Health Care Reform, Prevention, Cost-Savings

President Barack Obama will address the nation tonight in a prime time news conference on health care reform. This is the latest event in what has been a full court press by the White House in recent days to try to build awareness and momentum around the debate. At a White House Rose Garden event on Tuesday, Obama said, “We've agreed that our health reform bill will emphasize prevention and wellness by investing in programs that help Americans live healthier lives. We will save money, prevent illness, and increase the competitiveness of our country. “

IHRSA and its partners continue to encourage legislators to use prevention to contain skyrocketing costs. In a statement released Monday, the Partnership to Fight Chronic Disease (PFCD) urged Congress to focus on the number one driver of health care costs- chronic disease. "We must focus on disease prevention and wellness in order to reduce unnecessary - and often preventable - costs and create a sustainable health care system," said Ken Thorpe, Ph.D., PFCD Executive Director. "We hope that as other Senate and House committees continue through mark ups, they will make certain that their bills contain adequate measures to address the economic burden of chronic disease and control costs in order to insure the passage of comprehensive, sustainable health care reform legislation in 2009."

While members of Congress and the Obama administration discuss health care reform, the President continues to call on Congress to move bills out of committee and to vote before the scheduled August recess. Though some in Washington are beginning to call the deadline impossible, committees are working very quickly to mark up the bills as soon as possible making this a crucial time for IHRSA’s Personal Health Investment Today Act and Workplace Health Improvement Program Act.

“Our DC team has been actively engaging with key legislators in both the House and the Senate on including the WHIP and PHIT Acts in health care reform,” said Helen Durkin, executive vice president IHRSA public policy. “But we do not have a million dollars a day to spend like the insurance and pharmaceutical lobbies. Our strength is the number of fitness professionals across America that are passionate about creating a culture of wellness in our nation.”

Fitness professionals can do their part by writing an email to Congress asking for their support of exercise as part of prevention in health care reform. All of the details are provided online at http://ihrsa.org/campaign. Clubs will be speaking out for legislation that not only encourages Americans to lead healthy lives but also provides them tax incentives to do so while promoting health clubs and growing the number of Americans with gym memberships.

- Breanne McGahey

Obama Nominates Surgeon General

Earlier today in a White House Rose Garden ceremony, President Barack Obama nominated Dr. Regina Benjamin to serve as the next Surgeon General of the United States. By all accounts, she is a qualified doctor who is exceptionally dedicated to her patients in Bayou La Batre, Ala. (yes, Forest Gump fans the same shrimping community Bubba was from). But what position will Dr. Benjamin take on exercise, prevention and wellness?

As the fitness industry, we hope that the Surgeon General will make use of the high profile of her office to shed light on the impact that a healthy lifestyle can have on the health of all Americans. Bush's Surgeon General, Dr. Richard Carmona was a proponent of healthy lifestyles, he even spoke at an IHRSA Convention a few years back. Acting Surgeon General Dr. Steven Galson, has also promoted exercise and been a friend to the issue, especially during the release of the Physical Activity Guidelines.

According to Obama's statement today, "[Dr. Benjamin]'s been a relentless promoter of prevention and wellness programs, having treated too many costly and -- diseases and complications that didn't have to happen." This is great, but given her focus on rural health care one has to wonder how will so many important areas of health care be handled by a small staff with a limited budget. Coming from Alabama, Dr. Benjamin must be keenly familiar with the impact of a sedentary lifestyle. The Trust for America's Health reported earlier this month that Alabama has the second highest adult obesity rate in the nation at over 31% of the adult population. That is a shocking statistic.

I am curious to learn if Dr. Benjamin led efforts in her community to increase physical activity and improve eating habits. If so, she could very well become a powerful role model for the changes that need to occur in our communities that are hardest hit by the obesity epidemic. Only time will tell.

Dr. Benjamin said during her statement that she wants to become America's family physician. I hope that she and all family physicians across America start to better advise their patients on the importance of regular exercise and healthy diets.

