A growing chorus of health care providers believes something is missing from the debate about reform — personal responsibility, an individual pledge to move toward wellness.
“We have a huge disease burden, said Dr. James Rohack, president of the Board of Trustees of the American Medical Association who was in Colorado Springs last week. “Obesity is a problem and it is costing huge amounts of money.”
But personal responsibility isn’t something that can be addressed in a reform bill, although he did say House Bill 3200 does lay a framework for incentives for wellness.
“They don’t go into detail,” he said. “And there’s still work to be done on that part of it, but it does start the conversation.”
The AMA says reform should include ways to encourage the nation to move toward healthier habits.
“Obesity leads to diabetes and one of the side effects of diabetes is end-stage kidney failure, one of the only ways to get on Medicare before you’re 65,” he said. “We’re looking at a population that is aging, and we have to do something about wellness.”
Other groups claim that the health care system is “inefficient and counter-intuitive.” DividedWeFail.org, a health care reform lobbying group for AARP, said that the country trails other nations when healthy habits are considered.
“The life expectancy of Americans lags behind other developed nations, even though we’re wealthier and spend more on health care,” the group said. “These problems not only increase health costs, but they pose barriers to working and contributing to society. We know we can do more to eat better, exercise regularly, get preventive care and reduce our health risks.”
Lack of exercise and overeating, smoking and drinking too much alcohol, pose a growing threat to health care — simply in terms of dollars.
More than half of all people older than 50 have diabetes, high blood pressure, heart disease or some other chronic condition.
Sixty-six percent of Americans were overweight or obese during 2004. Obesity is associated with increased risk of diabetes, hypertension, cancer and osteoarthritis.
An estimated 14.6 million Americans have diabetes, at a cost of $132 billion every year. The Centers for Disease Control and Prevention expects that one in three 5-year-olds in the United States will become diabetic because they are overweight.
But despite the high costs of treating diseases such as diabetes, the health care debate centers around insurance reform, instead of encouraging healthier lifestyles.
“About 75 percent of health includes preventable conditions,” said John Suits, associate administrator for government services at Memorial Health System. “That means we can control it as individuals.”
While Americans might not have gotten the message, some groups are trying. Insurance companies, in particular, have a vested interest in controlling costs related to chronic, preventable diseases.
America’s Health Insurance Plans, a lobbying and trade organization for the nation’s insurance companies, said that 100 percent of its members offer wellness or health promotion programs. Most — 96 percent — offer chronic disease self-management programs and 70 percent offer access to a fitness center as part of the insurance plan.
The move toward wellness incentives shows what health care providers have known for years — most diseases in the United States are preventable, and those preventable diseases account for the lion’s share of costs.
“If we can contain those costs, then reform can center on other issues — issues that interfere with the patient-doctor relationship,” Rohack said.
Amy Gillentine covers health care for the Colorado Springs Business Journal.