Health Reform needs a WELLNESS emphasis

How can healthcare systems encourage patients to take greater ownership of their health so they live longer? That was the question posed to a Linkedin discussion group that generated some interesting responses. I initially weighed in with:

Public Health and Social Programs

We don’t often think of clean running water, indoor toilets, sanitation systems, and school vaccinations as having profound effects on the health of our citizens, but they have. So too would programs that address poverty, unemployment, and the widening income gap. That’s why next on my list is access to nutritious food, exercise opportunities, and full-time employment, which translates into access to health insurance.

Others said consumers would need support from various health care organizations and suggested several initiatives designed to move from medical response systems to health, wellness and prevention systems.

• Provide free access to prevention exams and lifestyle coaching, including education sessions and workshops. (Obamacare already does the first part of this.)
• Reward organizations that reduce costs by focusing on preventing medical errors, hospital readmissions, and unnecessary procedures. (Obamacare already does much of this by encouraging the formation of Accountable Care Organizations and shared access to electronic medical records among specialists in coordinated care teams.
• Develop individual wellness plans for all patients, including goals for diet, exercise, and sleep, and congratulate them for achieving milestones.
• Record vital measurements (height, weight, blood pressure, cholesterol, etc.) at each visit, track this in an electronic medical record, and report de-personalized versions of this to a government agency for population trend analysis. Also, encourage patients to maintain their own personal health records, which can be made available to medical professionals in emergency situations.
• Host walking and exercise groups with health professionals and local celebrities to promote physical activity and social connectedness, and exploit social media to help patients maintain motivation.

Internet Policies

My wish list also includes affordable access to broadband networks for telemedicine and policy changes that encourage telemedicine. For someone with a lifelong medication need such as enlarged prostate, for example, it makes no sense to be forced to see a physician every 90 days just to renew a prescription and for that visit to be face-to-face rather than a short video call. Health policy also needs to support new approaches such as home health care and home modifications that allow people to age in place rather than being forced into much more expensive institutional care.

End of Life

We should also allow physicians to provide end-of-life counseling way before it is needed and without the stigma of “death panels.” Death with dignity with family is often the best for the patient and for society, but ironically we refuse to talk about it.

Public Awareness & Support

Advertisers know how to change human behavior with repeated messages that resonate with target audiences – messages that define and address a perceived problem, need or desire.

The programs listed above would help, but they all cost money and need justification and political support. And if consumer awareness and advertising programs are added, like the anti-smoking ads, they too would need funding. The question is, “How can we build the business case and generate interest in funding public/private programs aimed at health & wellness?”

While it’s generally agreed that every dollar spent on prevention actually saves much more in the cost of medical care, but I don’t know how much more and have not seen reliable stats to point to. But with well over $2 trillion per year in current health care spending, there ought to be a way to justify spending a hundred billion to save a trillion or more in care costs, and increase worker productivity and economic development at the same time.

Below is information I added to a related Linkedin discussion on “Does society undervalue sleep?”

In my “Economic Value of Sleep” article I estimate the lifetime financial cost of poor sleep as easily exceeding $150,000 in accumulated net worth, but logical arguments rarely inspire consumers that need to “see” benefits, both financial & emotional. So here’s an emotional approach.

The “sex sells“ concept applies equally to sleep benefits, and sex also plays into the argument of getting the TV out of the bedroom, taking warm baths before bed, and so much more. Better sex also extends to healthy family relationships.

Has anyone discussed funding a national TV advertising campaign promoting Sleep? Partial funding might come from the National Sleep Foundation, but federal funding also seems justified, given sleep’s impact on health & wellness and the estimated $63 billion/year impact on U.S. worker productivity.