- Breanne McGahey

Costs, Including Prevention, Come Under Fire in Health Care Debate

The Senate Committee on Health, Education, Labor and Pension (HELP) held its first meeting yesterday on proposed health care reform legislation. The meeting, led by Senator Chris Dodd (D-CT) in Chairman Edward Kennedy’s (D-MA) absence due to illness, comes amid increasing talk of costs and implications on the federal deficit.

Earlier this week the Congressional Budget Office (CBO) reviewed the HELP bill in response to inquiries from Senators Kent Conrad (D-ND) and Judd Gregg (R-NH). The CBO estimated the plan currently being considered by the Committee would leave 37 million Americans uninsured and cost more than $1 trillion over ten years.

One of the areas addressed in the report is the cost for preventative care and wellness in health care reform. Overall, the report concludes that increasing access to preventative services and wellness could decrease costs by making people healthier but may not materialize savings because long-term empirical evidence is lacking for the broad array of services considered under this category, including programs to decrease obesity. One scenario presented is that while reducing chronic disease through healthy lifestyles would help people live longer, it could cost the government more in Social Security benefits.

In April, IHRSA along with the Partnership to Fight Chronic Disease called on House leadership to update how the CBO produces estimates for health care bills. It made several recommendations for how the CBO can accurately estimate the fiscal impact of prevention legislation, such as including the deteriorating health of the population its estimated impact in the future, scoring beyond ten years to capture the long-term value of prevention, and incorporating broader economic impact, such as worker productivity. "The inability of the CBO to accurately account for savings created by prevention and wellness further demonstrates the lack of historical support for wellness initiatives in Washington," says Helen Durkin, J.D. IHRSA Executive Vice President of Global Public Policy. "With Congress and the White House calling on prevention as a key component of reform, the CBO needs to reevaluate its outdated modeling."

Meanwhile, the Senate Finance Committee and House Democrats are preparing to introduce their own reform bills shortly. Early estimates on the not yet public Finance Committee bill are $1.6 trillion over ten years. It is unclear how many Americans would be covered under the plan. Reportedly Chairman Max Baucus (D-MT) wants the bill under $1 trillion. One thing that does seem apparent is that all options remain on the table. Despite some partisan banter, both sides seem willing to address health care reform. Costs and impact on the deficit will likely remain major points of contention throughout the debate.

- Breanne McGahey

The Personal Health Investment Today Act (H.R. 2105)

The following is detailed information on the Personal Health Investment Today (PHIT) Act (H.R. 2105). This bill is currently before the U.S. House of Representatives Committee on Ways & Means. If you would like to support this bill, join the virtual march on Washington by visiting http://campaign4health.org.

The PHIT Act (H.R. 2105) would eliminate a federal policy barrier and create a financial incentive for Americans to engage in physical fitness and exercise.

Americans could utilize up to $1,000 annually from their tax-favored accounts (such as FSAs and MSAs) to make expenditures related to organized individual and team sports, fitness and exercise, recreation and other physical activities. The PHIT Act would not increase the total contribution limits to those pre-tax accounts.

• 64% of American adults and 34% of American children suffer from overweight, obesity, and physical inactivity. These rising rates of obesity and Americans’ proclivity for inactivity are resulting in double digit annual increases in healthcare costs to the government and business.

• The Centers for Disease Control and Prevention (CDC) estimates that healthcare costs directly associated with inactivity were $76.6 billion in 2000; roughly one-third of those costs ($25 billion) fall directly on U.S. taxpayers since approximately one in three Americans is covered by a taxpayer-funded health plan.

• The PHIT Act would help to reverse the trend of increasing physical inactivity and obesity by eliminating a federal policy barrier and providing an important tax incentive to promote exercise.

• Public health experts agree that regular physical activity substantially reduces the risk and symptoms of numerous chronic diseases and medical conditions, resulting in fewer hospitalizations, physician visits, medications and lower health care costs.

