Americans’ Chronic Ills Pose a Hefty Care Burden

Nearly half of Americans suffer at least one chronic disease, everything from allergies to heart disease--20 million more than doctors had anticipated this year, researchers say.

And they warn that the fast-growing toll, now at 125 million among a population of 276 million, will reach 157 million by 2020. One-fifth of Americans have two or more chronic illnesses, complicating their care and making it more expensive.

The nation is unprepared to cope with the growing burden of chronic disease, with annual medical bills expected to almost double to $1.07 trillion by 2020, Dr. Gerard Anderson of Baltimore’s Johns Hopkins University told a meeting Wednesday of 1,000 chronic disease specialists.

“We think it’s the major public health challenge that could affect all Americans,” Anderson said.

Although doctors have made major advances in treating certain chronic illnesses, they cause 70% of all U.S. deaths, reports the federal Centers for Disease Control and Prevention, which convened the meeting to explore ways to better prevent and fight long-term illness.

It’s a difficult subject partly because so many different diseases qualify. Simple allergies may not kill someone, but they require a lifetime of medication and doctor visits. Heart disease can require even more complex drug therapy, surgery and testing. At the other extreme is Alzheimer’s disease, eventually requiring round-the-clock care.

Preventive care--weight management, disease screening, nutrition, exercise, geriatric assessments for the elderly--can stave off many chronic diseases. But it takes longer than writing a prescription, and few insurers reimburse fully, Anderson said.

He cited a rural Maryland physician’s lament about a diabetic patient, an overweight farmer whose insurance pays for a 20-minute visit, just enough time to test his blood sugar and adjust medication. The doctor says helping the man lose weight would do him more good, but he is not paid to provide that care.

Already 60 million Americans suffer multiple chronic illnesses, a number expected to reach 81 million by 2020 as the population ages, Anderson reported.