Monday, April 19, 2004

Don't blame others for health costs


Today's Page 1 story in the Enquirer's continuing series "Your Health/Your Money," reports that most people in Greater Cincinnati think people who lead "unhealthy" lifestyles should be forced to pay higher premiums for their health care. That's an understandable reaction from people struggling with ever-higher insurance costs, but one we should not put into practice.

Smoking and obesity each account for 300,000 to 400,000 preventable deaths a year in this country. Before those people die they often incur expensive health care - care that the rest of us help pay for though our insurance pools and taxes.

The Enquirer's survey found that the cost of health care is a greater concern than other health worries by a 2 to 1 ratio. The survey of 624 adults in seven Ohio and Kentucky counties was taken in January. More than half of those surveyed (57 percent) consider the region's health care to be in a crisis because they worry they may not be able to afford it.

It's easy to think that one way to reduce these expenses is to make the two-pack-a-day smoker bear the cost of his own lung cancer; or that the fat lady in the motorized grocery cart shouldn't expect the rest of us to pay the bill for the dialysis treatments brought on by her diabetes.

But who among us wants to sign up to be a member of the health police? And while the preceding examples may sound like easy calls, others are not. Should a person who skis or sky-dives as a hobby pay higher premiums for engaging in high-risk behavior? Should living with a spouse who smokes be considered a high-risk lifestyle? How about people who overdo exercise and are constantly seeing the doctor for sprains, strains and other effects of overexertion?

A far better approach is to increase public awareness of the benefits of good nutrition and reasonable exercise. Rather than penalizing people who are overweight or smokers, some employers have started offering incentives to those who achieve good health goals related to blood pressure, weight and cholesterol. According to the United States Department of Health and Human Services, more than 80 percent of U.S. companies with 50 or more workers offer some sort of good health encouragement, ranging from free vaccinations to fitness centers.

That sort of help-people-help-themselves approach is a far more practical way to reduce health care costs than the finger-pointing accusations uncovered by the Enquirer survey.

An irony uncovered in the survey was that 54 percent of those responding said they thought people who smoked, were overweight or otherwise did not take care of themselves should pay more for their health benefits than those who lead healthier lifestyles. That's almost the same percentage of people in the region's 14 counties who are considered overweight, according to statistics of the Health Improvement Collaborative of Greater Cincinnati.

So just whose unhealthy lifestyles are we complaining about anyway?

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