It’s early in the New Year, ‘tis the season to contemplate our ever expanding waistlines. As you may know, 65% of Americans are considered over fat and a third are obese. The current obesity epidemic is on the minds of health care and health promotion experts everywhere. It’s also on the minds of the self proclaimed diet guru’s looking to cash in on this growing (no pun intended) market.
Who’s to blame?
Honestly, who cares? Is blaming genetics (aka the fat gene), the fast food industry, fad diets (see the debate in Business Week) or even the food guidelines (I’m not kidding, check out this debate from MedPage Today, be sure to read it all see both sides) going to help us solve the problem? Which came first, the chicken or the egg? It’s a futile argument and it doesn’t change the fact that we are fat and getting fatter. Every diet, even the most bizarre, has worked for somebody at one time or another. And that one person will defend the merits of that diet forever, while the other 99 people blame themselves and go look for something else that will “work”.
The food industry spends over $25 billion a year on advertising; “Five-a-Day” for fruits and vegetables spent $1 million; which message are consumers getting? Each year something like 80 million Americans go on a diet and spend about $40 billion dollars. The long-term success rate of the average diet is poor and most dieters regain some or all of the weight back in 3-5 years.
We eat too much, move too little and then try to buy a miracle. Then we repeat the cycle over and over. Benjamin Franklin said, “The definition of insanity is doing the same thing over and over and expecting different results.” I agree!
Wake up America!
It’s time to stop letting the food industry tell you what to eat, stop letting the restaurants tell you how much to eat and stop to letting the diet industry lure you into buying the latest fad. I know that even if I wear a Nike golf apparel and use Nike golf equipment, I am not going to golf like Tiger Woods. It’s that simple. Why can’t we draw the same logical conclusions when it comes to food?
Because behavior change is hard, really hard and we want it to be easy. There is no easy button when it comes to weight loss and behavior change. I wish there was. Believe me, I will tell you if I ever find it – so will every health care and health promotion professional – we’re the one’s on your side.
What’s Next?
Trust a professional – a real one, with a degree and credentials. If you want to change your diet, talk to a Registered Dietician. If you want to exercise, talk to an exercise physiologist (ACSM or NSCA are good places to start). If you want to change your behavior, talk to an Intrinsic Coach®. If you want to learn more, research a site that’s not selling anything (web sites ending in .org or .gov). Here are a few of my favorites:
• FDA Facts About Weight Loss Products & Programs
• American Dietetics Association 2007 diet review
• ADA Good Nutrition Reading List
• My Pyramid Eating Plan
• Shape Up America
• For more links you can also visit my web site
Remember, it’s not about the product, the professional or the program – it’s about you. Here’s to your health!
Thursday, January 31, 2008
Friday, January 18, 2008
Arizona’s “Health Pulse” – Unanswered Questions, Part 2
Welcome to Part 2, the second unanswered question from Tuesday’s “Arizona Health Pulse Breakfast” sponsored by the Phoenix Business Journal and Blue Cross Blue Shield of Arizona.
Question 2: In essence, why don’t health care agencies pay for necessary preventive care or cover prescription drug costs when it comes to treating chronic conditions like diabetes or hypertension? Another excellent, but complex question. I’d like to address this question in two parts, first preventive care services and then the prescription drug costs.
First I’ll cover the question of preventive care. Dr. Smethers did answer this part of the question and I applaud BCBSAZ for their coverage of preventive services. Since leaving BCBSAZ I can confirm that other large insurance carriers do not cover prevention as a core part of the plan. Wise benefit managers can include a prevention option as part of their company’s plan, if this is something the company leadership supports (I will cover the importance of leadership support in future articles). Companies need to realize that they can either pay for prevention services up front or pay for the cost of disease later on. Clearly, the former is more cost effective.
The second part of this question asks about prescription drug coverage for certain chronic conditions. Dr. Smethers stated that charging reasonable co-pays for maintenance medications helps members realize the value of the service they are receiving. We have seen this demonstrated in health care and know that when services are offered at no or very low cost they are often taken for granted and sometimes abused (which opened the door for HMOs to reign in the system several years back). Although true, this is only half of the story. As a seasoned Health Promotion professional, I can shed some light on the other half, which is all about disease management.
