health care costs

There’s no nice way to say it.  We Americans are fat, and we get fatter every year.  According to the CDC; “About one-third of U.S. adults (33.8%) are obese.  Approximately 17% (or 12.5 million) of children and adolescents aged 2—19 years are obese.”

And it‘s getting worse.  The CDC predicts that one third of those born in 2000 will develop type two Diabetes, and some articles suggest that parents may possibly outlive their children.  

It’s a no brainer that a healthy employee is going to cost your company less than an employee that is likely to die in middle age due to cardiovascular disease and complications that come from obesity. 

The cost of healthcare premiums has doubled in the past ten years, according to the July 30th issue of The Economist. That makes it harder for your company to continue to offer healthcare.  But some companies have started to do more than “suggest” that their employees quit smoking, lean up, and adopt a healthier lifestyle.  Some companies have started to penalize the employees who don’t.  Many firms no longer allow smoking at their facilities.  In fact, The Economist cites GE Capital, who first offered their employees incentives for quitting smoking, and now, those who continue to smoke must pay an additional $650 for health insurance.

That’s where wellness programs excel.  Wellness professionals know how to build programs for your company that will inspire lasting change.  It’s one thing to lose 20 or more pounds, but to provide the education, information, and incentives to help your employee keep it off for a lifetime, quit smoking, and show their families how to do the same, is priceless on many levels.   

There’s an interesting blog written in the New York Times by Dr. Sandeep Jauhar, cardiologist.  He raises a few very interesting points on the higher insurance premiums and taxes that cover uninsured people, not to mention the diseases that come from people that are overweight, or smoke.  He poses and answers the question, “Why do we (taxpayers and employers) have to pay for others’ bad habits?” 

We’ve cited the statistics of obesity in this blog many times, obesity is rapidly growing and so are its related diseases; heart disease and diabetes to name a few infamous killers.  Nevertheless, people continue to over-indulge in smoking and consuming food that makes them ill, resulting in increased morbidity risk.

On the other hand, Dr. Jauhar points out that the reason people turn to unhealthy food choices is often because it’s cheaper in this country to eat highly processed junk.  Picture a family of five with severely limited income.  Does it make more sense to buy 3 fast food meat and cheese biscuits for .99 cents each for the kids before school or to purchase one head of organic broccoli for four dollars for dinner?   Economic reality possibly creates a more empathetic picture.  Could this same family be taught the consequences of eating fast food every morning as well as some healthy, affordable alternatives?  Of course. 

Either way, employers like yourselves will pay the price in increased premiums and rates to cover your employees. 

The point?  We Americans are our own worst enemy.  We love our excesses.  It takes discipline, time and perseverance to adopt lasting change.  In the health industry today, we are in the absolute battle trenches when it comes to enlisting and convincing our employees and the country to put the time and finances necessary into providing alternatives that ultimately save money and lives.  We must do everything we can to educate and enlighten.  These alternatives include corporate wellness programs, fitness programs, accurate health risk management and coordination of incentives given for healthy progress. And it has to happen now.  Either way, we’re paying for it.

According to a survey conducted by Towers Watson, the future of health care costs is expected to rise substantially for both employers and employees. 

In January 2010, I was asked by IHRSA to share my vision of the fitness industry with 30 other leaders and business people in “Ask an Industry Leader.”  The overall tone of the resulting publication was optimistic and hopeful.  In the past, the emphasis on health care was to help employees recover from disease.  For 2010, the Leaders all shared a common theme of shifting the emphasis from illness to prevention and wellness; the prevention of disease.

As 2010 draws to a close, the Towers Watson survey casts a grim shadow over continued optimism for next year.  The survey included 466 mid-sized to large companies and projected an overall 8.2% rise in health care costs in 2011.  Employers, faced with rising costs and the arrival of health care reform, say they need to raise the annual maximum amount employees pay for health care costs.   U.S. employees have already experienced reductions in annual raises and job benefits.  The projected jump in costs will most likely produce hardship and a wide gap of affordability for many employees.

If you believe in the power of prevention, however, good news still exists for 2011 according to Ralph Fontanetta, Senior Health Care Consultant with Towers Watson. 86% of U.S. employers plan to increase efforts to encourage employees to engage in wellness/health promotion programs with 65% already or planning to increase incentives for these programs. 94% will continue offering employer-sponsored health care plans for active employees.

We need to stay the course.  The “We” includes employers, health insurance companies, the wellness industry and the employees we serve.  It’s encouraging that employers will continue to offer wellness programs to their employees because it is a promising and positive alternative.   In this day and age, we know that exercise and diet have a direct correlation to preventing disease, promoting health and lowering the cost of health care.  The National Cancer Institute says that heart disease, the number one killer in our country today, is largely influenced by what we eat. Some cancers, stroke, diabetes, and high blood pressure can all be prevented by lifestyle changes, such as diet and exercise. 

We’re far from the end of the battle but hope endures. We must follow.

2010 has been a big year for food borne illness.  We’ve experienced massive recalls and warnings for locally produced eggs, breakfast cereals, and green, leafy vegetables. 

