July 3, 2009

You’ve Got to Change Your Evil Ways… for your health baby

Posted in Health Insurance, Health System Reform, Incentives for good Health at 12:04 am by healthyacrossthenations

In my reviews of comments on a number of sites with articles about US Health Care Reform, I noticed a few people bringing up their concern about the possible easier abuse on a more publicly available system, via consumers who have poor health behaviors (smokers, heavy drinkers, drug addicts etc) and the desire to not have to cross subsidize treatment and care for those who have chronically poor health behaviors.

I imagine that once a reformed system begins to take shape, like the one I describe on this blog, we might be able to adopt a few incentives for the public to develop healthier and more consistent health behaviors.

For example- a Health Fund  might offer consumers who swipe their fitness card into a Gym,  3 times a month at least,  benefits such as renewed Gym Membership at a highly discounted rate- or for free- and discounts on car rental or travel- or to alternative health services not offered through the fund, or discounts on school supplies- and so on.

And perhaps every year at the annual physical of the consumer (and when they start coverage) they will have the opportunity to sign a pledge of being free from chronically poor health behaviors such as smoking cigarettes and/or drinking more than 2-3 drinks a day, or even eating fast food more than 2 times per week. If they do sign, they can get some added benefits- perhaps like those above- or some other added value items- perhaps a voucher towards the cost of clothes, or computer software.

The idea would be to create an environment where the promotion of an overall  healthy lifestyle has both immediate AND long term perks and benefits- while those who continue with chronic poor health behaviors will have less or no perks at all- and be left on the fringe-

If they sign the document, and are then caught having participated in poor health behaviors to a point of destruction (can be determined by certain types of adverse health events caused by the culprit- among other things) – they will be fined quite a fee or perhaps suspended from the Health Sysytem for a period of time and made to pay for certain parts of  treatments specific to their poor lifestyle behaviors- on their own.  Perhaps for those who do not sign, the health funds might factor that into their capitation formula- solutions to those cases are many and can be worked out. For example, perhaps the people refusing to sign the pledge could be required to contribute a higher percentage of their income towards their Health Coverage than those who do sign- therby allowing privacy and freedom of choice- added choice comes at a cost, as it always has. In this example, these people can always have another chance to sign the pledge at their next annual physical and gain the benefits of the normal percentage rate of contribution from their income for their Health coverage.

This way people have the flexibility to decide where they want to make comprimises- if they had a bad financial year they can choose to cut costs by adopting healthier behaviors. This is how a market performs at its best- when there is choice and when their are incentives to behave in a healthy manner.

Additional thoughts welcome!

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