The continuing debate in Washington over health care reform is focused too much on the symptoms of our dysfunctional health care system and too little on the cause of and solution to the biggest problem — increased spending for rising rates of chronic disease.
Make no mistake — the health care reform legislation moving through Congress has some positive features. But the notion that costs can be controlled and health care made more affordable without either rationing services or reducing the use of services by improving people’s health is ludicrous.
We know from the HMO experience of the 1990s that Americans don’t like having others (insurers or the government) decide where and how often they can access health care services. What we don’t know is whether Americans can look in the mirror and accept that a large part of our health care problem is staring us in the face.
I’m talking about our Western lifestyle. We eat too much of the wrong foods, don’t get enough regular physical activity, carry around too many pounds and do a poor job of managing stress. These habits eventually lead to chronic disease and the associated treatment costs and reduced quality of life.
According to the Centers for Disease Control and Prevention, 75 percent of health care spending today goes to treat “preventable chronic disease.” Most of the spending goes to address the effects of smoking, overeating and physical inactivity in the form of diabetes, obesity, heart disease and some forms of cancer.
The CDC estimates that type 2 diabetes will afflict fully one-third of all Americans born after 2000. Our youngest generation of Americans may be the first to live a shorter life span on average than their parents, halting a record of improved health and longer lives by children over their parents dating back many generations.
We spend hundreds of billions of dollars today managing the symptoms of diabetes and precious little on a systematic approach to prevent this horrible disease. In fact, as we stand by wondering why premiums keep going up, obesity rates steadily increase around the country followed closely by increasing rates of type 2 diabetes. (Type in “diabetes maps + CDC” into Google and see the direct correlation between obesity and type 2 diabetes.)
The U.S. Congress has an opportunity to pass meaningful incentives to encourage businesses in this country to invest in a well-designed workplace wellness program. Iowa Sen. Tom Harkin has long been a champion of wellness programs and his bill (S-803) would provide a clear incentive of 50 percent of a business’ cost of a wellness program (up to $200 for the first 200 employees and a 25 percent credit for the remainder of the payroll).
Can a wellness program make a difference? My company, Occupational Medical Consulting, works with a dozen Maine companies to help change at-risk employee health behaviors that eventually lead to chronic disease. We have successfully moved people from high-risk health behaviors to medium or low risk through one-on-one health coaching.
Our health coaches don’t tell participants, “Well, you know, you should really stop smoking (or get more exercise or eat a healthier diet).” Instead, our coaches find out what is important and of value to the participant and determine if they are ready to change any of their habits. This motivational interviewing approach is effective at changing hard-to-change behaviors.
We’ve worked with companies ranging in size from 80 to 2,000 employees and have had a positive impact with each one. Improvements don’t happen overnight but positive change does occur. Our oldest client, Cianbro, has seen a remarkable return on their wellness investment and other initiatives in improved employee health and reduced health insurance costs.
OMC is not the only company providing wellness services. The Bangor Chamber’s Wellness Council of Maine is doing great work as well. Workplace wellness is a small but growing sector of the economy as businesses seek more effective strategies to control health care spending.
If we hope to solve the health care cost crisis, we must first understand the origins of the chronic disease epidemic in this country. Without a fundamental change in our lifestyles, we have little hope of achieving “affordable” health care in this country in our lifetime.
Physician Larry Catlett is founder and medical director of Occupational Medical Consulting of Leeds. More information can be found at www.omcwellness.com.