Question

what is meant by the fact that the US has a "disease management system"? why is that a bad thing

Answer 1

we do not have a health care system in America. We have a disease-management system -- one that depends on ruinously expensive drugs and surgeries that treat health conditions after they manifest rather than giving our citizens simple diet, lifestyle and therapeutic tools to keep them healthy.

People with chronic conditions generally use more health care services, including physician visits, hospital care, and prescription drugs. Increases in the number of people living longer with chronic conditions coupled with rising health care expenditures have spurred health plans, employers, and the government to look for ways to reduce health care use and costs. Disease management is one approach that aims to provide better care while reducing the costs of caring for the chronically ill. Disease management programs are designed to improve the health of persons with specific chronic conditions and to reduce health care service use and costs associated with avoidable complications, such as emergency room visits and hospitalizations.

Substantial reductions in health care service use and expenditures have occurred for many individuals enrolled in disease management programs. Disease management is still relatively new, however, and programs are still evolving. There- fore, the long-term impact of this approach is not known.

Disease management programs are becoming more popular

People with chronic conditions — 44 percent of non-institutionalized Americans — account for a disproportionate share — 78 percent — of health care expenditures in the United States.This is true regardless of health insurance status . Over the past decade, disease manage-ment has become an increasingly popular approach to caring for the population with chronic conditions in the United States.

Long term cost savings remains to be seen

While many programs have succeeded at reducing health care expenditures, the potential for long-term savings is still not known. This is due, in part, to the fact that to date, studies that have found substantial cost-savings are generally confined to a short duration of time, and are typically based on the experiences of a single plan or program or are restricted to certain areas of the country.Savings also vary across chronic conditions. A health plan in Seattle, for example, found that only one of its programs — a prenatal care program for high-risk pregnancies — produced a positive return on investment and improved patient outcomes. The other programs were costly to administer and did not serve many members. Disease management programs are still relatively new and it is too early to determine whether or not they are cost-effective in the long-run.

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