Envisioning the Wellness Future

Posted on August 22, 2013

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Pro athletes will occasionally “guarantee” a victory before a game, and a significant portion of Las Vegas’ casino revenue comes from bets on the future wrapped around sports.  The future can be such a tantalizing topic because it plays on our emotions and imagination…at least until you try to pin down details, like how something will happen.  Then reality sets in and most people lose interest.

Conferences can be frustrating venues for learning about ‘the how’. Conferences (and media) like to discuss ‘the what’ because it is easy to be vague, especially about exciting, but nebulous, ideas that few have the knowledge to better define. Healthcare reform.  Go to a healthcare conference, or read an industry magazine, and almost no one has the courage to go on record in an effort to predict the future about any aspect of healthcare reform—even supposed “futurists” are remarkably shy.

Why not?  By taking a stab at envisioning some specifics, it can spur some real innovation and give others a chance to build off your idea.

So when I hear discussion about “health vs. medicine”, and increase on “prevention and wellness”, and establishing “personal accountability” in our future health care equation, I want to know how.

Chronic disease is 75% of all healthcare spending, 81% of all admissions, and at least 50% is due to behavioral choices (i.e. modifiable) on the patient’s side.  If reducing chronic diseases like hypertension and diabetes is acknowledged as a major part of reducing cost (especially infrastructure)—and it has been— let’s not ignore the elephant in the room:  how does wellness work?  What does it look like in action?

I have some ideas.  I think we are going to be implored by our employers, insurers, media and hopefully family and friends, to make beneficial lifestyle decisions.  It won’t be easy.  This is not a diet for a week or a month, but long-term behavioral change—the activities most Americans do not have the patience or will power to execute.  The keys to lifelong health and wellness are not a mystery:

  1. Don’t smoke
  2. Don’t do drugs
  3. Don’t drink to excess
  4. Get decent sleep
  5. Eat well
  6. Exercise
  7. Minimize stress

That’s it.  If everyone could do those seven things, healthcare likely wouldn’t need reform.  I see a future where individuals will receive financial benefit for adhering to those seven tenets.  Our health insurance will cost less because soon enough those seven items will able to be monitored with individualized data (a wellness score, akin to a credit score?), much like the data “black boxes” in cars are providing insurers to monitor a driver’s behavior.  Good drivers benefit from not speeding and driving recklessly.  Good patients / employees will benefit from good blood pressure readings, eating well and minimizing stress.

The old model was:  live life however you wanted.  Go to the hospital to fix health issues.  Go back to living life how you want.  Go to the hospital to get fixed.  Grow old and die.

The new model is:  live life however you want.  If you make smart choices, you will pay less, enjoy a higher quality of life, and live longer.  Don’t need the hospital by not having avoidable health issues.  Grow old and die.

So how does that happen?  In Inc. magazine’s May issue, a small company culture feature on Trek Bicycles provides a glimpse.  Trek’s CEO states “If we’re going to pay for your health care, then you’re going to get a health risk assessment every year, and it’s not optional.”

Almost the same identical statement was made, in effect, from the government to healthcare systems in the Affordable Care Act:  ‘If we’re going to reimburse you for Medicare and Medicaid, then you’re going to do community health assessments every three years (to figure out how to help your citizens avoid hospitals), and it’s not optional.’

In the new economy, there is no more pouring money out without getting a return; every penny is a lever for change.

At Trek, insurance premiums are tied to health screenings.  The company cafe instituted a “Twinkie Tax” on junk food.  Trek built more bike trails around its campus, as well as a gym for employees.  They partnered with a local hospital to help the most at-risk employees. These are examples of how wellness will work in the future.

Some of this will involve improving the design of our neighborhoods and workplaces, to get people walking (exercising) and avoid accidents like getting hit by a car on a bike.  Cue Dr. Richard Jackson.

So, expect to see more screening around the seven items listed above.  It may be harder for overweight people to get jobs because, all things being equal, an employer will want an employee that less likely to need chronic disease management.  Expect to see employers in the food / health / wellness industries take harder stances on mandatory exercise programs, and absolute requirements for no smoking.  I mean, shouldn’t all hospitals be smoke free campuses?

All of this is tied to health care insurance cost, and company culture.  Employers will want top talent that is low maintenance.  Top talent will want employers with attractive company culture.  Be healthy, stay well and enjoy the spoils of the good life.  Here’s to your future.

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