Opinion — THE BIGPICTURE: Weighty advice for the future

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You've no doubt heard the adages before: An ounce of prevention is worth a pound of cure... A stitch in time saves nine. The directive embedded in both is to address an issue before it becomes a bigger problem.

Don't be surprised if these aphorisms represent the future face of long-term care policy. It's a no-brainer that delaying or preventing the common challenges of aging will help trim costs. An added benefit would be healthier lifestyles for millions of people. The concept makes sense at the most visceral level, and it's gaining traction among those in a position to drive change.
One such person is Ken Thorpe, a professor of health policy at Emory University in Atlanta. As a presidential adviser he got a first-hand look at the fiasco that was healthcare reform in 1993 and 1994. The insurance industry helped squash the effort with its "Harry and Louise" ad campaign. The ads showed a couple despairing over the plan's bureaucratic nature. If only they could have seen what was coming.
Since then, costs have soared and health insurance has moved beyond the reach of many more Americans – now an estimated 46 million people.
Thorpe is responding by enlisting others to help assault the healthcare system's real cost driver: chronic illness.
He has recently made presentations to leaders of both the Democratic and Republican parties that reveal several compelling points.
One is that that 75% of all healthcare costs are attributable to chronic diseases such as asthma, diabetes, heart disease and cancer. Another is that these ailments are linked to seven out of every 10 deaths. Obesity, which has doubled in 30 years, is by itself responsible for 30% of the increase in healthcare costs during that period. Currently, treatment of these diseases early on tends to be spotty at best.
Some of the presidential hopefuls are picking up the message. Sen. Hillary Rodham Clinton now uses Thorpe's statistics in speeches on her plans for healthcare reform. Barack Obama and John Edwards are putting these elements in their plans as well. Among Republican hopefuls, Tommy Thompson and Mike Huckabee are already on board.
Will hospitals and doctors be the initial targets? Probably. But guess who comes next? It's hardly a leap of faith to imagine this shift flowing to long-term care in the form of preventive care, combined with low-tech sensors that reduce the need for direct caregivers.
Unlike the failed healthcare reform movement of a decade ago, this new prescription for healthcare reform has legs among Democrats and Republicans. Prevention is no magic bullet. But it can make a big difference. And this time, Harry and Louise may not have much to kvetch about.

John O'Connor is the vice president of McKnight's Long-Term Care News. Contact him at john.oconnor@mltcn.com.