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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 | 2 Comments »
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