• The PHIT Act would change the types of expenditures that could be payable out of tax-favored investment accounts: flexible spending accounts (FSAs), medical savings accounts (MSAs) and/or medical reimbursement arrangements.

• Under the current set-up, Americans predominantly use pre-tax accounts to pay for treatment and detection of illnesses: prescription drugs, doctor visits, examinations and screenings.

• The PHIT Act would allow consumers to to pay with pre-tax dollars for prevention in the form of increased physical activity, including:

• fitness center dues
• group exercise classes
• youth sports league fees
• some exercise equipment
• other fees associated with physical activity programs

• Depending upon their income tax bracket, the PHIT Act could help Americans save 20-30% on the cost of physical activities, exercise programs and related expenses.

• The PHIT Act tax incentive represents an important tangible benefit that the federal government can provide to promote healthier lifestyles and reverse the rising costs of treating obesity-related chronic diseases.

• Fitness-related tax savings would provide a great incentive for Americans to take an important first step toward reversing their sedentary lifestyles and lowering healthcare costs.

Why is the PHIT Act necessary?
The PHIT Act would eliminate a federal policy barrier and create a financial incentive to engage in physical fitness and exercise.

What will the PHIT Act do?
The PHIT Act would change the types of expenditures that could be payable out of tax-favored investment accounts (such as FSAs and MSAs). Under the current set-up, Americans predominantly use pre-tax accounts to pay for treatment and detection of illnesses: prescription drugs, doctor visits, examinations and screenings.

The PHIT Act would allow consumers to set aside up to $1,000 ($2,000 per family) annually from their tax-favored accounts to make expenditures related to prevention in the form of increased physical activity, allowing fitness center dues, payments for some exercise equipment, and other fees associated with physical activity programs to be paid with pre-tax dollars.

What will the PHIT Act cost?
IHRSA has met with the Congressional Joint Committee on Taxation and has requested an immediate “score” for the PHIT Act, which will determine the total cost of implementing the bill over a ten year period.

Who is supporting the PHIT Act?
IHRSA has gathered broad support for the PHIT Act during previous sessions of Congress. The PHIT Act was re-introduced in the U.S. House of Representatives on April 27, 2009 by Representative Ron Kind (D-WI) and referred to the House Committee on Ways and Means. Co-sponsors, at the time of introduction, include Representatives Earl Blumenauer (D-OR), Kevin Brady (R-TX), and Zach Wamp (R-TN). (Full co-sponsor list.)

Rep. Ron Kind: Promoting Healthy Lifestyles

Last week, IHRSA fitness professionals gathered in DC for the Campaign for a Healthier America to lobby for support of the Workforce Health Improvement Program (WHIP) Act (HR 2106/S 913) and the Personal Health Investment Today (PHIT) Act (HR 2105). US Representative Ron Kind was the lead sponsor of both bills in the House. The following is a post by Representative Kind on The Hill Blog.

Let’s face it; Americans have been too sedentary, too long. Sixty-four percent of American adults and 34% of children suffer from chronic disease, often brought about by obesity and lack of physical activity. A recent study even found that 20% of our four-year olds are obese. If lifestyle changes aren’t made, these kids are going to become obese adults and struggle with chronic disease all their lives. This is something we must reverse.

There’s a lot we could be doing at home to take care of our health. In our everyday lives, we have control over exercising more, eating better and giving up smoking. And the better we take care of ourselves, the more dramatic decline we’ll see in health care costs.

The Centers for Disease Control and Prevention (CDC) estimates that health care costs directly associated with inactivity were $76.6 billion in 2000. By using the tax code to incentivize physical activity, through the WHIP and PHIT Acts, we can cut these outrageous health care costs.

That’s why I and Rep. Zach Wamp, along with several other likeminded members of Congress, recently introduced the WHIP (Workforce Health Improvement Program) and PHIT (Personal Health Investment Today) Acts - to give people the incentive they need to get active; further preventing illness and disease, improving worker productivity and reducing the amount spent by consumers and government on managing major health issues every year.