In March of this year, a study by a former FDA economist and current Ohio State University assistant professor in the department of consumer science, Dr. Robert L. Scharff estimates that “produce (fresh, canned and processed) accounts for roughly 19,700,000 of the reported illnesses documented, at a cost of approximately $1,960 per case and $39 billion annually in economic losses.” The study was funded by the Pew Charitable Trust.

Depending on the specific cause or  pathogen, food borne illness can result in a range of reactions from uncomfortable to death, or anything in between such as the loss of ability to return to work or function normally in society.  Callous as considering your bottom line may sound when it comes to potential illness or death, even sick days directly affect your company.

The Centers for Disease Control and Prevention estimates that approximately 76 million new cases of food-related illness — resulting in 5,000 deaths and 325,000 hospitalizations — occur in the U.S. each year. According to makeourfoodsafe.org, California pays an unbelievable annual $18,613,000,000 in aggregate medical costs.  New York pays an annual $10,375,000,000.

According to Erik Olson, of the Pew Health Group, “This report makes it clear that gaps in our food safety system are causing significant health and economic impacts.”  

Health and economic impacts, most certainly.  Those numbers, as with any other vastly devastating physical issues, such as obesity and the resulting diseases; i.e. cardiovascular disease and diabetes, can and should be reduced by prevention.  Food borne illness prevention calls for education.  Education comes from a comprehensive wellness program that teaches your employees the basics about food safety, how to clean, separate, cook and chill food, whether it’s necessary to spend more for organic to keep their families safe, how to store leftovers, and what to do in the event of a poisoning or emergency.   

As always, an ounce of prevention is worth a pound of cure.

The U.S. Department of Health and Human Services challenged our country with a national health objective called “Healthy People 2010”.  The goal was to reduce obesity to 15% of the entire population for each of the 50 states.

Results were bleak: not one state in the country was able to meet the challenge.  Mississippi weighed in heaviest at 34.4%.  Only two states, Colorado and Washington D.C., had rates below 20%.  Even bleaker, the results were self-reported which has shown that participants typically overstate their height and understate their weight.

The report says that the price tag on our collective obesity issue has reached a hefty $147 billion dollars a year.  The director of the Centers for Disease Control (CDC), Dr. Thomas Frieden, noted that not only did every state fail to reach their target, but that nationwide “obesity rates have doubled in adults and tripled in children” over the past few decades.

Fearsome numbers to say the least, and they draw a bright red line from your company to corporate health promotion.  Why?  Increased national obesity means increased death and illness from related diseases such as heart disease and diabetes. Any company that offers health insurance as a health benefit is directly affected by that $147 billion price tag.

There are numerous benefits of corporate wellness, including providing on-site foot soldiers in the war against obesity that know how to produce sophisticated, effective programs, results, and education.  Workplace wellness boosts employee morale, reduces stress and directly influences your company’s retention and talent pool.

It’s a war you need to win.  Arm your company accordingly.

According to the Mayo Clinic, starting a fitness program may be one of the best things an individual can do for their health. 

The latest Surgeon General’s report supports this as well.  In case you’ve lived in a cave for the past few years, you’ve already heard that regular physical activity reduces the danger of succumbing to heart disease, the leading cause of death in our country.  And for you CFO's out there, an active fitness participant can cost your organization up to $1,250 less in health care costs per year according to a 2008 study in the journal Preventing Chronic Disease. Wellness can also reverse the effects of hypertension, diabetes, and certain cancers, as well as reduce hospital admission rates significantly for these same conditions. Numerous studies also confirm that exercise can not only prolong your employees’ lives, but can also stave off depression, anxiety, and other emotional issues. 

What might not be as obvious as the fact that exercise is good for you and your employees is that like all things, exercise should be done in moderation.  Nothing breeds success like success, and for those who need exercise the most this means starting out with a low to moderate level of physical activity. Walking is a great example of a level of activity that for most employees is a safe and simple platform for better health.

Whatever program for physical activity your company offers in their wellness palate, it should be based on both common sense and solid science.  A moderate exercise program is one that your employees will be able to enjoy and stay engaged in for a long healthy lifetime.   

Smart business people make decisions for their companies that are based on numbers and facts, not fads.  A Duke University Health and Safety Surveillance study available in The Archives of Internal Medicine (2007;167:766-773) draws a line directly from a worker’s body mass index to the number of worker’s compensation claims they would file and how many days of work they would miss.  The higher the BMI (weight in kilograms divided by height in meters squared) the more lost workdays.  Workers that maintained a recommended BMI averaged about 14 lost workdays a year per 100 FTEs; workers classified as obese averaged 184 lost workdays per 100 FTEs for the same period.

As of this writing, most Americans receive health insurance from their workplace, which makes this information significant to you, the employer.  Your obese workers cost you over 21% more in health care costs than your normal weight workers.  Additionally, keep in mind that this study did not include issues such as absenteeism or presenteeism, although both certainly influence your bottom line.

A healthy body mass index is not a lifestyle choice any longer.  Your obese employees cost your company money.  That’s a fact.  Now, what are you going to do about it?  You’ve made the moves to make your workplace safer and greener, now implement the wellness programs you need to make your company leaner.