Sunday, June 6, 2010

Michael Ciamarra: Critical challenge for Alabama requires long-range planning

  Oftentimes, our state legislators and the governor appear to tackle the urgent, politically expedient and routine issues, without a focus on the long-term. State and federal lawmakers respond to what I like to call the "tyranny of the urgent," which frequently is in response to successful special interests’ lobbying efforts. It is much rarer when a legislative action is accompanied with "long-term strategy" or takes into consideration the future impact of a particular societal trend.

  A good example of neglecting long-term thinking would be the unfunded liabilities of the Alabama Retirement System which few lawmakers are willing to openly discuss. Instead, the legislature raised pensions by 18 percent over the last 10 years, adding an additional $3 billion to the state's, i.e. taxpayers' obligations.

  As a chess master, you learn to think strategically and plan very far ahead. During the so-called 'health-care' debate last year I raised this question: "How will Alabama's Medicaid agency and other state services, not to mention our entire nation's families, deal with the costs of Alzheimer's disease from now to 2050?" Sadly, this issue was sidelined, to a large degree. No grand chess strategy here.

  It was indeed an encouraging demonstration of long-range planning when the Alabama Legislature recently passed Rep. Laura Hall's, D-Huntsville, H.B. 384, which will create an Alzheimer's Disease Task Force. As our population ages and Baby Boomers continue to retire in increasing numbers, Rep. Hall's bill creates a serious task force to evaluate the future impact of Alzheimer's disease and related dementias on the residents of Alabama.

  Alzheimer's is a profound challenge to both public and private sectors and it is certainly critical now to think about long-term strategies and policy impact on our nation's health systems. As Neil Buckholtz, chief of dementias of aging at the National Institute on Aging said, "This public health emergency is just going to get out of control if we don't do something about it."

  Alzheimer's is a personal tragedy as well as a staggering national crisis. Alzheimer's currently afflicts as many as 5.3 million people in the United States. By 2029, the number of new cases is expected to exceed 615,000 and by 2050 that number could reach nearly 960,000. And the effects of the disease are emotionally taxing and financially crippling.

  Every 70 seconds someone in America develops Alzheimer's disease -- by 2050, someone will develop Alzheimer's every 33 seconds. Alzheimer's places an enormous burden on taxpayers and our health system:

-5.3 million Americans currently suffer from Alzheimer's - one-in-eight Americans over 65 and almost one-in-two over 85.

-Ten million baby boomers will develop the disease.

-The CDC lists Alzheimer's disease as the 6th leading cause of death.

-Today there is no cure, no disease-modifying treatment, and no prevention.

-In 2005, Medicare spent $91 billion on beneficiaries with Alzheimer's and other dementias and is projected to spend $189 billion by 2015.

-Given the present trends, Alzheimer's will cost Medicare and Medicaid a projected $19.89 trillion between 2010 and 2050.

-Because people tend to get Alzheimer's later in life, even a delay of onset has a significant effect in lowering costs. A five-year delay would save $8.51 trillion over that same period.
  According to the Alzheimer's Association’s recent 2010 Facts and Figures report, at least 91,000 Alabama residents are afflicted with Alzheimer's. If these trends continue, 31 percent of the state's population over age 65 will have the disease by the year 2025.

  At the national level in 2008, the economic value of the care provided by family and other unpaid caregivers of people with Alzheimer's and other dementias was roughly 9.9 million people at a cost of $94 billion. The 2010 Facts and Figures reports that there are nearly 188,000 Alzheimer's/dementia caregivers in Alabama which translates to an estimated 214,000 hours of unpaid care per year.

  As of today, there is no cure for Alzheimer's. There are no Alzheimer's survivors. Here is where research funding comes into play and where national leadership on this issue is very much required.

  However, there is hope. A consensus of three Nobel Prize-winning scientists and over 125 other neuroscientists have proclaimed that it is possible to end Alzheimer's by 2020.
  We are at one of those rare moments in history where circumstances are coming together to make real change possible. With the right resources and the right experts working together, a fundamental breakthrough in Alzheimer's disease is probable within a decade.

  In the meantime, the Alabama Alzheimer's Disease Task Force will review existing long-term care industries, resources, community-based resources and respite care to assist families, state support of Alzheimer's disease research through our universities and the university system's capacity to produce critical health care professionals, necessary long-range state policies and responses, and what needs to be done by through the efforts of public and private sector coordination. (Task Force recommendations or proposals will not be considered a medical protocol or standard of care for the treatment of this disease.)

  The task force will hold public hearings, discussions, webcasts and plans to produce a report next year. Let your voice be heard during these task force deliberations.

  We look forward to the thoughtful work of Alabama's Alzheimer's Disease Task Force and the recommendations they will propose. We know that it is just a beginning; new strategies and technologies will build on these initial proposals. A lot can happen in the next 30 years and it is refreshing that state lawmakers are beginning to think long-term rather than just toward the next election.

  About the author: Michael Ciamarra is vice president of the Alabama Policy Institute. See his "Inside Montgomery" interview with State Rep. Laura Hall on Alzheimer's here.

No comments:

Post a Comment