Disease Management (DM) programs are growing in popularity and are put in place by companies to help employees with certain chronic conditions effectively manage their condition. Some of the more popular DM programs are offered for conditions like asthma, heart disease, diabetes, hypertension and chronic pain. DM programs offer educational materials and often health coaching. An important and often overlooked component of an effective DM program is incentives. Companies use many types of incentives like apparel items, event tickets an even earned days off. Cash happens to be one of the best incentives out there. Most companies can’t give employees cold hard cash due to gift limitations and tax laws, but there are other creative ways to save employees some cash. One of those ways is to encourage them to participate in their DM program by offering lowered or even waived prescription drug co-pays (for condition specific drugs). I wish I could take credit for this brilliant idea, but I know pharmacy benefit management companies like Express Scripts are working to promote these types of programs. If you are going to offer an incentive, why not offer something that connects back to the program, a real win-win.
In closing I’d like to say, keep up the good work Dr. Smethers and the health promotion team at BCBSAZ. Keep fighting the good fight against our sworn enemy, preventable chronic disease!
For more information on Health and Productivity Management, please visit my website: www.awbrooks.com.
Question 2: In essence, why don’t health care agencies pay for necessary preventive care or cover prescription drug costs when it comes to treating chronic conditions like diabetes or hypertension? Another excellent, but complex question. I’d like to address this question in two parts, first preventive care services and then the prescription drug costs.
First I’ll cover the question of preventive care. Dr. Smethers did answer this part of the question and I applaud BCBSAZ for their coverage of preventive services. Since leaving BCBSAZ I can confirm that other large insurance carriers do not cover prevention as a core part of the plan. Wise benefit managers can include a prevention option as part of their company’s plan, if this is something the company leadership supports (I will cover the importance of leadership support in future articles). Companies need to realize that they can either pay for prevention services up front or pay for the cost of disease later on. Clearly, the former is more cost effective.
The second part of this question asks about prescription drug coverage for certain chronic conditions. Dr. Smethers stated that charging reasonable co-pays for maintenance medications helps members realize the value of the service they are receiving. We have seen this demonstrated in health care and know that when services are offered at no or very low cost they are often taken for granted and sometimes abused (which opened the door for HMOs to reign in the system several years back). Although true, this is only half of the story. As a seasoned Health Promotion professional, I can shed some light on the other half, which is all about disease management.
Disease Management (DM) programs are growing in popularity and are put in place by companies to help employees with certain chronic conditions effectively manage their condition. Some of the more popular DM programs are offered for conditions like asthma, heart disease, diabetes, hypertension and chronic pain. DM programs offer educational materials and often health coaching. An important and often overlooked component of an effective DM program is incentives. Companies use many types of incentives like apparel items, event tickets an even earned days off. Cash happens to be one of the best incentives out there. Most companies can’t give employees cold hard cash due to gift limitations and tax laws, but there are other creative ways to save employees some cash. One of those ways is to encourage them to participate in their DM program by offering lowered or even waived prescription drug co-pays (for condition specific drugs). I wish I could take credit for this brilliant idea, but I know pharmacy benefit management companies like Express Scripts are working to promote these types of programs. If you are going to offer an incentive, why not offer something that connects back to the program, a real win-win.
In closing I’d like to say, keep up the good work Dr. Smethers and the health promotion team at BCBSAZ. Keep fighting the good fight against our sworn enemy, preventable chronic disease!
For more information on Health and Productivity Management, please visit my website: www.awbrooks.com.
Thursday, January 17, 2008
Arizona’s “Health Pulse” – Unanswered Questions, Part 1
Welcome to my very first blog entry! I'd like to thank my good friend Kevin Hillstrom, President of MineThatData and author of the world's top ranked blog on Multichannel Forensics, for getting me started on this endeavor.
On Tuesday, I attended the "Arizona HealthPulse Breakfast" sponsored by the Phoenix Business Journal and Blue Cross Blue Shield of Arizona. As a former member of the wellness team at BCBSAZ, I was excited to see the latest data and hear keynote speaker Richard H. Carmona, M.D, M.P.H, FACS, 17th Surgeon General of the United States.
