Healthcare reform may go far in
extending medical coverage to millions of uninsured Americans,
but what kind of impact will it have on overall healthcare
costs? That is the $940 billion question on the minds of
most industry analysts these days. The actual answer may
not be known for some time, but many experts are leery of
relying upon current reform laws to provide the answers.
The reality is that healthcare costs may not improve until the
overall health of U.S. citizens improve, and that is the
reason why many organizations in both the public and private
sectors are continuing to take a proactive approach toward
encouraging healthier lifestyles in an attempt to lower their
healthcare costs.
Obesity the Primary
Target
Getting Americans to become healthier
sounds like a simple answer, yet it is a significantly
difficult goal to achieve – especially when you consider the
country’s current obesity trend. According to Dr. Delos
“Toby” Cosgrove, CEO of the Cleveland Clinic, the healthcare
reform bill will not curb the rising costs of healthcare
unless people become primarily responsible for their own
health and rid themselves of obesity and other preventable
conditions. In an interview with CNN Money, Cosgrove
cited figures from a 2009 RTI International study revealing
10% of healthcare costs in the U.S. are due to obesity, and
went on to say that the U.S. may be the “fattest” nation in
the world, with about two-thirds of Americans considered
overweight and one-third considered obese. At the
current rate, he estimated that half of Americans would be
obese within the next 20 years – which has spurred a movement
toward obesity prevention all over the country.
On the federal level, Michelle
Obama is targeting kids with her “Let’s Move” initiative to
end childhood obesity. Some lawmakers are trying to make
physical education in schools a priority again with Fitness
Integrated with Teaching (FIT) Kids Act that is making its way
through Congress. These initiatives focus on educating
youth in regard to living healthier while limiting the impact
on state and local budgets. However, there is still the
matter of the workforce population.
Many employers have initiated their
own corporate wellness plans to steer employees into healthy
living, and some have even taken an aggressive route. As
reported in the Eyes on Benefits dated Nov. 6,
2009, the State of
North Carolina is implementing an “obesity tax” based on body
mass index, following in the footsteps of Alabama as the
second state to offer such disincentives to state
employees. Yet, such disincentives may be difficult to
facilitate and may be subject to legal challenges (especially
on the state level), which is why some entities are looking to
use “carrots” rather than “sticks”.
The Miami-Dade
Project
A new approach by the Miami-Dade County
Health Department in Florida is targeting all residents with a
$14.7 million budget for obesity prevention that will add
unique incentives to the prevention approach. The money
will be used to increase access to fresh fruits and vegetables
through community gardens and farms, promote healthy options
in vending machines, and promote physical activity, among
other initiatives. In addition, anti-obesity programs
will be offered through the Parks and Recreation Department
and at local nonprofit organizations, while the Health
Department will be working with the University of Miami
regarding weight loss programs, including bicycle
paths.
This project is drawing a great
deal of attention because it focuses on personal
responsibility as an important component of health and
managing chronic disease. The difficulty is that while
eating can become an addiction for some, it cannot be treated
like other addictions to substances like drugs or alcohol
because you can’t cure someone by stopping them from
eating. The key is to change unhealthy behaviors and
build on a framework that allows people to take charge of
their own health.
No Easy Road to
Wellness
For programs like the Miami-Dade
experiment, the full effects may not be known for some time,
and progress may be slowed by the fact that the programs rely
on changing behaviors – and that in itself is never an easy
process. However, employers can be proactive and create
an environment of change through simple steps like offering
healthy snacks in office vending machines, creating on-site
fitness programs, and offering financial incentives for weight
loss. Businesses don’t have to go to the same lengths
that the Miami-Dade County Health Department did, but there
are carrots that can be offered to encourage healthier
lifestyles – and perhaps make a positive impact in healthcare
costs.
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