Jumpstarting a wellness society

The media have done a good job of reporting that the emerging bill will crack down on abuses by health insurance companies, and extend quality health coverage to nearly every American. In addition, much attention has been paid to the public option, which I am confident will be in the bill we send to the president’s desk later this year.

But a critical, transformational element of the emerging legislation has been largely overlooked.

Our comprehensive reform bill lives up to its name by including a robust array of provisions promoting wellness and prevention, and jumpstarting America’s transition into a genuine wellness society. The bill creates a sharp new emphasis on fitness, physical activity, good nutrition and disease prevention — in short, keeping people out of the hospital in the first place.

The fact is, we currently do not have a healthcare system in the United States; we have a sick-care system. The problem is that this “disease management” approach is all about patching things up after people develop serious illnesses and chronic conditions. And it has been a colossally expensive failure.

The World Health Organization ranks the U.S. healthcare system only 37th among nations, on par with Serbia. We spend twice as much per capita on healthcare as European countries, but we are twice as sick with chronic disease.

Our current system overspends and underperforms, and the reason is clear: Some 95 percent of our healthcare dollars go to go to treating illnesses after they occur. Meanwhile, we systematically neglect wellness and prevention.

Consider this: Right now, some 75 percent of healthcare costs are accounted for by heart disease, diabetes, prostate cancer, breast cancer and obesity. What these five diseases and conditions have in common is that they are largely preventable and even reversible by changes in nutrition, physical activity and lifestyle.

As President Obama said in his speech to Congress earlier this year: “[It is time] to make the largest investment ever in preventive care, because that’s one of the best ways to keep our people healthy and our costs under control.”

Let me be specific about some of the things our health reform legislation will do. The bill we passed in the Senate HELP Committee requires insurance companies to reimburse for the whole range of preventive services — everything from cancer screening to smoking-cessation to nutrition counseling — without any co-pays or deductibles.

The bill gives Americans the tools and information they need to take charge of their own health.

For example, chain restaurants will be required to display caloric information on menus and menu boards, and to provide additional information on sodium, fat and carbohydrates at the request of customers.

I believe strongly that wellness and prevention are not only about what goes on in a doctor’s office. That’s why our bill encompasses workplace wellness programs as well as “Community Makeover” and “Healthy Aging, Living Well” grants to help entire cities and counties to implement activities to get people active and promote good health.

The bill includes a Prevention and Public Health Investment Fund to provide for sustained national investments in these kinds of wellness programs.

The bill allows employers to reward workers for participating in workplace wellness programs by giving them up to a 50 percent discount on health insurance premiums.

I have long said that it makes no sense to extend insurance coverage and give everyone access to a healthcare system that remains fundamentally broken and unsustainable. We must also change the system itself. And that is what our bill will do.

Yes, we are going to crack down on health insurance company abuses, extend coverage and create a public option to give consumers choice and competition. But, just as important, we are going to give our citizens access to a 21st century health care system — one that is focused on preventing obesity and disease, and helping us to live healthy, active, productive lives.

Harkin is chairman of the Senate Committee on Health, Education, Labor, and Pensions.