Sunday, July 26, 2009

Lose Weight; Get Healthier, Not So Easy!

In my last blog ("Should we be Paying Individuals for Good Health Habits") I advocated that healthcare insurance companies reward their customers for practicing good health habits including: exercising, losing weight and quitting smoking, by reducing insurance premiums thus putting money back into their customer’s pockets. In the long term this alone will lower the number of people who suffer from chronic disease and save millions in healthcare costs.

Many applaud this idea which is embedded in the healthcare reform legislation that is currently being discussed. Several health plans now pay a percentage of a person’s health club or weight loss program fee. However, in spite of exercise and a million different diet programs, when it comes to losing weight and keeping it off, most people simply cannot win this battle. Who cannot say that they have lost 10 pounds only to gain back 15 pounds a year later? We live in a society where richer, fattier food in large portions is marketed to the American public as a way to experience the good life.

In a recent Boston Globe column: “Putting Obesity out of business” (www.boston.com/bostonglobe/editorial_opinionoped/articles),Ellen Goodman points out that overweight people are not where they are just because they do not have the will power to resist food but because we live in a country that makes it cheaper to buy fast food than fresh food; where portions served are bigger and where the food industry works very hard and spends a lot of money to make it attractive for us to eat more.

Accolades should be given to the Starbucks coffee shops in New York City where they are posting the outrageous number of calories in the drinks and pastries they sell, which for many are standard breakfast fare every day, (caramel macchiato grande whole milk 319 calories; white chocolate mocha venti, with skim milk 628 calories, classic blueberry muffin 422, mixed fruit scone, 335 etc.). Every Starbucks should adopt that policy.

If it became a law that every food company from MacDonald’s with its Big Mac – 540 calories, large fries – 539 calories, to the local ice cream parlor posted the calories of the foods that they sell; perhaps we would see a reduction in the pounds that people are carrying with them.


Hopefully, with more education, less marketing hype from the big food companies and posted calories people would begin to understand the real story behind what they are ingesting.

There are over 130 million Americans who suffer from chronic conditions, many caused by abusing their bodies with drinking and eating bad calories and introducing smoke and inappropriate drugs into their bodies. Millions more are on the brink of Type II diabetes, asthma, heart disease caused by over-indulging in bad eating and drinking. In discussions on healthcare reform, shaking up the food companies could go a long way toward a healthier nation.

Monday, July 20, 2009

Should We Pay Individuals for Good Health Habits, You Bet!

We have all heard about pay for performance for physicians. Now there are proposals that would, in effect, pay individuals for good performance for controlling their bad health habits by quitting smoking, changing their eating habits and losing weight.

In my book, Digital Communication in Medical Practice published by Springer for a physician audience, I propose that individuals should be compensated for recognizing the importance of good health habits and following through on programs that encourage them to make changes in the way they live.

A provision in the healthcare overhaul bill that is before the U.S. Senate right now proposes to reduce health insurance premiums by as much as half for those members who change their habits through exercise, weight loss and no smoking. This proposal has the potential to save employers thousands of dollars per year with a healthier workforce that has fewer lost days of work, more energy to perform at peak and less chronic diseases like Type 2 diabetes and hypertension.

In a recent Boston Globe article, writer Michael Kranish reported that some companies such as Safeway and EMC Corporation have already adopted such programs and provide positive feedback on their success. EMC offers its employees a 12 percent reduction in their insurance payments – approximately $300 savings annually on a family plan – for employees who take a health risk assessment and engage in sessions with a “life style coach” that the company offers. According to Delia Vetter who is in charge of the EMC project, about 90 percent of the company’s US workers participate in this program.

The Safeway grocery chain also provides reduced health insurance to its nonunion employees who demonstrate that they can meet certain health measures or take definitive steps to make themselves healthier, including quitting smoking and weight loss. About 74 percent of their workers participate and their savings can be as much as $1,560 per year for workers who have a family plan.

Politics as usual is rearing its ugly head in these discussions as some Congressmen and Senators try to ban provisions in legislation that would pay individuals to get healthier. We can only hope that enough members of Congress have the foresight to take the long view and understand that giving employers a model that encourages employees to work at becoming healthier will lower healthcare costs and elevate the quality of health for all of this nation’s citizens.