Skip Navigation Links
 



                     


 



   
    Learn More     Subscribe    
Join Now!      Login
 
 
 
FREE HEALTH
NEWSLETTER
 
 
Walking Quiz
Which of the following in NOT a direct benefit of a regular walking regimen?
 
 
 
 
I
ntegrator Blog
 


Guest Columnist Charlie Priester: On Obesity, Financial Incentives for Wellness and Integrative Practice

© John Weeks

The following is one in an ongoing series of columns entitled Integrator Blog by John Weeks . View all columns in series
Summary: The issue of insurers incentivizing good behavior, and particularly the relationship of such policies with the growing epidemic of obesity, calls integrative practitioners to the challenging balancing act of finances, health, behavior change and of compassion. Here, Integrator reader Charlie Priester, a self-employed, informed consumer of integrative, natural health practices - particularly of the self-care variety, wades into the debate. He offers ideas about how such policies can be good for naturopaths, acupuncturists and Yoga therapists, and for self-employed individuals like himself. Priester is a former colleague in publishing the hard-copy Integrator (1998-2002) and in developing the Integrative Medicine Industry Leadership Summits (2000, 2001, 2002).

The Integrator has repeatedly returned to the theme of incentivizing behavior because many hard issues must be held in balance (compassion, personal responsibility, economics, individuality, public health) and because Integrator columnist Michael Levin has repeatedly focused on the subject.

Here the writer, Integrator reader Charlie Priester, responds to Levin, to new research as reported in the New York Times and to recent Congressional perspectives from the perspective of a self-insured consumer and user of integrative services who has been close to the integrative practice field for a decade. Priester is a former colleague in publishing the hard-copy Integrator (1998-2002), the Industry Health News Files and the Collaboration for Healthcare Renewal News Files and in developing the Integrative Medicine Industry Leadership Summits (2000, 2001, 2002).

________________________________

If Government Demands We Purchase Insurance,
Government Should Demand Insurers Offer Incentives
for Healthy Behaviors


- Charlie Priester
Seattle, Washington
Image
Guest columnist Charlie Priester: One mandate deserves another
"After I read the latest issue of the Integrator Blog, specifically the column from Michael Levin entitled “Financial Incentives for Wellness: Good for Integrative Practice?” I was uncharacteristically moved to send a comment.


"My first reaction was to target weight loss: 'Even though Senator Ensign is a little like having the Wicked Witch of the West as a co-sponsor, you know I’ve been arguing for years that there ought to be some kind of financial incentive for wellness. No easy way to do it, I agree, but obesity and even just “overweightness” is clearly out of control in this country, and there’s plenty of evidence regarding the probability of a whole host of health issues based on it….'

   
Are these incentive programs
'good for integrative practice?' 
Well, they sure ought to be.

 
"The following day, an article in the New York Times appeared, citing a report by Kenneth Thorpe, which projects that if current trends continue, 43% of American adults will be considered obese by 2018. The number as of 2008 is 31%, which is scary enough, and that’s just adults!

"After doing a little more research, I came to realize that my first reaction basically lands in the 'Safeway Amendment' camp. Safeway CEO Stephen Burd offers his employees a break on their premiums if they meet certain criteria re: smoking cessation, weight, cholesterol and blood pressure. If they succeed at all of them, they can save as much as $800 per year on their share of premiums. In a Wall Street Journal editorial, Burd wrote that 'if the nation had adopted our approach in 2005, the nation’s direct healthcare bill would be $550 billion less than it is today.'

"Essentially, this 'outcomes' argument is that employers (and perhaps the government) should adopt the auto insurance model, which rewards or penalizes certain behaviors. No employee has to lose weight or quit smoking (this is America, after all), but there’s a financial incentive to do so.

"Every article I read adds to the complexity of the issue, but I keep coming back to the certain belief that no matter what Congress does regarding health insurance reform, if U.S. citizens don’t start to exercise more and change their diets to include more fresh, real food, healthcare costs will continue to spiral out of control.

   
  If the government is really interested
in taking on the bigger public health
crisis we face, and if they are in the
end going to mandate that everyone
buy insurance, I say they ought to
demand that health insurance companies
themselves offer financial incentives to
encourage healthier lifestyle choices.


