By Ayanna Johnson, Health Policy Associate

This post originally appeared at Mom’sRising.org.

The burden of asthma on the health care system continues to grow in the 21^st Century. Asthma effects more than 25 million Americans (8 percent of the population). Since 2001, the number of people diagnosed with asthma increased by 4.3 million, resulting in a 6 percent rise in overall healthcare costs. In 2007 alone, asthma was estimated to cost the United States $56 billion in health care costs and lost productivity.

Children have experienced increasing rates of asthma especially those living in areas with unclean air.  About 1 in 10 children have asthma, compared to 1 in 12 adults. The Centers for Disease Control reported that the largest rise in asthma, almost a 50 percent increase in new cases from 2001 to 2009, was among African American children.

Asthma, the chronic inflammation and constriction of the airways, can be treated and managed with appropriate medication. Almost half of all people with asthma in the United States have had an asthma attack; many of which could have been prevented with proper management. As, the incidence of asthma continues to grow, managing asthma is important to prevent further strain on the health care system.

Costs rise for asthmatics who do not take their medication as directed, leading to more missed days of school or work, hospitalizations and re-admissions and general decline in quality of life. A recent study found that 50 percent of children aren’t taking their medicine as prescribed, often because parents were afraid of medication side effects.  Approximately 11 percent of insured patients can’t afford their asthma medicine. Increasing the patient share of out-of-pocket costs for children’s asthma medications, led to more children needing emergency treatment for complications related to asthma (Karaca-Mandi et al 2012, JAMA).

Following a medication plan, or medication adherence, is important for asthmatics; it improves health outcomes and decreases overall costs. There are numerous reasons why people don’t take their medication as directed. It can be hard to understand that a condition like asthma is a chronic disease that needs to be managed daily.

Helping patients, parents, and caregivers understand asthma and talk with their health care providers about medication management can help to lower asthma health care costs and unnecessary emergencies. The National Heart, Lung and Blood Institute recommends developing an asthma action plan tailored to each individual to help control asthma, avoiding triggers for asthma, remaining physically active and consistently monitoring your asthma with your health care provider for changes.

The Script Your Future campaign, organized and developed by the National Consumers League, helps address the medication adherence problem for major chronic diseases, including asthma.  Patients need access to education to help take control of their asthma, especially for reasons that make sense to them. This campaign provides tools to manage medicines and sample questions to help start a conversation between patients and their   doctor, pharmacist or nurse about their medicine.  It also has information to help patients understand their condition. Many things—from allergies to poor air quality, stress, and anxiety—can trigger asthma. This  video explains more about what causes asthma and what patients can do to manage their health.  An important step to becoming adherent is to make the commitment to take your medicine. Script Your Future has a pledge tool—patients can pledge to take their medicines or even pledge to help their child take their medicine too.

By Sally Greenberg, NCL Executive Director

I read something unexpected in the Wall Street Journal (November 20, 2012) recently. William E. Conway, Jr., co-founder of the Carlyle Group, a private equity firm with assets of more than $150 billion in management, the third largest such firm in the world, wrote an Op-Ed piece entitled,“Why We’re Investing in America.” Conway noted that his firm has invested in nearly every region of the world over 25 years, but these days they are putting their investments in the United States because, in his words:

The US is characterized by inherent attributes that are often taken for granted: freedom, the rule of law, confidence in regulatory agencies. America has admired universities, the deepest and most-liquid capital markets, peerless medical systems and pockets of innovation such as Silicon Valley-all of which, though not perfect, are highly advanced and function smoothly. Nowhere on the globe can my firm invest in companies with as much confidence as we do in the US. And while we take comfort in the long-term safety of US assets, we also see opportunities for growth. This is because of a combination of very low interest rates, a strengthening housing market, and significant domestic energy discoveries.

I don’t know much about Conway except that he’s very rich and the Carlyle Group has been implicated in dealings with the Bush family, Middle East and even Osama Bin Laden, and recently bought a chain of nursing homes. They undoubtedly invest in some odious companies and industries. But I’m making a different point. I quote from Conway’s piece because I think it’s an astounding acknowledgement from a powerful US businessman that the United States, for all of our strict regulations and our corporate taxation that business loves to complain about – is a great place to invest precisely because we don’t suffer from widespread corruption, we have a highly educated and productive workforce, and orderly markets that are strictly regulated (not strictly enough, as we learned from the disastrous sub prime debacle of a few years ago and as former FDIC Chair Sheila Bair points out with frequency in her excellent book, Bull By the Horns) and business thrives under these conditions. Indeed, Conway talks of confidence in regulatory agencies in the US; they are predictable and they operate under the rules of administrative law. Conway ends the piece with this:

Many in America and beyond have been paralyzed by fear of the fiscal cliff, frustrated with Washington’s partisanship, mesmerized by the presidential election or stunned by the post-Great Recession recovery. Any way you look at it, though, now is a great time to invest – and there is no better place than America.

His Op-Ed tells us that a strong regulatory structure that attempts to keep capitalism in check is not only good for consumers, citizens and taxpayers, but also good for business.