The bills give employees pre-tax advantages for wellness activities, encouraging people to increase their physical activity. Not only does the WHIP Act affirm an employer’s right to deduct the cost of subsidizing or providing fitness center benefits to employees, encouraging them to offer the perk, but it also eliminates the income tax paid by employees on these benefits, giving them an incentive to get active. The PHIT bill increases the types of expenditures payable out of pre-tax health investment accounts, allowing taxpayers to use up to $1,000 annually for preventative exercise costs including fitness center dues, some exercise equipment, and sports activity fees, among others.

The WHIP and PHIT bills put us on the right track to reforming health care by keeping preventative measures in mind. These bills help remove the cost barrier associated with getting fit and promote a healthy lifestyle, furthering preventative health efforts and reducing our nation’s health care costs.

http://blog.thehill.com/2009/05/06/promoting-healthy-lifestyles-rep-ron-kind/

Campaign for a Healthier America

The Campaign for a Healthier America is a national grassroots project bringing together exercise enthusiasts to make healthy lifestyles a priority for all Americans.

The Campaign seeks to bring the fitness industry together with government, employers, medical and public health professionals, insurance providers, schools, and each of us individually.

We must work as one to create a culture and environment of wellness. To achieve this, we will:
- Encourage regular exercise and healthy eating for people of all ages and physical conditions
- Engage Americans in grassroots efforts to make their communities healthier
- Ask policymakers to encourage exercise by creating tax incentives and removing financial barriers

Learn more about the Campaign for a Healthier America and how you can join the movement by visiting, campaign4health.org.

Obama's health principles, translated

Over the last two years there has been a very clear growth in the attention paid to prevention and wellness as part of health care reform. Now that the Obama Administration and Congress have set their sights on the passage of a bill in 2009, it seems that every day there is another news article or video clip of someone who will play a role in this important reform making a clear pitch for prevention and wellness.

Here is a great story on Politico. Obama's health principles, translated. In the budget that the Adminsitration sent to Congress last month, they outlined 8 principles for health care reform. Politico translates the carefully crafted policy statements into something a little more, umm... "straightforward."

Check out #6:
"6. Invest in prevention and wellness. The plan must invest in public health measures proven to reduce cost drivers in our system — such as obesity, sedentary lifestyles and smoking — as well as guarantee access to proven preventive treatments.

Translation: Get in shape — and get used to hearing a lot more about “individual responsibility.” Quit smoking. Exercise. Eat better. And, to encourage a healthier diet, perhaps a fast food tax? Well, maybe not. Americans value their personal choice and wallets too much. Look for Democrats and Republicans to talk a lot about preventing chronic diseases."

Sounds like they are making a perfect case for the WHIP and PHIT Acts.

-Bre McGahey

This City Is Going On A Diet

If I was a political adviser to a governor, mayor, or town supervisor, I would urge my boss to launch a "wellness initiative." Aside from the obvious health benefits that such an initiative could provide to constituents, it also would associate my boss with several positive political attributes. Who would not want to be associated with wellness? "Wellness" is good, positive, buoyant, vigorous, vital - all wonderful traits for a politician to possess, or, at the very least, appear to possess.

In fact, several municipalities are taking the lead on wellness in their communities and enjoying great results. For example, in Oklahoma City, Mayor Mick Cornett is spearheading a brilliant anti-obesity campaign titled, "This City Is Going On A Diet," which, among other things, directs citizens to local fitness centers. In Carmel, Indiana, the Carmel Mayor's Wellness Challenge just kicked off its third year. And, as has been noted in several national media outlets, Somerville, MA is conducting a groundbreaking initiative titled Shape Up, Somerville.

I believe the success of these municipal programs, and the positive attention they've received, should give any club the confidence to approach its own elected officials to discuss the possibility of partnering to create a local wellness initiative. The officials should be thankful for the opportunity - it would be good for their constituents and it would be good for their political careers. Have any clubs tried this yet?

- Tom Richards