Put Your Money Where Your Waist Is

While some employers reward people for healthy behavior, others are beginning to take more drastic measures. With rising healthcare costs, and costs rising in many aspects of business, companies are trying to balance their budgets in ways employees may never have expected. Namely, charging them for being overweight.

Alabama, the second-fattest state in the U.S., is giving its more than 37,000 state employees one year to lose weight, or they will pay $25 per month for health insurance that otherwise is free. The state already charges workers who smoke.

While some people may think this is extreme, I – and I expect many in the fitness industry – think it is a fine solution to a problem that could otherwise get out of control. Since incentives such as free T-shirts or water bottles aren’t worth the effort to lose weight for many people, those types of small rewards only benefit people who are already fit, or who are already on their way to changing their behavior.

For people not already taking part in a fitness program, getting started can be the most difficult part. However, faced with a fee of up to $300 per year, maybe exercise doesn’t seem all that bad. And, as we all know, once they get started, there will be infinite rewards for these employees, in addition to not losing that $25.

Insurance ≠ Healthcare

When I think of healthcare — the actual act of caring for my health — I think of good nutrition, exercise and a measure of happiness. I don’t think of surgery, medicine or x-rays. Which leads me to ask an important question, especially in light of the upcoming presidential election:

Since when does health insurance equal healthcare?

Healthcare is a big issue with Clinton, Obama and McCain, and it’s one area where they all manage to disagree (to varying degrees). However, one aspect they all do agree on is the way to achieve a healthy America: through better health insurance. But while health insurance is important, it’s not the only way to secure better health for Americans. I’ll argue it’s not even the best way to get — and keep — Americans healthy.

But try telling that to politicians — especially those in this election. Once the Democrats cleared out of Pennsylvania, John McCain (Rep.) came for a visit. He told a group of about 300 Lehigh Valley Hosptial-Cedar Crest doctors and nurses all about his ideas for health insurance, which included this statement:

''I would like to see everything from insurance companies rewarding clients for wellness and fitness to employers rewarding their employees if they join a health club.”

Well, that would be terrific. But I don’t think it would do much to help Americans care for their health. For it to be a motivating factor to exercise, then all Americans would have to have health insurance, and they don’t. They’d all have to have easy access to a fitness center, and they don’t. The truth is, the health insurance industry would be far less stressed if there were fewer illnesses brought on by obesity and poor fitness.

All the health insurance in the world isn’t going to get America any fitter.

So what is the solution, if not through health insurance? Government-subsidized fitness centers? A magnetic strip on the back of a Health ID Card that tracks gym visits and reports the data to the Bureau of Exercise and Fitness Activity? Yearly visits from dreaded Fitness Auditors? My ideas seem a bit too Brave New World, so I’m curious — if you were on the candidates’ speed dial, what would you tell them? How would you help them get America to care for its health?

Exercise for Cash

Need motivation to exercise and eat right? How about cash? The British government is offering just that with a new program it is launching.

A health adviser to the government explains that children in the U.K. will receive taxpayer-funded financial bonuses into their state savings accounts if they maintain a healthy lifestyle. The payments into the Child Trust Funds would leave healthy teenagers with more cash than their less-fit peers when the tax-free policies mature on their 18th birthdays. Children who get immunized, walk or cycle to class, and take other healthy steps will get bonuses to their so-called “baby bonds.”

The idea came from Julian le Grand, chairman of Health England. Grand also said that healthy eating at school could be rewarded by linking swipe cards to the program. Exercise among young people could also be monitored, perhaps through pedometers or devices attached to bicycles, he said.

It’s about time, right? Fitness centers do all they can to motivate members, but most classes, programs, etc., only go so far. What if insurance companies actually paid people to work out, or at least made their insurance coverage much cheaper? The idea isn’t new, but the British government has finally made a serious gesture in that direction.

Fitness centers would definitely benefit from a plan such as this, since working out in a facility would be easier to track then, say, wearing a pedometer.

