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Major Stakeholders in Health Reform Debate Call for Improvements in Scoring of Congressional Health Care Proposals

Benefits of Promoting Health and Wellness and Reducing Common and Costly Chronic Disease Not Fully Captured in Current CBO Estimates, Group Says to Senate and House Leadership

WASHINGTON, April 22 /PRNewswire-USNewswire/ -- More than 100 members of the Partnership to Fight Chronic Disease (PFCD) - an organization representing some of the nation's biggest voices in health care - today called on leaders in Congress to encourage updates in the manner in which the Congressional Budget Office (CBO) produces estimates for the cost of legislative proposals in health care. Specifically, they called out limitations in the current methods that, once corrected, would more accurately recognize the value of health care efforts aimed at attacking a significant driver of health care costs: the unchecked growth in common and costly chronic diseases, and related problems such as obesity.

In a letter to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid, the 150 partners and affiliated organizations that signed the letter ask that, "As our nation considers comprehensive health reform proposals, we hope that you will encourage the Congressional Budget Office to address barriers to recognizing the economic value of prevention and chronic disease management."

The group outlined several recommendations for updating the manner in which CBO scores health care proposals including:

  • A revision of "baseline" cost estimates to take in to account the deteriorating health status of the population and the estimated impact of this trend on spending in the years ahead
  • The ability to score savings beyond the commonly-accepted 10-year scoring window in order to sufficiently capture the long-term value of population health improvement programs
  • An estimate of the broader economic impact a policy change to promote population health will have on productivity, and ultimately, the economy

In particular, the group said that it wants to encourage the CBO to find ways to incorporate the benefits of targeted interventions with proven success, as identified in the growing body of research on this issue, and estimate what the impact of these changes could be over the short and long-term.

Chronic diseases, such as diabetes, heart disease, are responsible for seven out of 10 deaths and affect more than 130 million Americans. The annual economic impact on the U.S. of the seven most common chronic diseases is estimated to be $1.3 trillion, which could balloon to nearly $6 trillion by 2050.

Full text of the letter to Speaker Pelosi and Senator Reid follows.

About the Partnership to Fight Chronic Disease:

The Partnership to Fight Chronic Disease (PFCD) is a national and state-based coalition of patients, providers, community organizations, business and labor groups, and health policy experts committed to raising awareness of the number one cause of death, disability, and rising health care costs in the U.S.: chronic disease. For more information about the PFCD and its partner organizations, please visit:

April 21, 2009

Dear Speaker Pelosi and Majority Leader Reid:

As members of the Partnership to Fight Chronic Disease (PFCD), we thank you for your leadership in Congress and support of President Obama in making health care reform a priority in 2009.

When it comes to the health of the American people, our nation currently faces a crisis. Despite all the resources being spent on health care in the United States, many Americans struggle with their health. Millions suffer from common and costly chronic health conditions such as diabetes, heart disease, and obesity. The rapid growth in these problems has caused individual health costs to soar, undercut U.S. competitiveness and burdened the public health insurance infrastructure.

Spending on patients with one or more chronic diseases now represents more than 75 percent of total spending on health care in the U.S., and even more in public programs such as Medicare and Medicaid. Until we address the true causes of this crisis, we will never be able to slow spending or make health care more affordable. Nor we will have a workforce - or an economy - that can perform to its fullest potential.

The PFCD, a national and state-based coalition of hundreds of patient, provider, community, business and labor groups, is committed to raising awareness about this issue, while also providing commonsense, bipartisan solutions to help solve the problem. We believe that investing in prevention and disease management will save lives and money now and well into the future. Recognition of the opportunity to achieve the long-term benefits of investment in these areas would provide a positive framework for health policy decisions.

As our nation considers comprehensive health reform proposals, we hope that you will encourage the Congressional Budget Office to address barriers to recognizing the economic value of prevention and chronic disease management. There are three key points that lead to insufficient recognition of the opportunities offered by investments in prevention and disease management:

  • The current government scoring windows cannot sufficiently capture the long-term value of population health improvement programs aimed at wellness and prevention.
  • Health care expenditure estimates depend critically on the assumptions made in the baseline, including projected changes in the current health status of the population and the estimated impact of health status trends. Currently, these assumptions are not transparent.
  • CBO scoring does not currently include analysis of the broader economic impact a policy change will have through changes in population health and productivity. Estimates of this societal cost impact would be of great value to legislators.

Such a holistic and comprehensive approach to reform is the only way that we will truly help improve Americans' health, spend our limited health resources more wisely, and boost our economy.

Thank you, in advance, for your support.


