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Or – Enough with the “Benefits” Already!
By Dr. David Edward Marcinko MBA, CMP™
[Former Licensed Insurance Agent]
[ME-P Editor-in-Chief]
An editorial just published in the Journal of the American Medical Association says research supports consideration of a wider policy of reimbursing for structured exercise programs, particularly in high-risk groups, such as diabetics.
Link: http://jama.ama-assn.org/content/305/17/1808.full
Present Status
Currently, health-insurance plans don’t treat exercise as medicine; only some plans offer a fitness benefit, usually a partial reimbursement for gym membership.
Yet, the push for this benefit does seem to be growing.
My Opinion
And yes, as a doctor and surgeon who treated diabetic bone and soft tissue infections, ulcers and related necrotic gangrene for two decades, there’s something to this philosophy in-theory. But, this “theory” is not grounded in risk-management principles or economic sense; and it does seem counter-intuitive to most insurance models that I know.
Note: Most adult diabetics are Type II, maturity onset and controllable.
Examples
For example, auto insurance does not pay for routine car maintenance, nor does home owner’s insurance or most other standard insurance policy types.
Question: Why should health insurance be any different?
Answer: Because it is a public good.
Oh, come on now! Obeying moral codes and legal boundaries is also a public good for civility; but we don’t mitigate the risk of breaking them with insurance policies; do we?
Why? They would be too expensive. Believe me, if insurance companies thought they could make a buck this way, they surely would!
Assessment
Aren’t these types of benefits already in place in some Flexible Spending Accounts, High Deductible Medical [Health] Savings Accounts , and employee cafeteria plans, etc.
Moreover, don’t we all know that we aren’t supposed to smoke, use street drugs, drink excessively, pig-out, or have promiscuous sex? Yet – we still do – like the diabetic who excessively indulges.
If you want to get-or-stay healthy[ier]; exercise more and eat less. A simple – understandable – and free healthcare Rx; but no best selling book, “breaking news” or JAMA report, here.
Conclusion
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Filed under: Ethics, Health Insurance, Insurance Matters, Op-Editorials | Tagged: diabetes, exercise programs, FSA, Health Insurance, HSA, MSA |
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Dr. Marcinko,
You will get some comments on this exercise / health insurance post.
One more point to consider – we’ve long given up using health insurance as “insurance”. I used to ask my graduate health administration students why we have insurance – to cover the big stuff that could wipe us out.
Yet, most people know that the beginning of the year is the time to pay their deductibles and use “insurance” – pap smears, eyes, vaccinations … Perhaps that was the focus of managed care. So, from that point-of-view; paying for prevention made sense.
For example, I recall that United HealthCare paid 50% of my gym membership after a year? I had to get the gym manager to sign my attendance. Sure, I would’ve gone anyway, but it was sweeter knowing the cost was reduced.
Hope
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Dear Dr. Marcinko and Colleagues,
The NIHCM Foundation is pleased to announce the release of a new report, “Building a Stronger Evidence Base for Employee Wellness Programs.”
Adoption of employee wellness programs has taken off in the United States in recent years, and a growing body of research indicates that these programs can improve employees’ health and work productivity, reduce health spending, and achieve a positive return on investment.
In the interest of helping to strengthen the evidence base and with funding from the Agency for Healthcare Research and Quality, NIHCM Foundation brought together nearly 40 experts in wellness and research methods to discuss the current state of the evidence and identify new directions for research.
The resulting research agenda reflected in this report is intended to guide future research and other activities to encourage and assist employers to implement evidence-based wellness interventions.
Click to access Wellness_FINAL_electonic_version.pdf
We hope that you find this report of interest and useful for your own work.
Sincerely,
Nancy Chockley
[President and CEO]
Julie Schoenman
[Director of Research and Development]
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