Helping Americans live well is good public policy

The healthcare plans circulating in Congress lack a proactive policy to help prevent chronic disease and promote health and wellness. Effective healthcare reform must do more than expand access to care and reduce its costs; it must include measures to improve our nation’s health.

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The prevention of chronic disease is a powerful step we can take to improve our country’s health and reduce healthcare costs. Smoking and obesity, two of the largest contributors to chronic disease, have a combined cost of $250 billion annually to the United States. According to the Centers for Disease Control and Prevention (CDC), chronic disease accounts for more than 75 percent of healthcare costs.

Smoking, obesity and their consequences result in nearly 750,000 deaths a year. Smoking is a leading contributor to lung cancer and chronic obstructive lung disease, which includes bronchitis and emphysema. Obesity, in turn, dramatically increases the risk of heart disease, diabetes, cancer, stroke and arthritis, among other conditions. More than one-third of American adults and 16 percent of our children are obese — this is a nationwide epidemic.

Through healthcare reform legislation, Congress has the opportunity to do something about it. We can enact policies to prevent chronic disease and encourage wellness by incentivizing healthy behavior and providing communities and individuals with the resources to improve their health.

First, creating a tangible incentive for individuals to embrace healthy lifestyles can help prevent chronic disease in the long term. Insurance discounts are a straightforward means we can use to encourage healthy living. Most automobile insurers offer safe driver discounts for responsibility behind the wheel.

A healthy living discount can reward healthy behavior and encourage personal responsibility, just as a safe driver discount does.

My proposal, H.R. 3472, would create health insurance coverage premium discounts of up to 20 percent for healthy behavior and improvements toward healthy behavior. This would give Americans a positive, concrete inducement to maintain healthy cholesterol levels, heart rates and body mass indexes, all of which are vital indicators of a person’s overall health and wellness. The bill also encourages regular visits to the physician, another preventative health measure.

Next, supporting programs that make healthy living a priority at the local level can help individuals make the everyday choices that lead to better health.

The Healthy Communities Act of 2009 (H.R. 3144) encourages a community-based approach to improving health and wellness. Based on a successful program in Armstrong County, Pa., the act makes grant dollars available for five-year, public-private partnerships to create a healthier local environment and reduce obesity through educational programs and nutritional counseling.

A community partnership approach helps keep local stakeholders — schools, hospitals, businesses and local governments — invested in the program’s success. Communities would have to reach certain annual benchmarks to continue to receive funding, ensuring that federal dollars remain effectively used. When a community creates a healthy environment for its members, individuals have another source of positive encouragement to make healthy choices.

Finally, Congress must ensure that Americans fighting obesity have the medical treatment they need to beat the disease. During my 25 years as a clinical dietitian, I saw firsthand that medical nutritional counseling is an effective treatment for obesity, yet it is not covered by the nation’s largest healthcare program. According to the CDC, approximately half the costs associated with obesity are paid through Medicare and Medicaid, but Medicaid does not pay for nutritional counseling.

The Obesity Treatment and Wellness Act of 2009 (H.R. 3092) would make this treatment available through Medicaid, giving access to nutritional counseling to low-income Americans, a group disproportionately affected by the obesity epidemic. This simple change in Medicaid would give the best care available to those who need it most.

It is good public policy to help Americans live well. These and other prevention and wellness proposals are proactive measures to fight chronic disease and the heavy burden they place on our healthcare system. It is imperative that healthcare reform include measures to help prevent chronic disease and promote healthy living.

I urge my colleagues to support robust prevention and wellness provisions in the final health care plan.

Dahlkemper is chairwoman of the House Small Business Subcommittee on Regulations and Healthcare.

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