While lawmakers, budget experts and health care policy gurus have long known that chronic illnesses like diabetes, hypertension and cancer threaten to overwhelm our health care system, too few in Washington, D.C., have recognized that chronic liver disease deserves to be part of the conversation. Left unchecked, chronic liver disease stemming from hepatitis B and hepatitis C is projected to cost our nation’s health care system more than $85 billion annually within 15 years and ravage minority populations, including millions within the African-American, Latino and Asian-American communities.
[IMGCAP(1)] Admirably, leading Members of Congress from both sides of the aisle have taken an important step in the past week to help address this public health crisis. H.R. 3974, the Viral Hepatitis and Liver Cancer Control Act, was introduced Oct. 29 in the House. Spearheaded by Rep. Mike Honda (D-Calif) in strong partnership with Reps. Charlie Dent (R-Pa.), Edolphus Towns (D-N.Y.), Bill Cassidy (R-La.), David Wu (D-Ore.) and Anh “Joseph” Cao (R-La.), the legislation would help establish, promote and support a comprehensive prevention research and medical management referral program under the Public Health Service Act for chronic hepatitis B and chronic hepatitis C virus infection. The legislation would provide a relatively modest $90 million in funding in 2011 — with additional funding in subsequent years — that would increase the ability of the Centers for Disease Control and Prevention to support state health departments in their prevention, immunization and surveillance efforts.
At a time of polarized health care debates, this legislation has already enlisted prominent bipartisan support that spans the political spectrum. Reps. Todd Platts (R-Pa.), Barbara Lee (D-Calif.), Bobby Rush (D-Ill.), Judy Chu (D-Calif.) and G.K. Butterfield (D-N.C.) and Del. Donna Christensen (D-Virgin Islands) have all signed on to the legislation as original co-sponsors. The depth and breadth of political support for increased funding for detection, prevention and treatment is testament to the gravity and urgency of this crisis.
Each of these Members is to be applauded for recognizing the human and economic costs that chronic liver disease inflicts on our nation. As many as 5.4 million Americans are infected with chronic hepatitis B or chronic C virus infection — and most don’t even know they are infected. With most cases undiagnosed, millions of Americans are not receiving preventative, life-saving and cost-effective treatment. For many individuals, the first time they become aware of their viral hepatitis infection is when it has advanced irrevocably to cirrhosis, liver cancer or liver failure.
The absence of meaningful prevention, detection and treatment programs means that chronic liver disease threatens to overwhelm federal, state and local health programs. Annual medical costs for patients with hepatitis C virus infection alone are expected to skyrocket from $30 billion in 2009 to $85 billion annually by 2024, according to a recent Milliman analysis. Many of these costs in the coming years will be borne by already-stretched Medicare and Medicaid programs, which makes action now even more critical.
Three demographic groups are at highest risk of infection. The baby boom generation — those born between 1946 and 1964 — are most likely to be infected with chronic hepatitis C virus infection. African-Americans are twice as likely as the general population to contract hepatitis C. One in 10 Asian-Americans has contracted hepatitis B. Again, given that most are unaware of their infection, few even know they have a virus, let alone that it can be treated or even cured.
In the coming decades, the complexion of our nation will rapidly diversify — and with it, so too will our health care challenges. It is vital that our entire health care system embrace and prepare for this historic shift. By modernizing our approach here and now to increased prevention, detection and management of hepatitis B and hepatitis C, policymakers will lay the foundation for an infrastructure designed to meet this challenge head on. And that’s something all Members of Congress can rally around.
Lorren Sandt is executive director of the Caring Ambassadors Program, based in Portland, Ore., and is chairwoman of the National Viral Hepatitis Roundtable, a coalition of more than 150 public, private and voluntary organizations dedicated to reducing the incidence of infection, morbidity and mortality from viral hepatitis.