Chronic health conditions, like obesity, cancer and arthritis, affect about half of the adults in the United States. In fact, according to the most recent data, about 117 million Americans have one or more chronic diseases.
Chronic conditions are common, often debilitating and expensive, too. The more severe a person’s disease, the higher the costs usually are. Take for example: A knee replacement for someone with debilitating arthritis is far more expensive than over-the-counter pain relievers for occasional pain.
Of course, treatment for certain conditions can be costly, but there can be hidden expenses, too. Just how much money do these conditions cost? Dr. Stephen Scott, MD, FACS, a bariatric surgeon with the Surgical Weight Loss Institute of Kansas City in Overland Park, Kansas, weighs in on the costs of some of the country's most expensive conditions. Dr. Scott is affiliated with Lee's Summit Medical Center and Menorah Medical Center.
Asthma and COPD
Asthma, a condition affecting 24 million Americans, causes airways to narrow, making breathing difficult. The exact cause of asthma is unclear, but genetics and environmental factors may be to blame.
Chronic obstructive pulmonary disease (COPD), another breathing disorder, is a condition that restricts the flow of air into and out of the airways that deliver oxygen to the lungs. This can happen as a result of a number of things, like thick or inflamed airways or a buildup of mucus in the airways.
COPD can be progressive, meaning it worsens overtime, but it doesn't have to be. Long-term exposure to irritants, like smoke, can cause COPD, which impacts more than 15 million people in the US.
So, just how costly are these conditions? The projected yearly cost of COPD by 2020 is $49 billion. Combined with the estimated annual cost of asthma—$56 billion—the total cost of the two conditions will reach about $105 billion. Both asthma and COPD can affect your day-to-day life, and can even prevent you from attending work.
In 2008, there were more than 14 million missed days of work as a result of asthma-related complications alone. In addition to lost productivity, the price of diagnosis and treatment can really add up.
A variety of medications, therapies and lifestyle changes can be prescribed to treat asthma and COPD, all of which come with a cost to the patient and/or the insurance company. In some cases of COPD, surgical procedures may be needed.
Arthritis is a painful condition caused by inflammation of the joints. The most common types are osteoarthritis and rheumatoid arthritis.
Osteoarthritis is characterized by the deterioration of the cartilage protecting your joints. Rheumatoid arthritis is an autoimmune disorder that breaks down the lining of the joint.
Data from 2013 to 2015 suggests more than 54 million Americans over the age of 18 have arthritis. As the population ages, estimates suggest the number of cases will reach 78 million by 2040.
For some, arthritis is a nuisance. For others, the condition can be debilitating, interfering with daily activities, like putting on socks and even walking. The physical burden isn't the only cost—the most recent data suggests the annual cost for arthritis in the US is about $304 billion.
This price tag includes direct costs, like treatment expenditures, and indirect costs, like lost wages. Medication, therapy and surgery—potential treatment options—can really add up. But who pays these hefty prices? "Patients, the healthcare system and society in general," Dr. Scott says.
Almost 38 percent of Americans over the age of 20 are obese, a condition characterized by a body mass index (BMI) of 30 or higher. Obesity can develop as a result of unhealthy behaviors, like inactivity and poor eating habits or medical conditions, like polycystic ovary syndrome. Certain medications and your genes can also increase your risk of the condition. Plus, obesity can up your risk for other complications.
"The comorbid conditions [of obesity] are expensive. These are the conditions either directly caused by obesity, or made worse by obesity," Scott says. People with obesity are at a higher risk of developing related conditions like type 2 diabetes, heart disease, sleep apnea, osteoarthritis and some cancers.
Treatment for obesity and its related conditions cost about $147 billion a year. The cost includes medical expenses only, like lifestyle changes, bariatric surgery and medications. Missed days of work and lost productivity would increase the cost of this condition even further.
"Of course the insurance companies end up paying, ultimately, because these patients cost more than non-obese patients," says Scott. In fact, the average annual medical costs for someone with obesity are about $1,430 more than their normal weight counterparts. And the people pay too—what insurance won’t cover, patients must pay themselves.
There are more than 100 types of cancer, and together they are responsible for more than 1.5 million cancer diagnoses each year. Cancer claims more than half a million lives annually.
There is a plethora of treatment options for cancer, like surgery, chemotherapy, targeted therapy, radiation and more. In addition to hospital stays, follow-up appointments and, in some cases, life-long medication regimens, many cancers require more than one form of treatment.
It's not so surprising that cancer is a costly condition. In 2010, the estimated price tag was $157 billion for medical treatment alone. There are some preventative measures that could save some bucks.
"You have a higher risk of developing and dying from some cancers if you're obese," Scott says. These cancers include colon, ovarian, breast, kidney and gallbladder. But maintaining a healthy weight isn't the only way to decrease your cancer risk:
- Kick the smoking habit
- Avoid excess drinking
- Get adequate sleep
- Say "yes" to recommended vaccinations—like the human papillomavirus (HPV) vaccine
- Ask your doctor about screenings
Heart disease is the leading cause of death among American men and women, responsible for about 610,000 deaths annually. It's among the costliest, too. Annual expenditures tally about $200 billion.
There are varying forms of the condition, but the most common type, coronary artery disease, is characterized by blockage of the arteries that supply blood to the heart. This can lead to a heart attack.
Heart failure, a type of heart disease in which the heart can't pump enough blood to the body, claims nearly 290,000 lives each year.
But what puts you at risk for heart disease in the first place? Obesity, a poor diet, inactivity, excess alcohol use and smoking can increase your risks.
"Obesity is one of the major risk factors for heart disease, but it also increases your risk for diabetes, which also increases your risk of heart disease," Scott says.
Diabetes is a condition in which the body can’t control blood sugar, either because the body doesn’t produce enough insulin—type 1—or because it doesn’t respond to it—type 2. Insulin is a hormone responsible for controlling blood sugar levels.
The cause of type 1 diabetes is somewhat unclear, though researchers theorize genetics and environmental factors may have something to do with it. Although the condition can be diagnosed at any age, it's most often found in childhood. The second form of diabetes occurs most often in adults and is typically the result of genetics and other factors, like obesity.
Diabetes can lead to nerve and kidney damage, vision loss and cardiovascular disease, all of which contribute to its $245 billion annual cost.
Doctor's visits, blood sugar monitors, medication and interventions to treat related conditions, like obesity, also add to the cost.
There are ways to prevent type 2 diabetes, including:
- Maintaining a healthy weight
- Getting more physical activity
- Eating smaller portions and monitoring daily calorie intake
Dementia is a category of symptoms associated with impaired cognitive function, like thinking, reasoning and remembering, that can progressively affect everyday activities. Symptoms of dementia typically worsen over time, and most of the conditions that cause the decline cannot be reversed.
So, what's responsible for this confusion and memory loss? Dementia is a result of nerve cell damage in the brain, and smokers, heavy alcohol users and diabetics, among other groups, are at a higher risk.
The annual cost for dementia has reached $259 billion, some of which is used to treat dementia-related complications, like inadequate nutrition and pneumonia. Home care aids or special housing also come with a price. This number doesn't include the unpaid care provided by family members and friends. In 2016, the economic value of this unpaid care reached more than $230 billion.
Although dementia most often affects older people, especially those 65 years of age or older, it can impact younger people, too.