Health Reform Is Useless Without Behavior Change
I have come to a sobering conclusion. All of this talk about reducing healthcare costs through reform is a waste of time unless the American population takes responsibility for their own health. And I don't see much evidence of personal responsibility built into any of the reform plans.
This change will take more than health insurers and employers passing more costs to the individual through higher copays and deductibles—or conversely lowering costs for proper testing, counseling, and immunization. It will also take more than doctors telling patients to get active and eat better or payers reforming payments so that physicians are properly reimbursed for providing that guidance. It will even require more than the government spending millions on wellness and prevention programs that are part of healthcare reform proposals.
All of these ideas are steps in the right direction, but they won't be effective without more Americans taking responsibility for their health.
In an article I wrote for the August 2009 issue of HealthLeaders magazine, I explored the idea that prevention can reduce health costs. During my interviews, one of the most depressing—and truthful—lines about health came from Michael D. Parkinson, MD, MPH, FACPM, principal at P3 Health LLC, which promotes personal and organization prevention, performance, and productivity improvements. Parkinson told me “there is no such thing as a healthy American any more.”
Parkinson, who is also past president of the American College of Preventive Medicine, and former executive vice president and chief health and medical officer at Lumenos, a pioneer consumer-driven health plan, pointed to the recent National Health and Nutrition Examination Survey that found only 8% of the population eats five fruits and vegetables a day, doesn't smoke, spends 30 minutes on physical activity a day, and is within 5 pounds of their ideal body weight.
You might consider that too high of a threshold, but how many people even meet two of those healthy living ideals? Stop by your local breakfast joint and you'll see what I mean.