“'Good for Integrative Practice?' you ask. Well, it sure ought to be, if for example, naturopaths could take all their expertise in the realm of nutrition and develop some 'certified' educational programs that employers could offer to employees. Or if acupuncturists could make the case that their treatments will help an individual achieve the outcomes that a Safeway demands. Or if yoga instructors harnessed the popularity of their discipline and persuaded employers that their classes should be considered as worthy of subsidy as gym memberships.

"For the self-employed and self-insured like myself, I wish insurance companies would offer discounts to people who eat well, exercise regularly, and meet whatever 'Safeway'-like criteria they want to set up. If the government is really interested in taking on the bigger public health crisis we face, and if they are in the end going to mandate that everyone buy insurance, I say they ought to demand that health insurance companies themselves offer financial incentives to encourage healthier lifestyle choices.

"Of course, as long as we’re at the mercy of our current for-profit health insurance industry, and so long as that industry makes money off self-motivated folks who pay premiums and rarely have claims, this is probably not going to happen."

________________________________

Comment: Priester's commented that whatever the government does, U.S. citizens need to change their habits. This brought to mind Recommendation #7 from Andrew Weil, MD on his Call to Action on health reform. After ticking off 6 powerful public health and top-down government-backed initiatives (which will need a bottom up citizens campaign to be passed), Weil expresses #7 simply: "Learn how to take care of yourself!"

   
 
Did anyone notice that the
Safeway amendment is not
called the Blue Cross-Blue
Shield amendment?

Priester is right:
we need a mandate.
  
More of the sobering information from the report on obesity by Thorpe, as cited by Priester, is worth re-stating as we ask ourselves whether we need additional hard-hitting tools for addressing the rise of obesity and its impacts. Here, from the New York Times account:
"Mr. Thorpe concluded that the prevalence of obesity is growing faster than that of any other public health condition in the country’s history. Health care costs related to obesity — which is associated with conditions like hypertension and diabetes — would total $344 billion in 2018, or more than one in five dollars spent on health care, if the trends continue. If the obesity rate were held to its current level, the country would save nearly $200 billion a year by 2018, according to the study."
The relevant questions here are, if the whole country were on the Safeway plan, what would the savings be? What would the loss be? 

As one who was until recently on a self-employed insurance plan, I am fully aligned with Priester's recommendation that insurers offer incentives for healthy behaviors. Unfortunately, I am also aligned with his view that insurers are not likely to offer such incentives as long as it doesn't make sense to their bottom line. Safeway,
as an employer and payer of benefits, is incentivized to keep its costs down and be inventive. But insurers, which are essentially cost-plus operations (they are allowed to keep a given percentage of premiums for overhead and profit, and the percentage stays pretty much the same as the base increases) has its bread buttered by the rise in costs. 28% of $100 is less than 28% of $200. Did anyone notice that the Safeway amendment is not called the Blue Cross-Blue Shield amendment

Yes, we need what Priester requests: a government mandate.



Send your comments to johnweeks@theintegratorblog.com
for inclusion in a future Your Comments Forum.
Add your comment      
About The Author
Resumes are useful in employment decisions. I provide this background so that you may understand what informs the work which you may employ in your own. I have been involved as an organizer-writer in the emerging fields of complementary, alternative and integrative medicine since 1983. Happily, I have learned some things. I was once called an "expert in alternative medicine" by......more
 
Share   Facebook   Buzz   Delicious   Digg   Twitter  
 
 
 
 
 
 
From Our Sponsor
 
 
 
 
 
 
Featured Events
Wellness Inventory Certification Training - Level I
     February 18-May 20, 2014
     Los Angeles, CA USA
 
Additional Calendar Links
 
Wellness, Thinking, dimension!

Search   
Home       Wellness       Health A-Z       Alternative Therapies       Find a Practitioner       Healthy Products       Bookstore       Wellness Inventory
Healthy Kitchen       Healthy Woman       Healthy Man       Healthy Child       Healthy Aging       Wellness Center       Nutrition Center       Fitness Center
Free Newsletter      What Doctor's Don't Tell You      Stevia.com      Discount Lab Tests      First Aid      Global Health Calendar      Privacy Policy     Contact Us

Disclaimer: The information provided on HealthWorld Online is for educational purposes only and IS NOT intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek professional medical advice from your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.