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How America Can Afford to Grow Older: A Vision for the Future

This summer, AARP volunteers and activists spent the August Congressional recess meeting with members of Congress in their states, urging them to stop budget cuts that weaken this important safety net.

Here in West Virginia, AARP has been having an ongoing dialogue with the governor's office, policy makers and law makers about strengthening not just Medicaid, but Social Security and Medicare, as well.

With nearly 40 percent of West Virginians on either Medicaid or Medicare, with 22 percent of the population of West Virginia receiving Social Security, this dialogue is critically important to the health and well-being of everyone in this state.

Capping, or simply cutting federal spending on Medicaid only shifts the burden to the states and/or increases the amount of uncompensated care among doctors and hospitals…which in turn would inevitably be shifted to employers and employees as higher premiums.

The solution lies in taking a long-range view and attacking the problem at its source: our dysfunctional health care system, which is grossly inefficient, and often does harm when it is supposed to be doing good. It doesn't make sense to fine tune individual programs when the whole system is broken.

We can make health care much better-and constrain costs in the long run. Here are seven ways to do it:

1. Achieve the efficiencies and savings that information technology can deliver. It helps achieve many of the other goals for transforming health care.

Most medical records are still kept on paper and mailed or faxed. This is painfully slow and costly. So are prescriptions, which would be more accurate, faster, and cheaper if they were "e-prescribed," as is now called for in the new Medicare law. Some hospitals and practices have good internal IT systems, but they aren't connected to each other. So your primary care physician and, say, your orthopedist cannot be on the same virtual page at the same time.

Creating this infrastructure will cost us money now. But in the future there will be a huge return on investment-and we can pay for it ourselves, not put off the day of reckoning for the next generation. Fortunately, this is starting to gain some momentum.

2. Reduce medical errors, which result in hospitalizations and deaths in the hundreds of thousands. This will improve quality and reduce the cost of care.

The Midwest Business Group on Health found that failure to focus on quality - and thus tolerating too high a level of medical error - costs the nation's businesses about $300 billion a year, or between $1700 and $2000 per employee.

Aside from the harm done to patients, aside from the inappropriate or undelivered care, aside from the overall negative effects on health status, it is clear that we will never manage the costs of health and disease if we continue to waste money like this.

And, here again, IT can help. It has been shown to reduce medical error-such as wrong dosages or the wrong medication-by as much as 90 percent.

3. Promote health and healthy behavior from infancy onward.

There are some things we can't do much about, such as genetics and accidents. But we can affect the majority of our health outcomes, and we need to take personal responsibility for our health and the health of our children and grandchildren.

At the National Institute on Aging they say that, "Osteoporosis is a pediatric disease with geriatric consequences." If you don't get enough calcium in your teen years when you build more than 90 percent of your bone mass, you will pay the price when you are older.

And, as we say in our AARP program in 27 states to promote physical activity, "If you've got a moving part, move it."

Did you know that the largest increase in chronic diseases is among people in their 30s, including obesity and diabetes? In nearly all cases, these problems are caused by behavior-by eating too much, by exercising too little.

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