But a similar program in the U.S. isn’t going to materialize on its own. Facility owners, healthcare providers and all healthy-minded people need to work to make it happen.

We all know that most people need motivation to exercise and eat right. Maybe money will finally be what tips the scales in the right direction.


P.S. Happy St. Patrick's Day!

Just Say No to Dues Taxes!

How can government justify taxing health club membership dues, and what are you doing to help put a stop to this? Especially at a time when the obesity epidemic is causing a national healthcare crisis! Federal officials have estimated that treating obesity-related illnesses costs about $93 billion a year, and that was from a report in 2004.

It’s not like government hasn’t recognized the importance of this issue and taken numerous others steps to raise awareness and provide incentives for people to take better care of their health. In 2004, the Centers for Disease Control and Prevention predicted that obesity, caused by a sedentary lifestyle and poor nutrition habits, would overcome tobacco as the leading cause of death in the U.S. In 2006, the Health and Human Services secretary announced plans to develop physical activity guidelines, and in 2007, members of the advisory committee who will develop them were announced.

Other industries have also played a role in raising awareness and helping to curb the trend. The media has published countless studies on the benefits of fitness to combat obesity, which is a major cause of death. And, in the past several years, insurance companies have begun offering premium discounts to individuals who work out at fitness facilities. The company that has been most in the news lately is Medica Insurance Company. In 2003, Medica Insurance Company started offering $20-per-month incentive payments to members of fully insured plans who exercised at Life Time fitness centers at least eight times per month. It now also has agreements with most YMCAs and YWCAs in the Minnesota area, and, most recently, it added Curves fitness centers to its plan.

Currently, 25 states (almost half) impose a tax on fitness center dues. (You can view a summary of these on IHRSA’s website.) Yet, in 2004, the IRS approved tax deductions for obese Americans for doctor-approved weight-loss expenses, which include stomach-stapling surgery, approved weight-loss drugs and nutritional counseling. What kind of a mixed message is this?

For now, a few changes have been seen. On November 7, the Michigan Senate repealed its newly imposed sales tax on health club services. Then, in mid-November, the Maryland sales tax bill deleted health clubs after more than 14,000 emails, petition signatures, postcards and phone calls in protest.

This issue should be at the top of the fitness industry’s list to nip in the bud before it’s too late. It’s time for every fitness facility operator to do their part in making a major impact on reversing the tax on fitness center dues. Keep informed, write to your legislators and help be a part of fixing this national healthcare crisis — not just on a business level, but on a national level.

Michael Moore’s Personal “Sicko”

Regardless of what you think of his documentary Sicko, or of your political leanings, Michael Moore is a living, breathing example of one way to ease the burden on our nation’s healthcare system: People can take responsibility for their own health and lose weight, which would tackle many health problems at its root.

Two fitness professionals agree. Jim Labadie and Ryan Lee, health advocates in Florida, are challenging the admittedly overweight Moore to live a healthier lifestyle. They created the Michael Moore Health Challenge, and state, “This is about Michael Moore exercising regularly and improving his diet so he can become a better role model for preventative care.”

Being obese can cause a list of health problems, according to WebMD, including type 2 diabetes, heart disease, high blood pressure, arthritis, sleep apnea and stroke. And, these problems cost the U.S. healthcare system billions (yes, that’s billions) of dollars each year. According to the Centers for Disease Control and Prevention, obesity and its associated health problems have a “significant economic impact on the U.S. healthcare system.”

A study on the costs attributed to obesity found that medical expenses for overweight and obese people accounted for 9.1 percent of total U.S. medical expenditures in 1998, and may have reached as high as $92.6 billion in 2002 dollars.

Michael Moore may have made some good points in his documentary, but the one thing he can achieve right now is control over his own health, and set an example for others who are overweight. Says Jason C. Brown, founder of CrossFit Philly, a training program and studio in Mt. Airy, Pa., “He’s a billboard for type 2 diabetes, cardiovascular disease and all those bad things associated with obesity. He’s preaching about healthcare costs, and he’s directly affecting it.”