The Total Economic Burden Of Pain

Many experts in healthcare economics point out that chronic medical conditions are directly associated with higher costs (G., 2010). This association is mainly attributed to the high usage of all types of care (Kongstvedt, 2013). Reports show that the number of people suffering with chronic conditions is radically rising and forecasts suggest that the number of American’s with one or more chronic conditions will continue to grow by an estimated 37% between 2000 and 2030 (G., 2010). It is in our patient’s main interest to shift our current focus from treatment for acute conditions to target a better utilization of the recorded 78% of health spending devoted to people with chronic conditions. The new strategic approach is one of developing quality medical care for people with chronic conditions which require ongoing care and care management to improve their health status (Kongstvedt, 2013).

The selected policy Essence of Care 2010: Benchmarks for the Prevention and Management of Pain, includes the latest benchmarks on the management of pain and its prevention. It presents up to date reviewed views, with the aim to deliver

Unfortunately, many people who suffer from chronic back or neck pain do not get relief from non-surgical care.

“The Patient Protection and Affordable Care Act (ACA), informally referred as Obama Care, is a United States federal statue signed into by law by president Barak Obama on March 23, 2010”( Laxmaiah MAnchikanti,2012). Obama care assures they will provide insurance for everyone, with improvements in quality of and reduction in the cost of health care, opponents criticize it as being a massive bureaucracy laden with penalties and taxes that will ultimately eliminate personal medicine and individual practices (Laxmaiah Manchikanti, 2012). Based on these 2 years since 2010, the prognostics for interventional pain management is unclear. They may provide insurance for everyone but with cuts in Medicare to fund Obama Care. Practically limiting expansions on Medicaid

Back pain and the perception of pain is a common symptom with multiple causes. According to Porth (2011), at least 2/3’s of people will have one or more

Pain is a condition that is determined and described by the person reporting it. There are several components to pain including the emotional, psychological, and physical aspects. Many health professionals struggle to understand this phenomenon and thereby insert their own perspectives into the pain assessment of patient reporting pain. The Affordable Care Act (ACA) (2010), also titled the Patient Protection and Affordable Care Act H.R. 3590, was passed by Congress and signed into law on March 23, 2010 (U.S. Department of Health and Human Services (DHHS), 2013). Hospital value based purchasing programs (VBP) were developed to align patient quality care and outcomes to the support initiatives from the ACA. A component of the VBP includes patient satisfaction. Patient satisfaction is a self-reported response to questionnaire administered by a third party. Many hospitals utilize Press Ganey to administer the survey for the inpatient and outpatient patients. One component the survey includes patient’s self-reporting how well their pain was managed during their hospitalization. This measure of satisfaction can have an adverse effect on patient outcomes and increase opioid use in this setting. Patient satisfaction and pain management are both subjective however pain management while within scope of healthcare professionals should not be included in the patient satisfaction survey.

Recognizing that the prevention of chronic disease and promoting population health is the key to controlling health care expenditure, the inclusion of pain management is a positive aspect of the legislation. While chronic pain is not in the top leading chronic diseases, the cost to the health care system is higher than heart disease and diabetes combined.2 This paper will discuss Title IV - Prevention of Chronic Disease and Improving Public Health. Subsection D - Support for Prevention and Public Health Innovation of the PPACA, including the funding of the United States Department of Health and Humans Services (HHS) for research in public health services and the examination of best prevention practices. One focus of this part of this provision is research and evaluation of pain management, the assessment, and treatment standards through an Institute of Medicine Conference on Pain Care.3

According to The World Health Organisation (1999), defined pain as an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is traditionally described as acute or chronic pain. The prevalence of chronic pain (CP) is higher than of acute of pain, as it affects 7.8 million people of all ages in the UK (Chronic Pain Policy Coalition., 2006). The current leading cause of mortality that is accounting for 60% of all deaths is due to chronic diseases and is also a problem as causes an increasing burden on the health care service (World Health Organisation., 2007). CP can affect a person’s quality of life if managed poorly, statistics shows that 25% of people lose their job and 22% leads to depression. (Chronic Pain Policy Coalition.,

percent of the gross domestic product (GDP) (Sisko et al. 2014). In order “[t]o attract patients and meet contract obligations regarding quality” (Henke et. al. 78), hospitals have made vast improvements by advancing medical treatments and hiring more employees. One problem which hinders success in hospital quality involves patient’s pain perception. John S. Hoff, a health care lawyer and policy analyst in Washington, D.C., concludes that under the 2010 Patient Protection and Affordable Care Act (Obamacare), pain

Murray J. McAllister created this website because he had concerns for how chronic pain was being understood and managed in the current healthcare system. There is no uniform or consistency in how chronic pain is being treated among healthcare providers. Many providers also correlate chronic pain to a previous orthopedic injury and not from a nervous system related condition. This poses many concerns

Low back pain (LBP) is a common condition worldwide; approximately 50-80% of adults suffer from LBP at least once during their lives [1, 2]. LBP represents a major health problem because of its prevalence, high probability of recurrence, consequences, and healthcare cost [3-6]. LBP has physical, psychological, and economic impacts on individuals. Furthermore, LBP is still the primary cause of absenteeism and disability in every industrialized society [226].

Almost half a million people in the US suffering from lumbar spinal stenosis and many more experiencing cervical spinal stenosis.

In the United States, over 50 million people suffer from chronic pain. The annual cost of chronic pain is around $100 billion. Moreover, 46% of the people suffering from chronic pain lack adequate pain relief (http://www.painfoundation.org/painful.htm).

A solution to this problem would be for doctors to refuse imaging tests on the first patient visit regarding uncomplicated back pain. Then, if symptoms persist, on the second visit, imaging tests can be done. This simple policy would cut deeply into that 25% and probably save billions of dollars. It may be that prescribing aspirin or some other mild pain reliever should instead be the new first step that doctors take in these kinds of circumstances.

The healthcare system plays a key role in the economic stability of our country, as every year trillions are spent in attempt to combat disease and health issues that plaque humanity. As it makes up a significant amount of the expenditures in the economy, so the costs associated with health care of those in pain from illness and injury, including lost productivity, increased need of assistance in living and also the cost of death in some cases, is important to the economic stability and over all standard of living in our country. The key to economic prosperity is balancing the need for care with the costs of illness to keep as many people healthy and well without breaking the bank of collective society. The costs of healthcare have been increasingly problematic in recent years with so many issues surrounding the current system. With the “total health care spending in the United States expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970, meaning that health care spending will account for nearly 20 percent of gross domestic product (GDP), or one-fifth of the U.S. economy, by 2021” (Aetna). With this in mind it is apparent that as we look at the trillion-dollar industry of the medical community it seems that it needs to be a major focus of our nation as a whole and with the many issues come many creative solutions. First let us analyze the reasons behind the current cost and the major problems facing this industry and than discus what