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Health care savings start in the cafeteria.
April 4, 2010 12:54 PM

Now that Universal Health Care is the law of the land, we can get started on a true national dialogue regarding the #1 driver in costs to our health care system: unhealthy diets. An article from the NY Times back in November did a pretty good job detailing the problem:

A study in the January-February 2009 issue of the journal Health Affairs concluded that 75 percent of the country's $2.5 trillion in health care spending has to do with four increasingly prevalent chronic diseases: obesity, Type 2 diabetes, heart disease and cancer. Most cases of these diseases, the report stated, are preventable because they are caused by behaviors like poor diets, inadequate exercise and smoking.

75% of the $2.5 trillion in health care spending has to do with FOUR preventable chronic diseases (obesity, Type 2 diabetes, heart disease, and cancer)? That is astonishing and really shows how important it will be to alter both our eating habits and the amount we excercise as a population.

But even more telling is the fact that of those four preventable diseases, obesity is BY FAR the #1 driver in increasing health care costs:

Obesity alone threatens to overwhelm the system. In a recent study [.pdf], Kenneth Thorpe, chairman of the department of health policy and management at the Rollins School of Public Health at Emory University, found that if trends continued, annual health care costs related to obesity would total $344 billion by 2018, or more than 20 percent of total health care spending. (It now accounts for 9 percent.)
Just get us back to the obesity levels of 1987 and you'd have enough money to cover the uninsured. The problem is that our free market system has led companies to come up with delivery systems of food that trick us into thinking we want more of it:
"It just isn't true that people stop when they should," says Dr. Pi-Sunyer, director of the New York Obesity Research Center and chief of the division of endocrinology, diabetes and nutrition at St. Luke's-Roosevelt Hospital Center. "Americans are overriding their satiety signals. So to say eat until you're satiated is not a helpful health message.

But Ms. Totten -- an associate at the Jefferson School of Population Health at Thomas Jefferson University in Philadelphia and a nurse midwife by training -- contends that overeating doesn't result from a nationwide failure to count calories, but from the fact that so many people consume a diet of processed, refined foods. "People overeat Doritos because those foods are designed to trick the body’s beautiful ability to be able to self-regulate," she said. "When you eat primarily health-supporting foods you will recover those protective mechanisms."


Yes, there is no doubt that these choices are personal, but we can certainly devise programs to "trick" or rather, motivate, workers to choose more healthy diets. And with our health care system solidly in the hands of the private market, the incentives -- and savings -- are going to have to come from the large companies that provide health coverage (i.e. PAY for insurance) to so many millions of Americans:

I.B.M., for example, says that from 2005 to 2007 it invested $80 million in what are broadly defined as employee wellness programs, and thereby saved $190 million in health care costs. Some $79 million of that was in fewer medical claims; the rest came from reduced absenteeism and "presenteeism" -- a measure of lost productivity when employees are sick on the job. "A relatively small investment can have a big payoff," says Joyce Young, I.B.M.'s director of well-being.

The individual stories are impressive:

That was certainly the case for Diane Akin, a product quality manager in I.B.M.'s storage technology division in Tucson. This year, she received $300 in rebates from I.B.M. for completing online programs in physical activity, nutrition and preventive care, courses that inspired her to go on an exercise and nutrition kick.

"I lost 40 pounds and my cholesterol and blood pressure are down," says Ms. Akin, who is in her mid-50s. "I don't think I would have done it otherwise. The incentives, all the online support groups and goal-setting and monitoring really helped."

Ms. Akin added that she was no longer worried about becoming diabetic, a condition that could have hit I.B.M. with an annual bill of as much as $20,000 in treatment costs.

It's a pretty straight-forward incentive system: pay your workers to adopt healthier eating habits!

Perhaps the biggest corporate success story is Safeway, a rarity among big employers in that it has kept per-capita health care costs from rising. Annual costs at the chain, based in Pleasanton, Calif., are roughly the same as they were in 2005, when Steven Burd -- Chief Executive of Safeway -- decided to tackle the issue.

He says Safeway has achieved this leveling by shifting its plan toward cheaper generic drugs and through the company's voluntary Health Measures plan, in which employees are checked for their weight, blood pressure and cholesterol levels and whether they smoke. For each test that's passed, workers are rewarded with reductions in their payroll contributions to health care coverage. For individual plans, this can add up to almost $800 a year.

Although these stories are the exception to the rule, these types of health and wellness plans ARE present in the new Health Care Bill (see page 7 of this .pdf from the Kaiser Health Care website).

Check out the rest of the story
to learn more about the future of these wellness programs in corporate America.

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