Why Americans are part of the health care problem

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(MoneyWatch) COMMENTARY This country's spiraling medical costs highlight another stark reality: Americans are part of the problem. 

It's been well documented that many people in the U.S. are overweight, get too little exercise, eat poorly, and indulge in too many unhealthy behaviors, such as smoking and drinking to excess. Studies show that roughly half of all medical claims could be avoided if people took better care of themselves and made smarter decisions about obtaining medical treatment.

If we could reduce these avoidable claims by just a fraction, total health care costs in the U.S. would fall instead of continuing to increase. And we'd have more than enough health care providers to serve the increased demand that will come from covering the uninsured. We'd also be in a better position to pay for the unavoidable claims.

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Health insurance systems of all types -- governmental, commercial, or employer-sponsored -- should pay attention to the results of the wellness program at the highly regarded Cleveland Clinic. At a time when the average health insurance premium for family coverage has increased by nine percent, some employees at the Ohio non-profit medical center haven't experienced a premium increase in two years. How did they do it?

The Cleveland Clinic stopped hiring smokers, launched healthy eating and exercise initiatives, and removed sugared beverages from their offices. The organization also offers employees financial incentives to keep up their health, offering reduced insurance premiums to those who meet certain wellness metrics. To that end, workers receive effective coaching on how to stay healthy. Half of all enrollees participate in programs to manage their diseases, compared to 15 percent nationwide. As a result, employees feel responsible for their health and believe it's within their power to improve it.

The clinic's CEO, Dr. Toby Cosgrove, along with other champions of wellness programs, have drawn criticism that they are overstepping their bounds. They've been accused of acting like "Big Brother" by telling you what to eat and how to live your life. But you know what? If Big Brother pays your medical bills, he deserves to tell you what to eat and how to exercise. And if you don't like it, you can pay your medical bills yourself.

This might sound harsh and cold-hearted to some readers, but the fact is that we will bankrupt Medicare and other public health care programs if current trends continue. Then we all run the risk of having limited or no health insurance, and that would really be harsh. So why not take reasonable steps now to prevent this outcome?

I fully acknowledge that there are some people who do everything right with their health and still fall victim to unavoidable medical conditions. But if we all followed the Cleveland Clinic's advice, we'd minimize the costs spent on avoidable medical conditions, and we'd have the resources to treat the unavoidable ones

I'd like to see insurance policies that offer a premium discount if you meet certain health metrics, such as body-mass index, blood pressure readings, and cholesterol counts within healthy limits. After all, many auto insurance policies give discounts to good drivers, and life insurance policies often charge lower premiums if you're a nonsmoker. So why can't medical insurance do the same?

But you don't have to wait to buy such insurance or go to work for the Cleveland Clinic. Many employers offer innovative and effective wellness programs, and I'd strongly encourage you to participate if that's available to you. You'll thank yourself when you reach your 80s and 90s and are still taking your grandkids on fun outings instead of having them visit you in the hospital or nursing home. And you might help reduce the federal deficit in the process!

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    Steve Vernon helped large employers design and manage their retirement programs for more than 35 years as a consulting actuary. Now he's a research scholar for the Stanford Center on Longevity, where he helps collect, direct and disseminate research that will improve the financial security of seniors. He's also president of Rest-of-Life Communications, delivers retirement planning workshops and authored Money for Life: Turn Your IRA and 401(k) Into a Lifetime Retirement Paycheck and Recession-Proof Your Retirement Years.

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