NCHC recommendations for reducing health care spending overlook schedule control as key to adoption of healthier lifestyles
The National Coalition on Health Care has issued its recommendations for bending the relentless rise in health care costs, Curbing Costs Improving Care the Path to an Affordable Health Care Future. The bulk of the report focuses on treatment and payment reforms with one section devoted to “Prevention and Population Health.” A key recommendation is sin taxes to deter the consumption of tobacco, alcohol and sweetened beverages. That’s hardly a prevention and wellness strategy.
Conspicuously absent are meaningful recommendations to give people more control over their lives and schedules so they can spend more time engaging in healthy behaviors like getting adequate exercise and sleep and eating a nutritious diet. Achieving it will involve nothing short of a transformation of how we conceptualize knowledge and information-based work and when and where it gets done. We no longer need to commute daily to an office to do it, thanks to the widespread availability of information and communications technology. Here’s how one blogger described this arguably obsolete work routine:
1 – Wake up earlier than you want to.
2 – Get stuck in traffic on the way to work.
3 – Feel stressed all day at work.
4 – Go home, throw a frozen dinner in the microwave because you’re too tired to cook.
5 – Plop down in front of the TV because you’re too exhausted to do anything else.
6 – Go to bed later than you meant to.
7 – Repeat.
This is a toxic societal lifestyle that over time sets the stage for the development of chronic, preventable conditions that drive much of the health care spend. A 2011 University of Minnesota study found when people are afforded control over when and where they perform their jobs, they got more sleep and exercise. Bravo. That’s true, low (negligible) cost prevention that can go a long way toward maintaining health and reducing medical utilization and spending.