The mandate being formed by the health department of Florida in collaboration with the office of Insurance Regulation would provide up to $40 per month per insured member in gym membership. This mandate would provide a 100% reimbursement if the member in a period of 4 weeks makes 12 or more visits.
The mandate would also cover up to 4 reimbursable visits to a nutritionist per calendar year, capped at $250 per year for each covered member. The population of USA is approximately 306 million out of which 30.6% are obese i.e. about 90 million of the American population comes under the category of obese.
If we are to assume that every American follows the mandate for a healthier and a safer lifestyle it would mean a total of $12240 million per month. Likewise if only the persons affected by obesity are to follow the mandate it would cost around $3600 million per month.
America has the highest percentage of obese people in the world; therefore plans and strategy are being formed. The groups or the stakeholders who support or are benefited from the proposed solution are basically those which are concerned with the health department with their goals being to introduce a healthier lifestyle for all Americans.
In this case to decrease heart attacks and other diseases related to the heart. These groups include American Heart Association, YMCA and other fitness facilities, Center for Disease Control and Prevention Florida Heart Disease and Stroke Prevention Program; these are the agencies responsible for implementing the proposed solution.
The stakeholders would consider the proposed solution fair and equitable based on their goals and missions to reduce heart disease prevalence in Florida and the remaining U.S. due to the fact that the mandate imposed would be on both public and private Florida payers and would aim to lower the staggering payments these payers are currently making to treat preventable diseases while seeking to elevate the health status of participating Floridians.
The groups which are likely to be penalized (oppose) are the insurance companies or the insurance payers.
Insurance Payers may oppose the solution as they will be drawn to figures showing what they will be responsible for paying out based on gym reimbursement and nutritionist visits.
The Florida Insurance Council has health insurance members that would oppose the suggested mandate based on opposition to 2007 bills presented to them which would mandate certain health benefits.
In addition to these opposition a few government agencies may oppose this mandate as according to their statistics following this mandate would result in a loss e.g. American Association of Health Plans studies in 2002 showed $10 billion of the nearly $70 billion increase in premiums from the previous year were the direct cause of mandates and regulations placed on the payers.
Obesity is an alarming problem in America, therefore Florida’s governor has taken the lead in the fight against obesity and physical inactivity in the state. The Crist/Kottkamp administration has placed obesity prevention on top of its concerns.
The administration has already allotted a total of $1.3 million for the establishment of the Governor’s Commission on Physical Fitness to strengthen his fight against obesity. If we as a country were to go back to the obesity levels we saw 20 years ago, studies have shown that healthcare spending would be approximately 10% less than they are today per person.
This equates to nearly $200 billion in savings (Partnership to Fight, 2008). This is what the proposed solution intends to do, not only for the stakeholders that may currently oppose the solution but for the health of the state whose morbidity and mortality rates for cardiovascular diseases have gotten out of control.
Payers aren’t the only opponents that would serve to gain in cost savings from supporting the mandate. Employers that previously implemented reductions in healthcare cost to employees that actively worked to address risk factors saw a return of $16 for every $1 put into the program due to decreased absenteeism.
This solution would not only help reduce heart disease in the state through physical activity and good nutritional decisions but also be able to provide incentives to members or stakeholders financially.
Ultimately both the government and the people will be benefited because for the people it means a more healthier and a longer lifespan and for the government it means more money in the reserves as now the government will able to save money which was once being spent on many cases of heart diseases.
Yes we are able to save money in the future or the long run, the treatment for heart or chronic diseases is very expensive, and if the number of obese person rises the chances of heart problems increases too resulting in an increase in cost for the treatment. This solution can be compared with PEPFAR, the President’s Emergency Plan for AIDS Relief, was first announced in 2003, it had four main areas of concerns
· 55% to provide treatment for those living with HIV/AIDS
· 15% for palliative care for those dying from AIDS
· 20% to provide HIV prevention services
· 10% to help AIDS orphans and vulnerable children.
Taking an example from this program it is noticable that 70% of the resources are being spent on people who either have AIDS, meaning the money is being spent on their expensive treatment, we should learn from this situation and start “preventing” heart problems in our own country rather than trying to cure it, as that will be more expensive and also there is a chance of a person losing his/her life because of the disease.
A decrease in obesity means a healthier lifestyle and therefore a decrease in cost for the insurance companies for the expensive treatment. With the help of these mandates people will start going to gyms and will stay in shape and ultimately decreasing the cost for insurance companies due to the prevention that the provided solution has presented.
Heart Information, Florida Heart Research Foundation http://www.heartplate.org/heart.htm
Chronic Disease http://www.doh.state.fl.us/Family/chronicdisease/PDF/ChronicDisease.pdf
CARDIOVASCULAR H EALT H http://www.doh.state.fl.us/Family/Heart/PDF/female_deaths_2000.pdf.
4. Fitzgerald Paul, The Cost Of Heart Disease In The United States
The 2008 Florida Statutes http://www.leg.state.fl.us/statutes/index.cfm?mode=View%20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=627.6489&URL=CH0627/Sec6489.HTM