of the need for accurate budget scoring. These legislators introduced a bill that requests CBO to estimate the long-term health savings that are possible from preventive health initiatives.
The Preventive Health Savings Act (H.R. 2663/S. 1422) defines preventive health as “an action designed to avoid future healthcare costs that is demonstrated by credible and publicly available epidemiological projection models.” Acceptable projection models would include data from clinical trials or observational studies.
The Act also requires that CBO conduct an initial analysis to determine if a prevention bill would lead to substantial savings beyond the normal 10-year scoring window. In addition, the Act allows leaders of budget or health-related Congressional committees to request additional analysis of the 10 to 20 year window and 20 to 30 year window. This is a major step forward in recognizing savings.
Over 50 organizations, representing healthcare groups, associations, patients, and employers support the legislation. The Alliance for Aging Research is one of these organizations and we urge you to reach out to your member of Congress and Senators to let them know that you believe that prevention and wellness are critical to the nation. Encourage them to join as a sponsor of The Preventive Health Savings Act—H.R. 2663 in the House of Representatives or S. 1422 in the Senate. If enacted, the Act will ensure that the government has the authority it needs to use robust data in its decision-making so that sound preventive health policies are given a fair chance in Congress.