Cutting Medicare and Medicaid Will Cost You More Money
Treating Catastrophes is Much More Expensive Than Advanced Primary Care
Well, here we are again. We have reached the federal debt limit and politicians are targeting entitlements like Medicare and Medicaid, but this does not make a bit of sense. We can provide primary care for everyone and save money. By providing optimal medical therapy in advanced primary care practices to Medicare and Medicaid patients, we prevent and delay expensive medical catastrophes.
Medicare alone is 13% of the federal budget. Six of the top ten chronic conditions impacting Medicare patients are cardiometabolic. Medicaid patients have a much higher burden of cardiometabolic disease. Check out the slide below.
Patients with diabetes and heart failure generate roughly one third of medicare spending. Patients with chronic kidney disease generate a quarter. Of course these diseases often overlap, and I am not sure how much these diseases in combination would contribute, but for many patients they don't overlap and together the impact would be greater. Optimal medical therapy for type 2 diabetes begun at an average age of 55, reduces heart failure hospitalizations over the next 21 years by 70% compared with usual care. Hospitalizations generate the lion's share of heart failure costs.
Optimal medical therapy delivered in primary care can reduce the premature disability, death, and cost of these conditions but very few of us have access to optimal medical therapy. The Europeans live longer for half the impact on gross domestic product. Everyone has access to outpatient primary care and optimal medical therapy is more available. The answer to the government costs in healthcare is to make primary care delivering optimal medical therapy available to everyone to prevent these catastrophic late stage complications. It is crazy to further constrain primary care access in the people who need it most. Primary care is relatively cheap and some people want to restrict that. Hospitalizations, dialysis, and implantable defibrillators are extremely expensive but no one is turned away. You will pay for one or the other. I would rather pay for primary care.
Agree 100%
Perhaps we should all write our respective senators and representatives attaching a copy of this message of hope for reducing avoidable excess cost for Medicare and Medicaid while improving health outcomes for beneficiaries. We could also attach this message to our letters to CMS administrators at the national and state level. We need organized action.