I am not a health care policy guru. However, I have been very committed to the issue of self-responsibility for health. It is key to manifesting everything you want in your life and work. We have an epidemic affecting over one third of our population’s well-being and productivity!

Follow the logic of an expert I recently heard on how basic it seems to significantly reduce our tsunami of growing future health care costs as a Nation. As no insignificant aside, people will feel better and be more productive. How can we argue with that?

In essence, our Federal government should fund preventative programs that help people establish a healthy relationship with our abundance of food and drink, and be more active through simple strategies, camaraderie and a lifestyle coach. For example, commune with friends while walking, talking, or playing an active game. (However, basketball for those men over 50 who have not been very active is not recommended to be played using the “skins and shirts” method of showing which team you are on. You may be showing “too much skin!” Ha.)

Recently, in Washington DC, while advocating on the Hill in support of the YMCA Diabetes Prevention lifestyle change-based program (YDPP), I heard Ken Thorpe PhD. offer a solution.

First, the background:

26 million Americans have diabetes. 79 million (1 in 3) adults over 20 years old have pre-diabetes and are at high risk of developing Type 2 diabetes.

Obesity has doubled since 1987 and is 8-20% of health care spending. If obesity had stayed the same since 1987, we would have spent $250 billion less.

YDPP evidence based results show a 58-71% reduction in risk of those pre-diabetics that participated in reducing the risk of developing Type 2 diabetes.

Chronic disease is over 75% of the over $2 trillion in health care spending per year. In 2007, diabetes cost $218 Million.

ENTITLEMENT REFORM IS NEEDED TO REVERSE THE GROWTH IN SPENDING.

40% of the growth in health care spending is LIFESTYLE conditions such as, overweight, hypertension, diabetes, back problems, and depression (and those in this group may take 7-10 medications). Many of these illnesses and corresponding costs are preventable. The highest costs are related to the treatment of cancer and heart disease.

For every $1 of medical cost related to these lifestyle conditions, the indirect costs of absenteeism and presenteesism contribute to a $4 cost of lost productivity!

The projected lifetime care cost of an obese individual is $224,000 (17% of our health care costs); of an overweight individual $211,000; and a normal person $191,000. This is a $32,000 difference. This is contrasted to smokers because typically their life span is shorter.

According to Dr. Thorpe’s research, avoidable death is 30% genetic and 70% behavioral and environmental.

Sadly, only 1-3% of health care spending is on prevention.

Our rising costs and the underlying lifestyle-condition diseases are in fact, PREVENTABLE. There are over 18 million Americans with stages of diabetes that could be helped and prevented. As these aging Americans enter the Medicare system ultimately at age 65, without turning this epidemic around, costs will continue to skyrocket.

With programs like the YDPP, Dr. Thorpe estimates the US could save $35-60 billion in Medicare spending over their lives; and $8-13 billion over 10 years if the program is only started at age 65.

THE SOLUTION:

USE $15 THE BILLION ALREADY SPECIFIED IN FEDERAL FUNDS (UNDER THE AFFORDABLE CARE ACT) TO:

-create a National Diabetes program

-ensure no copays if the prevention program is used

-create medical homes & community health teams

-Statewide Exchanges: define care coordination and prevention as an “essential benefit.”

If YDPP were offered as a benefit at age 60 at a cost of $80 million/year, with $2 billion already in the funding plan for next year, it would still leave $1 billion to do further research. We could readily fully cover age 60-64 (at a cost of $220-320/year/participant) and include YDPP as a prevention “expectation” in health insurance in the exchange.