Where has all the prevention gone?

This time last year, supporters of healthy lifestyles were buoyed by the stump speeches of of then candidate Barack Obama and Senator John McCain. They spoke of prevention, exercise and healthy eating habits. They didn't agree on much, but they did both speak of the power of healthy lifestyles in reducing health care costs.

Fast forward one year. Despite all the rhetoric from Democrats, Republics, Members of Congress, the Administration and all the cable news pundits, real prevention appears to be the forgotten solution. Now that all the major bills have been introduced, it's clear that the oratorical support for healthy diets and regular exercise have not yet translated into policy initiatives.

This is important for a number of reasons. First and foremost, if the causes of chronic diseases, which account for 75% of health care spending are not adequately addressed, no amount of reforms on paper will bring real costs savings. To put it in medical terms, we're treating the symptoms, not the disease. And at the rate our society is going (and growing), today's kids will be the first generation to have a shorter life-span than their parents. How will this play out if that generation is still struggling to reign in health care costs because no one stepped up to the plate and told Americans it's time to start making some hard decisions.

Our CEO, Joe Moore, often writes about the creation of a culture of wellness. I love this. Not because I work for the health club industry, but because I am someone that tries to do what I can in my daily life to make healthy choices. Once you start to educate yourself about wellness and prevention the truth of what our daily habits are doing to us is shocking. Maybe this was what it was like back in the day when people didn't understand the full extent of the health implications of smoking cigarettes.

A poll out today says that 79% of Americans support health care reform. So how can the people that support healthy lifestyles take this support and get people to support healthy lifestyles? THe first thing everyone can do is speak out to Congress and President Obama. We need to share our stories about how healthy habits translate into less chronic disease, lower health care costs, and more productive and happy employees.

If everyone tells their story, we can start a movement. Look at what the anti-smoking movement did. Maybe this can be the wellness movement. Join the movement for a healthier America and share your story today. http://ihrsa.org/campaign.

- Breanne McGahey

Everyday Leaders Bring Health Reform to Life

Joe Moore, IHRSA's President and CEO appears on the homepage of the Washington Post with a guest column in the "Focus on Leadership." While Congress is busy debating the various health care reform bills, Mr. Moore writes "Leaders must emerge from all industries, sectors, and corners of the country, while existing leaders must make the health of their followers, employees and students a priority." Read the full column.

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

Twists and Turns Create Urgency and Road Blocks for Health Care Reform

The health care reform debate is fast becoming a thrilling political drama with non-stop action. As Democrats in Congress and the White House push for passage of reform legislation by the end of the year, some by August, the breakneck pace is hitting some significant roadblocks.

As reported in last week’s issue of Capitol Report, the Congressional Budget Office estimated that the initial bill proposed by Senator Edward M. Kennedy’s (D-MA) Health, Education, Labor and Pension Committee would cost over $1 trillion, and leave more than 37 million Americans uninsured after ten years. Since that report, the Senate Committee on Finance has delayed the release of its bipartisan bill in an effort to trim the costs of the plan before it is made public. The White House has been working very closely with Senator Max Baucus (D-MT) and the Finance Committee, as many observers believe that it is the best chance to produce bi-partisan support.

White House Chief of Staff Rahm Emmanuel, HHS Secretary Kathleen Sebelius, and White House health reform director Nancy-Ann DeParle meet on Tuesday with Democratic Senators, from both committees to discuss the issue. Later today, President Obama will host a town hall meeting on health care at the White House after holding a meeting with five governors that hosted regional health care forums.

Meanwhile, the House held numerous hearings on health care reform this week. Introduced last Friday, the House legislation is the work of three House Committees. The bill lacks funding sources and has not yet been reviewed by the CBO.

- 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.)

Obama Urges Congress to Pass Health Care Reform by August

Makes Economic Case for Reform, Includes Prevention
President Barack Obama has asked Congress to pass health care reform legislation before their August recess and called this a “make or break period.” The move comes as health care reform is increasingly a key issue for the White House. Yesterday, a major report was released and Obama met with Senate Democrats on key Committees to discuss reform.

The report, released early in the day, presented the economic case for health care reform from the White House Council of Economic Advisers. It covers the current economic impact of health care on the nation’s economy and a forecast of what could happen without reform. It then discusses key components of reform that would have major economic impacts, including slowing health care cost growth and expanding coverage.

The role of healthier lifestyles was noted as a key element of successful health care reform. “It will also be important to encourage individuals through education and incentives to make healthier lifestyle choices, such as exercising and healthy eating,” the report stated. “This is important because healthier lifestyle choices have positive, direct benefits on lowering costs.”

Yesterday afternoon, President Obama met with about two-dozen Democrats on the Senate Committee on Finance and the Senate Committee on Health, Education, Labor and Pensions. Both Committees are working to create their own health care reform bills. Obama’s message to them coincided with the report from earlier in the day, that it is a major imperative for the White House that long-term costs are driven down. In addition, the group discussed how to fund immediate changes to the nation’s health care system. According to reports, there was talk about the taxation of health benefits, which Senator Max Baucus of Montana claims will raise $250 billion annually. A White House statement said that Obama prefers funding methods outlined in earlier reports that do not include such taxes.

Underscoring the days events was the sense of urgency being conveyed by Obama. "We can't afford to put this off," Obama said at the start of a meeting the Senate Democrats. "This window between now and the [Senate's] August recess I think is going to be the make-or-break period. This is the time where we've got to get this running."

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/

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

Duke U. New Medical Team - What it's missing

Duke University recently decided to tackle the issue of why more people are seeking treatment in hospital ER's even when they have access to primary care providers. They asked patients two questions: What isn't working for you? and What could we do better? Then they listened. The changes made to the Duke Family Practice Medical Offices, focusing on decreasing waiting time and increasing service, sound great. Patients can interact with the office online, know if they are going to have to wait and how long, but most importantly they created a new type of medical team.

Each team has a physician, nurses, pharmacists, social workers, and physicians assistants. It's an interesting concept and one that cold provide tremendous benefits, especially for the patients at most risk in our health care system.

When I was watching the segment on the NBC Nightly News, I was struck by the forward thinking of the changes but also I couldn't help but wonder, what if the teams also had nutritionists and personal trainers? If these teams could help people actually implement lifestyle changes it could make them healthier, and as a result, require less medical care.

The clip showed a patient who was overweight. The doctor was listening to her carotid artery and another member of the team was reminding her to skip the salt on food. The woman likely has cardiovascular issues. The team approach will probably help her but imagine the difference if there were a nutritionist that could show her proper portion sizes, what kinds of foods to purchase at the grocery store and how to cook delicious and healthy recipes. Now imagine that there were a personal trainer that could show this woman simple ways to to start building exercise into her life. Helping her learn how to strength train and start a cardio regimen. The results would be far beyond what a reminder to pass on the salt could ever bring about.

There are stories all the time about people whose doctors tell them they need to eat better and exercise. Somewhere between the doctor's office and the patients home that advice falls short. Many people simply don't know how to change their habits to lead a healthier life. It's not their fault, but they don't know where to gain that knowledge. If the medical community took steps to build a bridge between what patients are doing and what they should be doing, there could be an incredible change in the health of our nation. There is a role here for the fitness industry and it's up to the passionate people in this community to make it a reality.

Visit msnbc.com for Breaking News, World News, and News about the Economy

- Breanne McGahey