Overcoming the Unwelcome Stigma

A frequent topic of discussion in our meetings is how the industry can learn to better speak to and serve members of their communities that are overweight. No one will deny that this is a struggle for our industry or that is it one that must be overcome.

Right now about 17% of Americans are members at health clubs. Meanwhile, 67% of Americans are either overweight or obese. Clearly, our industry has a tremendous amount to offer the majority of Americans that struggle with their weight, but before we can help them, we must make them feel welcome enough to enter our clubs.

A sad story came across my desk this morning about a woman who was asked not to use the equipment at her new gym because of her weight. At 380 lbs. the management felt it was unsafe for her to use certain equipment that had weight limits. They offered her an alternative fitness plan, but she was not interested and instead took her story to the local television station.

This story is sad for a few reasons. First, it must have been a crushing emotional blow to this woman for whom weight must be a brutal daily struggle. Second, it's sad because the story will become an excuse for others to not step foot in a gym because it will reinforce their perception that gyms are only for skinny people. That means, these people won't reap the health benefits that are out there and waiting for them.

As an industry, we must do a better job of making overweight people feel welcome at clubs. That is not just about how there are treated when they are there, but how we market to them and attract them to our facilities in the first place. Personally, I feel the industry would be better served to cease using all images of ultra thin women in sports bras working out. Now, I've worked out in a lot of clubs in my day and I can honestly tell you, it's a pretty rare site to see. But for those that haven't been to a lot of clubs, it's no wonder they feel that they need to lose weight BEFORE they join a gym because all of the ads make it look like the land of beautiful people!

Let's start showing images that reflect the people that are really in the club. Young, old, and middle-aged. Athletes, average Joe's and Jane's, and yes, people struggling with their weight. The more we do this, the better we will be able to serve everyone and make our country a healthier place. We have the knowledge, we have the passion, we have the equipment for safe and effective weight loss. Now, let's put out the welcome sign for everyone.

Before I sign off, I just want to say that there are some amazing programs out there in our clubs that welcome people struggling with their weight and help them succeed in living a healthy lifestyle and those stories far out-number the stories like the one I came across today.

Governments Eye Healthy Lifestyles for Tax Revenue

As shocking as it may sound, the fitness industry faces attempts by state and sometimes local governments every year that try to tax health club membership dues and services.

We strongly believe that exercise is medicine, so for us that is like taxing a your insurance co-pay for an annual wellness exam with your physician. No one politician would ever suggest that idea. Yet, in state after state they target residents who have taken control of their health and exercise at health clubs.

Currently, Governor Ed Rendell of Pennsylvania and members of the Washington DC Council are considering proposals that would extend the sales to certain services, including health clubs. We're rallying fitness professionals and health club members in Pennsylvania and DC to speak out against taxes on their healthy habits. To date the response has been impressive, with thousands of messages sent to legislators.

All of this brings up a bigger question though: why is your health club membership a favorite target of legislators?

There are many possible answers to this question. Most legislators will claim that a shift from a product-based economy to one the centers on the sale of services, necessitates that all services be taxed. Based on your personal beliefs on taxation, you could find merit in that argument. But why is it that the services of physicians, hospitals, and clinics are never included? They too offer services.

Clearly, there is am important need to educate legislators everywhere that exercise is medicine and just as they would never consider taxing diabetes testing supplies, they should also never consider taxing exercise in the safe and supportive communities of health clubs.

- Bre McGahey

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

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.)

Baucus, Grassley Release Report on Financing Health Care Reform

The following is an excerpt from Capitol Report, a weekly e-newsletter from IHRSA Public Policy. IHRSA Members- subscribe today!

On Monday, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa) released a report on policy options for financing comprehensive health care reform. This is the third and final report from the Committee before they begin to mark up legislation in June. Three potential areas for funding are explored in the report; two are significant for IHRSA’s health promotion efforts.

One section the report explores current health care tax expenditures. Among those, are nine different policy options including modifying or eliminating Flexible Spending Accounts (FSAs). Any change to FSAs is of particular importance to the fitness industry as it is the main tax vehicle for the Personal Health Investment Today (PHIT) Act (H.R. 2105).

While this report is not an outline of legislation that the Committee will consider, it does indicate the direction of the policies the Committee could well pursue. IHRSA has been and continues to heavily lobby members of the Senate Finance Committee and other Senators for their support of the PHIT Act. In fact, two Senators have expressed strong interest in introducing the bill in the Senate (it is currently, and historically has been, introduced in the House only). Fitness professionals are also speaking out. Earlier this month during the Summit for a Healthier America, fitness professionals met with staffers on the Committee and the offices of Senators on the Committee. It will be vital to the potential inclusion in any health care reform legislation that there is vocal support for Americans to continue to have access to FSAs and that FSAs be expanded to encourage healthy lifestyles.

The Senate report did address lifestyle tax proposals to “promote wellness and healthy lifestyle choices, and curb activities that increase overall health care costs.” The two policy options presented included the taxation of alcoholic beverages and excise tax on sugar-sweetened beverages. These measures demonstrate the Committee’s recognition that tax policy is a proven way to effect individual behavior change.

While these policies might “curb activities that increase overall health care costs” they do not go far enough to “promote wellness and healthy lifestyle choices.” Diet is only one part of the balance needed for a healthy lifestyle. Physical activity provides health benefits that diet alone cannot achieve. IHRSA will continue to lobby the Finance Committee and key Members of Congress for their support of tax policies that encourage physical activity as part of health care reform.

While IHRSA lobbies key Members, it is important that all Members of Congress hear from fitness professionals in their districts about the power of exercise and its impact on the people that they represent on Capitol Hill. You can make your voice heard by joining the Campaign for a Healthier America’s virtual march on Washington.

- Breanne McGahey

Campaign for a Healthier America Advocate Spotlight

This week, the Campaign for a Healthier America spotlight is on our new friend and advocate for healthy lifestyles, Michael Field. He is the owner of Gold's Gym in Providence, Rhode Island. This is a great club! Not only have fitness professionals from this club attended our Summit for a Healthier America in DC, but they are a sponsor and event host for Shape Up RI.

According to the Shape Up RI website, "Shape Up RI is a statewide exercise and weight loss challenge founded by Brown Medical School student Rajiv Kumar on the belief that the solution to healthy living lies in the power of teamwork and peer support. This annual health campaign encourages Rhode Islanders to pursue healthy lifestyles through increased physical activity and better nutrition."

IHRSA is proud to Michael and Gold's Gym Providence as part of our family of fitness professionals who work hard every day to make America healthier!

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.