We’re mak­ing gains against ill­ness, but we could use more—and less

We’re gain­ing in fight against can­cer and HIV, but other gains are bad news

Modern Healthcare - - Front Page - DAVID MAY As­sis­tant Man­ag­ing Edi­tor/Fea­tures

As the health­care in­dus­try con­tin­ues to face plenty of func­tional, op­er­a­tional and clin­i­cal chal­lenges, it’s the same for our health prog­no­sis in gen­eral. Al­though there’s been good news in re­cent weeks on a num­ber of fronts, we, as a nation, face af­flic­tions that will prob­a­bly al­ways dog us.

Providers con­tinue to be con­founded by pa­tient-safety and qual­ity is­sues. Pa­tients en­ter­ing a hos­pi­tal are still too vul­ner­a­ble to con­tract­ing in­fec­tions they didn’t have upon ad­mis­sion or ex­pe­ri­enc­ing other life-threat­en­ing com­pli­ca­tions. Then there are over­doses of ra­di­a­tion in rou­tine med­i­cal test­ing. Wrong-site surg­eries. Dan­ger­ous drug in­ter­ac­tions. Be­cause we’re hu­man, such mis­takes will never dis­ap­pear, but we can and must con­tinue to de­mand an on­go­ing path to im­prove­ment.

At the same time, we can’t say there hasn’t been progress in­volv­ing ill­ness and dis­ease.

The Amer­i­can Can­cer So­ci­ety last month re­leased its an­nual re­port on progress made against one of the most dreaded di­ag­noses we can face. And slowly but steadily we’re win­ning this fight. Ac­cord­ing to the or­ga­ni­za­tion’s re­port Can­cer Sta

tis­tics, 2010, death rates dropped 21% for men and 12.3% for women from 1991 to 2006, which means that some 770,000 deaths from can­cer were pre­vented.

Screen­ing pro­ce­dures en­abling early de­tec­tion of can­cers are among the rea­sons cited for the gains as well as im­proved treat­ments. Here, it’s our on­col­o­gists and the rest of the provider team do­ing what they do best—sav­ing lives.

Smok­ing ces­sa­tion is an­other rea­son cited for the de­cline in can­cer rates, and the lat­est data from the Cen­ters for Dis­ease Con­trol and Pre­ven­tion also rep­re­sent good news, show­ing that adult Amer­i­cans have been steadily kick­ing the habit. Since 1965, the per­cent­age of adult cig­a­rette smok­ers has dropped by more than half, from 42% to 20% in 2007.

Last month also brought ex­cit­ing news in the fight to de­feat HIV/AIDS. Al­most daily dur­ing the XVIII In­ter­na­tional AIDS Con­fer­ence held in Vi­enna, there were re­ports of new drug com­bi­na­tions to help keep in­fec­tions in check, as well as other po­ten­tial break­throughs in the quest to block new cases of the virus. Re­mem­ber that it wasn’t so long ago when in­fec­tion with HIV was a quick death sen­tence. Again give thanks to the physi­cians and re­searchers for to­day’s long-term sur­vival rates.

We also know that in many na­tions, much of Africa for in­stance, the lack of re­sources to fight HIV means the out­look re­mains grim for the pop­u­la­tions of those more un­der­de­vel­oped re­gions. Even in our own coun­try dis­par­i­ties in treat­ment are ap­par­ent, one fac­tor that led the Obama ad­min­is­tra­tion to re­cently launch a new na­tional strat­egy to fight HIV.

Mean­while, the ad­min­is­tra­tion con­tin­ues to take a high-pro­file role, led by first lady Michelle Obama, in at­tempt­ing to budge an­other seem­ingly in­tractable pub­lic-health cri­sis: obe­sity.

On top of all the health prob­lems di­rectly linked to obe­sity in Amer­ica, and the eco­nomic toll as­so­ci­ated with them, there are other more in­di­rect costs that are quickly mount­ing as well.

As Mod­ern Health­care re­porter Shawn Rhea ex­plained in her Aug. 2 spe­cial re­port (p. 26), the sup­ply-chain costs tied to obe­sity are adding up, and much of the cost isn’t re­im­bursed. While spe­cific es­ti­mates of the to­tal tab are elu­sive, one source said the added costs of spe­cial prod­ucts such as over­sized wheel­chairs and other med­i­cal de­vices re­designed specif­i­cally for the mor­bidly obese have led to “sig­nif­i­cantly more” ex­pense for providers.

We ap­plaud the en­tre­pre­neur­ial spirit be­hind the com­pa­nies that have rushed to de­liver the vi­tal sup­ply of these jumbo prod­ucts, but just from a pub­lic-health per­spec­tive it would be nice if this lu­cra­tive mar­ket didn’t need to ex­ist.

Maybe one day it won’t.

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