AAFP Takes Lead in Launching National Chronic Disease Coalition

By James Arvantes • Washington
5/25/2007

The AAFP has played a key role in launching a national coalition that has vowed to make the management and prevention of chronic disease a major issue in the 2008 presidential campaign.

AAFP President Rick Kellerman, M.D., of Wichita, Kan., explains why the work of the Partnership to Fight Chronic Disease fits with the concept of the patient-centered medical home while former AAFP President Warren Jones, M.D., of Ridgeland, Miss., looks on. Jones, who currently is executive director of the Mississippi Institute for the Improvement of Geographic Minority Health, also spoke during the event to launch the PFCD.

The coalition, known as the Partnership to Fight Chronic Disease, or PFCD, consists of more than 40 organizations that represent a diverse and powerful cross-section of business and labor groups, health professional organizations, community agencies, and consumer and other stakeholder groups. Coalition members -- including the Academy, which was represented by AAFP President Rick Kellerman, of Wichita, Kan. -- officially launched the PFCD on May 15 during an event at the YMCA National Capital here.

Former Surgeon General Richard Carmona, M.D., M.P.H., chairs the coalition, and Kenneth Thorpe, Ph.D., a former deputy assistant secretary for HHS who advised the Clinton White House on health policy, serves as its executive director.

The PFCD's mission is based on the following objectives:

educate the public about chronic disease;
mobilize citizens to call for change in how governments, employers and health institutions approach care for chronic disease; and
challenge state and federal policy-makers to make prevention and management of chronic diseases a primary concern.

Raise Public Awareness

"Right off the bat, we want to raise awareness about this issue among voters so they understand the link between chronic disease and health care expenditures," said Thorpe, chair of the Rollins School of Public Health at Emory University in Atlanta, at the launch event. "That means we will have to do some grass-roots educational efforts."

One of the PFCD's goals is to make the U.S. presidential candidates aware that chronic diseases are "key drivers" of health care costs, with the hope of convincing the nation's next president that the country needs a health care system that places a greater emphasis on prevention while providing "more effective clinical management of patients with chronic diseases," said Thorpe. The coalition plans to target key presidential primary states to generate attention and to influence the candidates' perceptions about the prevention and management of chronic diseases, he added.

"Our goal is to really restructure and reframe this debate about health care reform," said Thorpe, who moderated a panel at the launch event that included Kellerman and nine other speakers.

Kellerman said that "one of the problems with our current health care system is a fragmentation of care," a situation that should be addressed through a patient-centered medical home model.

"The American Academy of Family Physicians believes every American needs a personal medical home -- a personal physician who can help coordinate and provide comprehensive care as part of a health care team," Kellerman said. He stressed that the coalition "fits perfectly with the concept of the medical home."

"Family physicians across the country see patients every day who suffer from the end result of chronic diseases," Kellerman said.

Thorpe and coalition member Mark McClellan, M.D., Ph.D., a former CMS administrator, outlined what they called six "unhealthy truths" that are primarily drawn from CDC data.

Chronic diseases are the number one cause of death and disability in the United States, accounting for more than 1.7 million deaths each year, or seven out of every 10 deaths.
Chronic disease expenditures account for 75 percent of the nation's overall health care spending. For example, of the nearly $2 trillion the United States spent on health care in 2005, almost $1.5 trillion was spent on care for people with chronic diseases. For public programs, treatment of chronic diseases constitutes an even higher proportion of spending -- more than 96 cents out of every Medicare dollar spent and 83 cents out of every Medicaid dollar spent.
Two-thirds of health care spending during the past 25 years is due to a rise in the prevalence of treatable chronic disease.
The number of Americans who are obese has doubled since 1987, and this accounts for nearly 30 percent of the rise in health care spending.
The vast majority of chronic disease cases could be prevented or managed. The CDC estimates that 40 percent of cancer cases and 80 percent of heart disease, stroke and type 2 diabetes cases could be prevented if Americans quit smoking, ate healthier diets and made other behavioral changes to increase fitness. Moreover, chronically ill patients receive only 56 percent of clinically recommended health care services.
According to a recent national survey by APCO Insight, a global public affairs and opinion research firm, only a small fraction of Americans -- fewer than one in six -- are aware that chronic diseases account for about 70 percent of deaths and more than 70 percent of health care costs in the United States.

Coalition members are convinced that the PFCD's sheer size and scope will make it a capable and articulate voice during the 2008 U.S. presidential campaign.

"I don't think you could put together a broader, more effective, more powerful coalition of people who are dedicated, in a truly bipartisan way, to getting this done than we have put together here," said Thorpe.

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