Chronic Disease Partnership Driving Health Care Reform Debate

A coalition to fight chronic disease already has had a significant impact on the 2008 presidential campaign by convincing several of the candidates to adopt chronic disease prevention and management as major themes of their national health care proposals.

The Partnership to Fight Chronic Disease, or PFCD, a coalition composed of the AAFP and 79 other organizations from a broad cross section of society, recently unveiled its "Ideas for Change" policy platform. (26-page PDF; About PDFs) The PFCD is calling on each of the Republican and Democratic candidates for president to adopt the five predominant health care themes in the platform, which are

All of the Democratic candidates' health care plans contain at least some of the elements laid out in the Ideas for Change agenda, and more Republican candidates are embracing the coalition's proposals, even though health care usually is not a major campaign issue for Republican candidates during the primary season, said Kenneth Thorpe, Ph.D., executive director of the PFCD.

Sen. John McCain, R-Ariz., for example, has made chronic disease prevention and management a cornerstone of his recently released health care proposal, and former Arkansas Republican Gov. Mike Huckabee speaks often on the campaign trail about the impact of chronic disease in driving up health care costs.

"None of these issues were under discussion in the 2000 and 2004 presidential campaigns," said Thorpe in an interview with AAFP News Now.

Ideas for Change represents the next step for the PFCD, which was founded last spring. Since its inception, the coalition has sought to re-energize and refocus the debate on health care, arguing forcefully that the nation's health care system should be based on a primary care model that employs the patient-centered medical home. Unlike many other coalitions, the PFCD is focusing on making health care more affordable through changes in the delivery and payment systems, which entails an emphasis on primary care.

"Before you can craft effective ideas for changes and solutions, you have to have a clear understanding of the problem," said Thorpe.

For example, he points out that 85 percent of the population has health insurance, and 96 percent of those with insurance voted in the last presidential election. For those voters, health care affordability is the number one issue, followed by other related concerns, such as health care access and health care efficiency. The goal, Thorpe said, is to "rebuild the delivery model to focus more on primary care and then to find ways of bringing the uninsured into a system that is clinically more efficient and less administratively complicated," thus producing better outcomes.

By taking this approach, the PFCD has built a powerful coalition that includes business and labor groups, health professional organizations, community agencies, consumers, and other stakeholders. By contrast, there is no consensus on ways of paying for health care or ways of providing health care for the 15 percent without health insurance, Thorpe said.

"Health care reform is politically controversial," he explained. "If we are going to be successful, we have to build coalitions and convince groups that usually fight each other to work together."