HCW Benefits Blog

Contributor:
Ellen Tucker, Consultant
Hill, Chesson & Woody 

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.

For more information, please visit the following links:

• The Miami-Dade Diet: Healthcare Won't Cost Less Until People Get Healthy
• KevinMD.com: Prevention Improves Health and Lowers Healthcare Costs 
• Tackle Obesity and We Lower Healthcare Costs