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Actual Health Care

You could practically hear every eye in the room roll back when Dorothy, our human resources director, explained why our health insurance rates were increasing so dramatically and what we could do about it: “You can just stay healthy!”

To be fair, that was the last, impromptu “option” on the list, but it struck us as pretty obnoxious coming from an executive of a newspaper corporation.

This was 1988 and health insurance was just starting to get more complicated and far more costly, with increases pushing 50% year over year. My employer did not have control over the rates, but Dorothy got the brunt of our frustration. I was just starting out in newspaper journalism, not a lucrative profession. So every dollar counted.

It took me many years to realize that Dorothy was right that the aspect of my health insurance that I had the most control over was my health itself.

Whither Wellness?

The brokers see it as focusing on the health care costs rather than on the insurance rates. It certainly makes sense.

But what you won’t find in the article are wellness programs. That’s because even though 50 million employees are covered by them, the programs don’t work. At least, that has been the finding of a few significant studies, lately.

For example, researchers on behalf of the National Bureau of Economic Research last year published the results of the Illinois Workplace Wellness

Study, which may prove to be fatal to wellness programs, or at least how they are conducted. Besides looking at studies, the three researchers actually set up a wellness program for an employer with more than 12,000 workers.

What they found was one of those conclusions that seems obvious in retrospect: The people who were more likely to do healthy things were most likely to participate in the program and were also more likely to be healthy already.

“After one year, we find no significant effects of our wellness program on the many outcomes we examine,” according to the report.

It is not difficult to imagine why. Who wants to be nagged by their employer and health insurer? It would seem to be a perfect way to get the inner brat to pout and refuse to comply.

More Dollars For Less Health

And it is obvious that we are not well. One look at the chart accompanying this letter reveals that.

The disease burden chart shows just how miserable many Americans are. It features the total number of years lost to disability and premature death. Not an area in which the U.S. wants to be No. 1.

We have all seen the statistics showing that the United States spends the most on health per capita for the worst outcomes. We spend twice as much as other developed countries for some of the worst results, such as the highest infant mortality.

These findings coincide with the growing realization that Americans are committing suicide by fork. The Centers for Disease Control reported that nearly all premature deaths are caused by lifestyle.

“The results of this analysis indicate that, when considered separately, 91,757 deaths from diseases of the heart, 84,443 from cancer, 28,831 from chronic lower respiratory diseases, 16,973 from cerebrovascular diseases (stroke), and 36,836 from unintentional injuries potentially could be prevented each year,” the CDC wrote.

It is clear that “lifestyle” means diet. Study after study shows it, but one massive study published in The Lancet this April is the most compelling. These researchers looked at 17 years’ worth of data from 195 countries. Here is what they found:

“Suboptimal diet is responsible for more deaths than any other risks globally, including tobacco smoking, highlighting the urgent need for improving human diet across nations. Although sodium, sugar and fat have been the main focus of diet policy debate in the past two decades, our assessment shows that the leading dietary risk factors for mortality are diets high in sodium, low in whole grains, low in fruit, low in nuts and seeds, low in vegetables and low in omega-3 fatty acids.”

So, Dorothy turned out to be right. Pills, tests and surgery are not health care, but actually disease management. We are ultimately the best managers of our health.

Steven A. Morelli is editor-in-chief for InsuranceNewsNet. He has more than 25 years of experience as a reporter and editor for newspapers, magazines and insurance periodicals. Steve may be reached at [email protected] Follow him on Twitter @INNSteveM. [email protected].

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