The Centers for Disease Control and Prevention (CDC) rid this country of malaria, and do you even know anybody with smallpox or polio? For trivia buffs, here is a brief history about them. When they do epidemiology, they do it very well, better than anyone else on earth. Likewise, their National Institute for Occupational Safety and Health (NIOSH) has been a major contributor to the dramatically lower number of occupational fatalities in the US. When NIOSH was founded in 1970, there were about 14,000 fatal work-related injuries per year. In 2014, with a workforce nearly twice as large, there were 4,679 — still 4,769 too many, but significant progress nonetheless.
But when the CDC does fifth-grade math and Statistics 101, not so much. Consider one of the CDC’s “arresting facts:’
They are actually right about this arresting fact: 7 out of 10 Americans do die of chronic disease each year. The cause of this? It’s called “civilization.”
Here is another one of their statistics:
Newsflash: You can’t fit 20% of kids into 5 percentiles no matter how much they weigh.
And in the immortal words of the great philosopher Carole King, on the whole it was a very good year for the undertaker. Diabetics die an average of 1.5 times apiece:
In each case, we kinda know what they meant. But they didn’t actually say what they meant. And I can tell you from my experience on Jeopardy that if you don’t say what you intend to say, Alex will take away your money. Not saying what you intended to say means what you did say is wrong, no matter how big you write your name.
And now, they’ve done the exact same thing for chronic disease…except that I really can’t figure out what they mean. “86% of healthcare spending is on people with chronic disease.” Even at 75%, this was already the#1 urban legend in all of healthcare. But 86%? Seriously? $6 out of every $7? Take out birth events, and it’s more like $11 out of every $12. Take out trauma, primary care, gynecology, imaging, sports injuries, and you’re already in mathematically impossible territory.
While this CDC whopper is bad news for frustrated fifth-grade math teachers everywhere, this sudden and unexplained boost from 75% to 86% is good news for the wellness industry. This timing is not likely a coincidence given the ties between the CDC and some wellness promoters. It comes at a time when the wellness industry is getting skewered in the media, employees (the actual end-users) hate wellness so much they need to be bribed or fined to submit, the industry’s own numbers don’t add up and when we change their numbers per their request, they add up even less,
Wellness industry executives never miss an opportunity to misinterpret a statistic they don’t understand, and the CDC is just begging to have wellness vendors misinterpret this as “Chronic disease now accounts for 86% of healthcare spending” — and push employers into more prying, poking and prodding. Of course, what they should be doing instead, based on the list of costly admissions below, is exactly what Quizzify proposes: educating employees on how to avoid harms of overtreatment, rather than pushing them into the treatment trap.
Funny thing, for an industry so behind the times that they still urge guys to get PSA tests (and fire them if they don’t, in one case we’ll be posting soon), wellness vendors didn’t let a minute go by before misinterpreting the CDC statistic, as we predicted. Here is Concentra, saying: “Chronic disease accounted for 86% of healthcare spending,” and if you read down, proposing more prying, poking and prodding.
A couple of weeks ago, Concentra decided even 86% wasn’t enough, so they added a little extra, just in case the CDC omitted a few cases of dishpan hands:
We hate to pour coffee on the wellness industry’s invalidity bender here, but someone has to provide actual facts, since the CDC seems to fear them as much as wellness vendors do. We’ve already posted the top 25 inpatient DRGs in the country for employees, both by frequency and by cost, and we’re posting them again below. As you can see, none of those conditions accounting for “more than 86% of health care spending” — nor any of their common complications — show up on this list. Instead, the overlap with anything that can be avoided with pry, poke and prod programs is almost zero. Even randomly, you’d expect more of an overlap, let alone if 86% of cost is due to things that 3-P programs address.
If that’s the case, how did the CDC come up with that statistic? It’s not sourced, so we have no idea. Our suspicion is that they’ve lumped a whole bunch more diseases in there, like maybe gum disease. So why not add tooth decay? Dandruff? Cellulite? Ring around the collar? They already list “stroke,” which is about as acute as diseases get. As we say in Surviving Workplace Wellness, every minute of delay after a stroke increases the odds you’ll end up like the Kardashians.” Likewise, they list cancer, as in: “My doctor says I have lung cancer, but we’re staying on top of it. He says I need to lose 15 pounds.” (For these two items, we do think we know what they mean. Some cancers stay with you but can be controlled, and disease leading to stroke is chronic…but that’s not what they said.)
Perhaps this 86% statistic is technically accurate for some health policy wonk parlor game where one player tries to act out a chronic disease, but it’s wrong on its face for any useful purpose involving employee wellness. For employees, it’s all about birth events, orthopedics, day surgeries, imaging, drugs, doctor visits, and a ton of one-time events, small potatoes, catastrophic illnesses, and/or none-of-the-above. While the CDC is busy lumping everything together into this 86% figure, we are recalling the opposite observation in Why Nobody Believes the Numbers that “everything in life has an 80-20 rule, and in healthcare the 80-20 rule is that 80% of the time, there is no 80-20 rule.”
Boys and girls, DO try this one at home…
Who Are You Going to Believe, the CDC or Your Own Eyes?
Before you answer, “Oh, our consultants told us to do more wellness,” try one thing. Try what we suggested above, for your own population. List the top episodes of care in total in your own organization. Here it is for the country as a whole:
As we’ve mentioned on multiple occasions, this list is populated with things no one can do anything about, as well as things addressed by Quizzify. Feed your population all the broccoli they can eat, and make them wear fitbits 24-7. You won’t prevent a single one of those DRGs.
Al: I think the CDC should engage you to straighten out their math. We’ll call is the “Lewis’s Theory of Chronic Disease Probability”, or do we have a better suggestion from your wide and diverse audience.
I would require them to show proof of a GED first.
just for the record, because I don’t ever mean to disparage people who don’t richly deserve it, I am NOT talking about the CDC as a whole. They do a great job. I was specifically referring to whoever came up with this fantastical 86% figure.
I think someone once asked “what is it about health care analysis that causes people to check their IQs at the door?” But if they didn’t, I will.
Doesn’t it seem convenient that this ridiculous number is coming on the heels of Johnson & Johnson’s and Vitality’s (amongst others) decision to jump on board with the theoretical ‘fat tax’ that swept our LinkedIn pages a week ago? While the conditions (DRG’s) collected to come up with this number obviously go well beyond obesity numbers, it seems to be in the best interest of the wellness vendors associated with the CDC, as well as others, that ‘statistically’ speaking, more people, a whopping 11% more are now extremely unwell and are the economic scourge of our society.
Maybe it’s a reach but when it comes to our government and it’s institutions, such as the CDC, I won’t put anything past them if they think they can make a buck on it.
Well, all these people in the CDC’s “partnership for chronic care” all know the leading wellness promoter. The other coincidence you could add is that all this nonsense about stock prices came out at the same time. I don’t think there is anything coincidental about these three things happening at about the same time. The difference is that wellness vendors are allowed to make stuff up. I would expect that the CDC would be held to a higher standard and am disappointed that they aren’t.
It’s utter nonsense what the CDC and other say about chronic diseases…please keep calling this one out.
If one really studies claims data objectively, he or she could never confirm they myth that chronic conditions are driving most health costs, unless aging is a chronic condition. tom