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Editor’s note: Commentary provides university faculty and staff an opportunity to express their opinions in The Miami University Report. Contributions should be no longer than 500-600 words in length and should be directed to Bill Houk (physics),

Miami’s proposed health care cost solution is Band-Aid that won’t heal the cut

Jay Kimiecik, physical education, health and sport studies

Health care costs are on an out-of-control upward spiral so at some level I can understand Miami’s proposed solution-salary-based contributions paid by all employees. But this is a knee-jerk, short-term solution to a problem that is not going to go away. This pay-out-of-our-hide solution certainly won’t prevent health-care costs from rising will it? In fact, Hewitt Associate’s Health Value projects a 15.4 percent increase next year. So instead of solving or preventing the problem, we are like everyone else and reacting short-sightedly to the problem. I have two main thoughts relating to Miami’s proposed solution.

First, we know this: preventable illness accounts for 70 percent of all medical treatments. The primary causes of the leading diseases in this country (heart disease, some forms of cancer, overweight/obesity, diabetes) are certain lifestyle behaviors that for the most part are under one’s control (e.g., physical inactivity, alcohol consumption, poor eating habits, smoking).

As a personal example, I don’t drink or smoke. I exercise four or five days a week, manage my stress reasonably well and maintain my weight. Why should my monetary contribution to the health care cost problem be the same as someone who drinks, smokes, is overweight and doesn’t exercise? For example, one study found that persons outside a healthy weight range had 143 percent higher hospital inpatient utilization than those in a healthy weight range. Miami — along with many other companies — is erroneously lumping everyone together and saying "You are all equally bad now pay the price." Instead of being rewarded for living a healthy lifestyle, I’m being penalized.

Of course, genetics and cultural factors need to be considered but it ultimately comes down to choices each of us make every day that not only determine our health but also our health care utilization. Certainly there are exceptions to this rule, but Miami is not taking this individual factor into account with its proposed "solution."

Second, and as important, instead of penalizing all of us for unhealthy living, why doesn’t Miami try to help us adopt and maintain healthy living (there’s a novel idea). Studies clearly show that quality employee health and fitness programs not only improve employees’ quality of life but also enhance an organization’s financial health.

You might say that we have the recreation sports center but that alone is not enough to meet the health behavior change needs of most moderate-to-high health risk Miami employees. Worksite health behavior change studies show that the most significant changes in disease-risk reduction occur when individualized outreach and behavioral counseling is offered within a state-of-the-art health and fitness facility. I personally guarantee that if Miami (or a benefactor) put up money to develop such a program and facility, we would have healthier, more productive employees and less health care utilization. Miami would also save money in the long run.

If we want to be First in 2009 let’s start by leading the country in progressive thinking and health programming for its employees. Instead of reacting to the health care cost problem like everyone else, let’s demonstrate to others how to solve it. We won’t be First in 2009 if we do what everyone else does now will we?

Date Published: 11/21/2002
Volume: 22   Number: 17


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