Any effort to overhaul our nation’s health care system with the intention of reducing health care costs needs to include specific mandates for patient accountability with respect to their own care and treatment.

Patient non-compliance is a significant contributing factor to out-of-control health care costs in this country. Consider, for example, that about 50 percent of the two billion prescriptions filled each year are not taken correctly – and many prescriptions are never filled (which, in fairness, is oftentimes the result of the high costs of prescription medication).

Many appointments for diagnostic tests and follow-up visits with primary care physicians are cancelled by patients and never rescheduled. It has been estimated that 10 percent of hospital admissions are due to patient non-compliance.

A recent study in the New England Journal of Medicine estimated the annual cost of hospital readmissions resulting from inadequate coordination of care and treatment at $17.4 billion. Compare this with the cost of patient non-compliance on the U.S. economy, which is estimated at almost $200 billion per year.

The statistics associated with chronic diseases (such as cancer, heart disease and diabetes) are even more disturbing. Chronic diseases account for 70 percent of all deaths in the United States each year. In Massachusetts alone the economic impact associated with these chronic diseases is over $30 billion each year. This number could be dramatically reduced through early detection, treatment and a healthy lifestyle.

President Obama says he believes comprehensive health reform should include investment in prevention and wellness. The extent of that “investment” remains to be seen. Nevertheless, if the president hopes to gain substantial support for his plan from the medical community, a significant investment in prevention and wellness needs to be a key component.

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