Following a report in the Globe and Mail on January 3, 2010 wellness advocates, as well as others in the health care community, are no doubt rejoicing over the recent decision of insurance companies to focus at least some of their efforts on prevention. Despite the fact that research has substantiated the need for a more prevention-focused health insurance model for decades and the evidence on the role of prevention in combating chronic diseases, something happened in 2010 to persuade the insurance industry to focus on prevention.
While this is a step in the right direction, one cannot help but wonder what is the driving force behind this decision at this time. And the answer is the rising cost of providing insurance. And what drives these insurance costs? To a great extent, unhealthy eating, sedentary lifestyle and increasing body weight; all well documented lifestyle-related and highly preventable risk factors. And these lifestyle-related risk factors and unhealthy habits, coupled with the fact that we are also growing older, creates a type of a “perfect storm” or as the Canadian Diabetes Association states,” economic tsunami” that threatens to create an unsustainable burden to employers and governments and negatively impacts insurers bottom lines. Type 2 Diabetes is a perfect example. The economic burden of this type of diabetes in Canada, that affects approximately 90% of people who have the disease (and there are many of us!) is estimated at over 12 billion in 2010, about double the cost in the year 2000 and rising. And it is no coincidence that as the prevalence of type 2 diabetes increases, so do our waist lines and body weights while our lifestyles become increasingly more sedentary – and that of our children!
The type of care insurers cover is “sick-care” not “health-care”. Essentially a do-nothing scenario, until people get sick. This is a failed strategy and requires a fundamental shift on the way we view health and the way we pay for health. And more clinics to measure blood pressure or body mass index are not the answer without a comprehensive, concerted effort to help people decrease their risk and become healthier. We have been measuring our waist-lines and blood pressures and we know they are increasing. The question is “what are we going to do about it?” And the challenge to the insurance industry is to embrace prevention and help people stay healthy or become healthier. As for the ROI, the value of Comprehensive Workplace Wellness is well established. Speaking as the principal investigator of Healthy LifeWorks, the 4-year wellness study quoted in this Globe and Mail article, I can state that findings are very much in line with the U.S. and other data on the economic benefit of keeping people healthy. We know enough now on the value of prevention and the link between employee health and productivity to truly embrace prevention and wellness. As for the “breakthrough” over the next year or so of predicting for an employer where their best investment is or helping identify for an individual employee future health problems, we can do these now. And the message is simple: eat a healthy diet, do regular physical activity, maintain a healthy body weight and follow a healthy lifestyle.
As for the privacy and confidentiality issue, it is doubtful that individual employees would consent to have their health status monitored by the insurance industry, which as the article states, “… will also make them (the insurers) more valuable to employers!” In fact, companies must be cognoscente of the perception of lack of confidentiality and privacy on the part of employees when this type of data are collected by their insurers.
As a final note, I am pleased to see the recognition of incentives as a motivational tool for those enrolled in wellness programs. However, the strategy is still largely focused on what has gotten us into this mess in the first place: the do-nothing, “sick-care” scenario. And paraphrasing Albert Einstein:
“The problems we have created as a result of our current level of thinking cannot be solved with the level of thinking we had when we created them”.
[...] noted in my previous blog, “Insuring Prevention?,” linking reductions in health risks to insurance premiums can have negative consequences. Thus, [...]