The undersigned Partnership to Fight Chronic Disease national and state partners and other concerned organizations (see full list below)

    National partners and other concerned organizations:

    AdvaMed (Advanced Medical Technology Association)
    Alliance for Aging Research
    Alzheimer's Foundation
    American Academy of Nurse Practitioners
    American Academy of Nursing
    American College of Physicians
    American College of Preventive Medicine
    American Dietetic Association
    American Osteopathic Association
    American Pharmacists Association
    American Society of Health-System Pharmacists
    Arthritis Foundation
    Cleveland Clinic
    Community Health Charities of America
    The COSHAR Foundation
    DMAA: the Care Continuum Alliance
    Easter Seals
    Healthcare Leadership Council
    Health Dialog
    Intercultural Cancer Caucus
    IHRSA: International Health, Racquet & Sportsclub Association
    Marshfield Clinic
    Medical Fitness Association
    Men's Health Network
    Milken Institute
    National Alliance for Caregiving
    National Alliance on Mental Illness
    National Association of Chronic Disease Directors
    National Business Coalition on Health
    National Changing Diabetes(R) Program
    National Family Caregivers Association
    National Health Foundation
    National Latina Health Network
    National Multiple Sclerosis Society
    National Patient Advocate Foundation
    Novo Nordisk
    Park Nicollet Health Services
    Pharmaceutical Research and Manufacturers of America
    Pharos Innovations Prevent Blindness America
    Self chec, Inc.
    YMCA of the USA

    State partners:

    Arkansas Respiratory Health Association
    Lupus Foundation of America, Arkansas Chapter

    Alliance of Health Disparities
    Colorado Cross Disability Coalition
    Colorado Gerontological Society
    Lupus Foundation
    Mission Medical Clinic
    National Association of Hispanic Nurses
    National Alliance on Mental Illness
    Rocky Mountain Stroke Association

    AFSCME Council 31
    Arthritis Foundation of Greater Chicago
    Community Health Charities Illinois
    Mental Health Summit
    Midwest Business Group on Health
    Mount Prospect Chamber of Commerce
    NAACP Lake County
    Springfield YMCA
    United Way of Lake County

    Arthritis Foundation
    Community Health Charities of Iowa
    Iowa Biotechnology Association

    Maryland Academy of Family Physicians

    American Cancer Society of Minnesota
    Arthritis Foundation, North Central Chapter
    Minneapolis Urban League
    Sabathani Community Center
    United Cerebral Palsy of Minnesota

    New Hampshire
    Advanced Laser Therapy
    AIDS Services for the Monadnock Region
    Council for Children and Adolescents with Chronic Health Conditions
    New Hampshire Association for Acupuncture and Oriental Medicine

    New Jersey
    Action Cystic Fibrosis
    Carpenters Fund of New Jersey
    HealthCare Institute of New Jersey
    Juvenile Diabetes Awareness Council of New Jersey
    Lung Cancer Circle of Hope
    Mental Health Association in New Jersey
    New Jersey Association of Mental Health Agencies
    New Jersey Association of Osteopathic Physicians and Surgeons
    New Jersey Hospital Association
    Partners in Care
    Steamfitters Local 475

    North Carolina
    Alliance of Disability Advocates
    Arc of North Carolina
    Autism Society of North Carolina
    Children and Family Services Association of North Carolina
    Easter Seals UCP North Carolina
    National Alliance on Mental Illness-NC
    National Association of Social Workers-NC
    National Multiple Sclerosis Society, NC Chapters
    North Carolina Mental Health Association
    North Carolina Psychological Association

    The Academy of Medicine of Cleveland & Northeastern Ohio
    Area Health Education Centers - Ohio
    Statewide Program
    Arthritis Foundation of Central Ohio
    Chris Holland, Oregon City Schools, Ohio
    Cleveland Clinic
    Columbus Public Health
    County Commissioners Association of Ohio
    David C. Epstein M.D. MBA
    Fairhill Partners
    The Free Medical Clinic of Greater Cleveland
    National Alliance on Mental Illness Ohio
    Ohio Alliance of YMCAs
    Ohio Association for Health, Physical Education, Recreation & Dance
    Ohio Association of Free Clinics
    Ohio Association of School Nurses
    Ohio Asthma Coalition
    Ohio Dietetic Association
    Ohio Nurses Association
    Ohio Osteopathic Association
    Ohio Public Health Association
    Stark Prescription Assistance Network
    Ohio State University Medical Center
    Prevent Blindness Ohio
    United Cerebral Palsy of Central Ohio
    University of Toledo

    South Carolina
    Black Nurses Association of South Carolina
    Chi Eta Phi, Delta Eta Chapter
    South Carolina Diabetes Today Advisory Council
    South Carolina Public Health Institute
    United Way Association of South Carolina
    YMCA of Greenville

    AIDS Resource Center of Wisconsin
    Metropolitan Milwaukee Association of Commerce
    Wisconsin Association of Health Underwriters
    Wisconsin Dietetic Association
    Wisconsin Manufacturers and Commerce

cc: Douglas Elmendorf, Director, Congressional Budget Office; Keith Fontenot, Associate Director for Health Programs, Office of Management and Budget; Bob Kocher, Special Assistant to the President for Health Care, National Economic Council; Nancy-Ann DeParle, Director, White House Office of Health Reform; Senate Health, Education, Labor, Pensions Committee; Senate Finance Committee; House Ways & Means Committee; House Energy & Commerce Committee; Kate Leone, Senior Health Counsel, Senator Reid's Office; Wendall Primus, Policy Advisor, Speaker Pelosi's Office

SOURCE Partnership to Fight Chronic Disease
Copyright©2009 PR Newswire.
All rights reserved

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