A health reform bill coming out of the Senate Health, Education, Labor and Pension (HELP) Committee includes a few billion dollars for health prevention.
The bill will, “pave sidewalks, build jungle gyms and open grocery stores, but it won’t bring down health care costs or make quality coverage more affordable,” Senator Michael Enzi (R-WY) told the press.
But paving sidewalks for sedentary Americans to walk on, building jungle gyms for overweight kids to play on, and adding greengrocers to urban centers would go a long way to improving health and health care in the U.S.
The HELP bill has earmarked $10 billion annually for a so-called “prevention and public health investment fund.”
Health Populi’s Hot Points: There are many ways to skin this statistical cat. The costs of lifestyle-driven ills in the U.S. come from multi-faceted origins. Let’s just look at three big hits: obesity, smoking, and sedentary living.
Obesity: The cost of obesity in the U.S. has been pegged at $147 billion per annum. Among Americans age 2 to 19 years of age, the American Heart Association says that 32% of non-Hispanic white males and nearly 30% of non-Hispanic white females are overweight. Among non-Hispanic blacks, 31% of males and 39% of females are overweight. If we can get to this challenge early in life — think of a sort of Head Start for Health — we can prevent diabetes and other diseases that not only cost a lot to the health system, but detract years from life and quality from the remaining years in that American life.
Smoking: Cutting back on smoking could cut health costs in the U.S. by $100 billion a year, according to the CBO. It still amazes me when I walk out of an office building or hospital (yes, hospital) and have to wade through the smoky outdoor corridor where workers ritually convene to drag on cigarettes during a coffee break (or more likely, cancer break?). Nicotine remains one of the most addictive substances on the planet. Today, though, there are many avenues to quitting: new delivery mechanisms to deliver just the right chemical to just the right part of the brain at just the right time. They’re available over the counter and via prescription. Their costs are deductible from health savings accounts. Fiscal cynics say that the taxes added to the economy via cigarette purchases add to the tax bottom line for the nation. I say, let the workers live longer and pay into the tax funds in their lifetime.
The costs of sitting still. Another aspect of the Senate bill is what some critics find laughable: funding for bike paths. The point here is to change the state of play in town planning and get people walking and moving about again. I’m on holiday this week in a place where I can walk most places — there’s greenery to breathe in, people to greet on the street, and outdoor produce markets with fresh, local foodstuffs. Yet most of our daily lifestyles in the U.S. involve sitting, usually tethered to an electronic device whether for entertainment, infotainment, or work. The emergence of health-e games is a hopeful sign: the new Wii Resorts hit the electronic games shelf in July 2009 to add to the Wii Fit portfolio of health e-games. My colleague Doug Goldstein of iConecto has found that the health e-games market is expanding very quickly, both longer games and the more casual gaming segment. Don’t stereotype this market, either — women are as likely to do exergaming and men, including people over 35.
When you read that the U.S. health system can’t afford to fund prevention, consider the source and the angle, and the lifecycle cost of not doing so.