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Wicked Local Essex - Markey & Smith: Health Care Faces A Perfect Storm

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Location: Washington, DC


Wicked Local Essex - Markey & Smith: Health Care Faces A Perfect Storm
By U.S. Rep. Ed Markey & U.S. Rep. Chris Smith

When Barack Obama is sworn in as the 44th president in January and the new 111th Congress convenes, fixing our country's health care system will be a top priority, and for good reason: our nation is facing the public health version of a "perfect storm." The wave of retiring baby boomers, combined with a stressed Social Security program, a strained Medicare safety net, and a health insurance system that leaves millions without coverage will create massive challenges for the next president.

One area of our health care system that holds great promise for reform - and could produce significantly improved care and substantial cost savings - is our nation's approach to caring for Americans with chronic diseases, including Alzheimer's Disease.

As House co-chairs for the Congressional Task Force on Alzheimer's Disease, we are keenly aware of the devastating impact of Alzheimer's and related dementias on those diagnosed with this dreaded disease, their loved ones, and our federal and local healthcare systems. Today, the estimated national tab for caring for individuals with dementia is $100 billion a year. That amount will skyrocket as the number of Americans with Alzheimer's disease or a related dementia is expected to triple from the current 5.5 million to more than 16 million by 2050.

There is no cure for Alzheimer's disease. While existing medications can help manage symptoms, we strongly support funding for basic and applied research to find a cure. The National Institutes of Health (NIH) is the crown jewel in the federal government's research effort, and a strong NIH is needed to help find a cure for Alzheimer's and other chronic, debilitating diseases. Unfortunately, since the doubling in NIH funding ended in 2003, the NIH budget has failed to keep pace with biomedical inflation. As a result, the NIH has lost more than 15 percent of its purchasing power. We need to get the NIH budget back on track.

As we search for a cure, the health care system also must help health planners confront difficult decisions and recognize warning signs for those who may be afflicted with Alzheimer's. We need to better identify those at risk and those who have the disease. An overwhelming number of Americans with memory problems fail to report this health issue to their doctors, according to the Alzheimer's Foundation of America (AFA). We know that the biggest risk factor for Alzheimer's disease is age and, annual memory screening could help catch more emerging cases earlier. The earlier Alzheimer's disease is diagnosed, the sooner individuals can make plans for the future and obtain support for themselves and their families.

Once a diagnosis has been made, finding the right care can be overwhelming for patients and their families. Often, these patients have one or more other chronic conditions and are juggling massive health care bills. Studies have shown that coordinating care and improving training for health care workers would cut costs, improve the quality of care and lead to better experience for patients and their families.

Unfortunately, Medicare does not currently pay healthcare providers for care coordination. That's why, in September, we introduced the Independence at Home Act, bi-partisan legislation to address the critical needs of these patients, for whom coordinated care has the greatest potential to achieve positive results. Through the creation of a 3-year demonstration project in 26 states, our legislation would provide for coordinated, patient-centered health care directed by physicians and nurse practitioners working as part of a team of caregivers qualified to deliver quality health services for Medicare patients with multiple chronic conditions, such as Alzheimer's, Parkinson's, ALS, diabetes and other conditions.

One of the keys to better coordinate care is effective use of long-term care technology. Simple devices can be very cost-effective and widely utilized. For example, 60 percent of individuals with Alzheimer's disease and related illnesses are likely to wander from their residences, and up to half will become seriously injured or die if they are not found within 24 hours. Emerging technologies can assist with rapid response, and more quickly take individuals out of harm's way. Other monitoring, assistive, or information technologies for home based care, long-term facility based care and caregiver support may improve care and avoid accidents.

The improvement of the quality of long-term care services for individuals with Alzheimer's disease and their families is urgently needed. There are a lot of effective, high-quality nursing homes, but according to a recent Government Accountability Office report, one in five nursing homes is placing residents at risk of death or serious injury. We need to weed out the bad players and better train the good ones.

The nation is at a critical crossroads that requires decisive action to assure the safety and welfare of millions of Americans with Alzheimer's disease and other chronic diseases. The solutions are out there, and we look forward to working with President Obama to implement them.

U.S. Reps. Edward J. Markey (D-MA) and Chris Smith (R-NJ) are the founders and co-chairs of the Bipartisan Congressional Task Force on Alzheimer's Disease.


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