Dr. Carmona’s address was inspiring and depressing all at the same time. Dr. Carmona is an outstanding speaker who’s passion for public health comes across loud and clear. It was inspiring to hear his dedication to serving people and his message about both the need for and the power of prevention. The depressing part, although not a surprise, is how difficult it is to do something good in Washington because of partisan politics. For the record, I have no desire to debate politics nor the pro’s and con’s of Democracy. I just wish we could all get along and unite against the common enemy of chronic disease.
Anyone who is interested can get a free copy of the report, so I won’t take the time to re-hash the findings. One comment I will add is that I hope to see the sample size grow from year to year to increase the validity of this data.
I would like to address two audience questions that were (in my mind) left unanswered:
Question 1: How much of the health care budget should be allocated to wellness and prevention programs? Excellent question! The answer given was about incentives and participation- although interesting, did not answer the question. And, with all due respect the EVP of External Operations is not a health promotion professional and shouldn’t be expected to know what I know on the subject.
The answer is complex and depends on your organization. There are some important questions you need to ask your company leadership that have to do with your business goals, health care spending trend, age of your workforce, turnover, injury rates, absenteeism rates, productivity, etc. There is not one simple answer that will work for every business. In general, if you want your program to have an impact you need to budget about $100-150 per employee per year. A small price tag considering that in 2005 total U.S. health care spending was $2 TRILLION (about $6,700 per person). In 2006, the annual premium for an employer health plan was $4,200 for a single employee. This number seems low to me, as I have one client who’s medical cost PEPY were over $6,000 and when you factor in prescription drug costs, workman’s compensation and disability it brings the number to over $10,000. So, if you were this client, I would recommend spending at least 1-1.5% of the total per employee cost. What a bargain, especially when you consider the documented $3 to $1 ROI of a comprehensive HPM program!
I’ll address the second question, which had to do with insurance coverage for prevention in my next article. For more information on Health and Productivity Management, please visit my website: www.awbrooks.com.
On Tuesday, I attended the "Arizona HealthPulse Breakfast" sponsored by the Phoenix Business Journal and Blue Cross Blue Shield of Arizona. As a former member of the wellness team at BCBSAZ, I was excited to see the latest data and hear keynote speaker Richard H. Carmona, M.D, M.P.H, FACS, 17th Surgeon General of the United States.
Dr. Carmona’s address was inspiring and depressing all at the same time. Dr. Carmona is an outstanding speaker who’s passion for public health comes across loud and clear. It was inspiring to hear his dedication to serving people and his message about both the need for and the power of prevention. The depressing part, although not a surprise, is how difficult it is to do something good in Washington because of partisan politics. For the record, I have no desire to debate politics nor the pro’s and con’s of Democracy. I just wish we could all get along and unite against the common enemy of chronic disease.
Anyone who is interested can get a free copy of the report, so I won’t take the time to re-hash the findings. One comment I will add is that I hope to see the sample size grow from year to year to increase the validity of this data.
I would like to address two audience questions that were (in my mind) left unanswered:
Question 1: How much of the health care budget should be allocated to wellness and prevention programs? Excellent question! The answer given was about incentives and participation- although interesting, did not answer the question. And, with all due respect the EVP of External Operations is not a health promotion professional and shouldn’t be expected to know what I know on the subject.
The answer is complex and depends on your organization. There are some important questions you need to ask your company leadership that have to do with your business goals, health care spending trend, age of your workforce, turnover, injury rates, absenteeism rates, productivity, etc. There is not one simple answer that will work for every business. In general, if you want your program to have an impact you need to budget about $100-150 per employee per year. A small price tag considering that in 2005 total U.S. health care spending was $2 TRILLION (about $6,700 per person). In 2006, the annual premium for an employer health plan was $4,200 for a single employee. This number seems low to me, as I have one client who’s medical cost PEPY were over $6,000 and when you factor in prescription drug costs, workman’s compensation and disability it brings the number to over $10,000. So, if you were this client, I would recommend spending at least 1-1.5% of the total per employee cost. What a bargain, especially when you consider the documented $3 to $1 ROI of a comprehensive HPM program!
I’ll address the second question, which had to do with insurance coverage for prevention in my next article. For more information on Health and Productivity Management, please visit my website: www.awbrooks.com.
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