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Obesity crisis; Commonwealth Fund survey on employer mandate for health care benefits




Jump to:Choose article section...EMPLOYERS SUPPORT BENEFIT MANDATE

Nearly two-thirds of U.S. adults are overweight. That's 131 million super-sized Americans. So what's a food-conscious country to do with this ever-growing epidemic? Look to primary care doctors for help, according to a recent report in the Archives of Internal Medicine.

Since the average American makes three office visits per year — 60 percent of which are made to their primary care physicians — primary care doctors are in the perfect position to get their patients up and running. Literally. The report offers specific "call to action" recommendations to doctors that don't necessarily need to be time consuming. In just three or four minutes, physicians can integrate physical activity advice into a routine office visit.

The report's recommendations include:

  • Calculating a patient's body mass index. If within the healthy range, congratulate the patient. If above the range, explain the risks of excess weight: doubles the risk of heart disease and premature mortality, and triples the risk of diabetes.

  • Write a prescription for exercise, such as walking briskly five days a week or even taking the stairs instead of the elevator.

  • Walk 10,000 steps per day. Use a pedometer to gauge your progress.

  • Discuss weight-loss medication or surgery for those patients who don't see an improvement after six months of dieting and increased exercise.

As for why the growth in overweight adults, the answer's easy. We're eating more these days. Over the past 30 years, women have increased their caloric intake by 22 percent and men by 7 percent, says a recent study from the Centers for Disease Control and Prevention. On average, women consume 1,877 calories per day (compared to 1,542 in 1971), and men consume 2,618 calories (compared to 2,450 in 1971). The government's daily recommendation: 1,600 calories for women and 2,200 for men.

Second only to tobacco in preventable U.S. deaths, poor diet including obesity and physical inactivity caused 400,000 U.S. deaths in 2000. That's more than 16 percent of all deaths, compared to 18 percent (435,000 deaths) for tobacco. This two percent gap is substantially narrower than in 1990, when poor diet and inactivity caused 300,000 deaths (14 percent), compared with 400,000 for tobacco (19 percent), says a new report from the CDC.

With an increase in the number of obese adults, there's also a rise in the number of obesity-related disability claims, reveals an UnumProvident report. Individuals filing obesity-related claims have significantly higher medical costs, averaging more than $51,000 per claimant per year. Health care costs directly attributable to obesity are estimated to be $70 billion, roughly seven percent of total U.S. health care costs.


The U.S. spent $1.7 trillion on health care in 2003, or 15.4 percent of the national economy, reveals a recent report by the Centers for Medicare & Medicaid Services. While health care spending grew by 7.8 percent in 2003, that was down from 2002's 9.3 percent rate increase. Projections for 2004 are even lower at 7.2 percent.


Nearly one-third of Americans have trouble paying for prescription drugs, and 75 percent of them cut back on their dosage as a result, says a recent Associated Press poll. Other findings from the study: 65 percent favor giving the government authority to negotiate with pharmaceutical companies for lower prices, and 65 percent also support importing drugs from foreign countries.



Despite double-digit increases in premiums, the majority of employers support a mandate that companies provide such benefits or pay into a fund to cover the uninsured, says a new Commonwealth Fund survey. Of those surveyed, nearly eight in 10 employers offered health insurance to their employees, 91 percent of who reported premium increases over the past year and 84 percent predicted further increases in the coming year.

To deal with the rising costs, one third of employers who offer insurance increased employee copayments or coinsurance, and 31 percent increased employee shares of premiums in 2002. One in four raised deductibles, one in five eliminated or reduced benefits, and just fifteen percent said they offset premium increases with smaller raises for employees.

The importance of health insurance isn't lost on employers, however. Nearly 60 percent say it is very important to provide health insurance to their employees or contribute to the cost. Of those who currently offer coverage, two-thirds say it improves employee health, and 61 percent say it improves employee morale. What's more, 56 percent of all employers support policy that requires employers to offer benefits or contribute to the cost.

Roughly one-third of benefit specialists would look to consumer-driven health benefit models as a potential cost-control option, according to the annual "Top Five Benefit Priorities" survey conducted by the International Society of Certified Employee Benefit Specialists & Deloitte Consulting. This marks the first time that consumerism in plan design and consumer-driven health care plans have cracked the top five on the list. Controlling health care costs was the No. 1 priority for the fifth consecutive year.


In 2002, almost five million parents had alcohol problems, says a new report from the substance Abuse and Mental Health Services Administration. Sixty-two percent of these parents are male, and 69 percent were married. The nearly 5 million alcohol-dependent or alcohol-abusing parents who live with children under 18 at home, make up 28 percent of all adults with alcohol dependence or abuse.


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Mar. 17, 2004;22.