Monday, April 9, 2007

The Cost of Unhealthy Behavior: Got Wellness?

Here is an interview of Dr Steven Aldana conducted by WELCOA president Dr David Hunnicut.

Some of the key points are;

  1. Sedentary Lifestyles account for 15% OF ALL HEALTHCARE COSTS and only 20-25% of the population achieves the recommended 30 minutes of daily physical activity
  2. The total healthcare costs associated with a male 24 year old tobacco user are $220,000 which breaks down to a healthcare cost of $40 per pack of cigarettes of paid for by someone besides the smoker. 23% OF AMERICANS USE TOBACCO.
  3. Obesity accounts for 12% of healthcare costs and 67% of the US population is either overweight or obese today.
  4. Factoring in preventable health conditions aside from smoking you have an additional 40% of healthcare costs.
  5. For those without an actuarial background we now have 70% of healthcare costs tied directly to lifestyle decisions. Physical Inactivity, Diet, Tobacco Use and preventable disease.
  6. 70% OF deaths in America are attributable to strokes, heart attacks, diabetes and cancer which are all influenced very significantly by diet.
This week the media is reporting Consumer Driven Healthplans are getting a lukewarm reception from employees provided with alternative plans. What a shocker. Lets see, 80% do not get enough exercise, 23% smoke, 67% are overweight and or obese.

We have seen the enemy and its us.


gas28man said...

Ah, yes. The problem isn't costs. It's lack of virtue. Mmmm-hmm. Good luck tilting at that windmill.

Dan Buckle said...

I would rather be lucky than good gas28man but thanks all the same for that prescient observation.

Craig said...

The premise of your argument, apparently that we need to be more accountable for our personal health and the associated cost trends associated with failure to do so, is a valid point. However, I seriously question your statistics. While I'm sure you could jerry-rig some statistics to support your point, I would suspect some hyperbolic statistical practice underlying them, at very least, with regard to "preventable" disease and what you included in that category, without accounting for, I would guess, whether efforts to prevent the diseases and yet disease progression occurred anyway.

However, isn't it more convenient to factor blame and hyperbole into the equation.

Dan Buckle said...


Thanks for the comments. I expect to see Dr Aldana when he speaks in Houston later this month and will inquire regarding the composition of the "preventable" category.

At the end of the day its not about blame or hyperbole. While not all disease is preventable, there are behaviors which certainly increase the probablilty of a diseases progression take for example someone at high risk for diabetes type 2.

Robert said...

Great post!

Confirms a recent post at my weblog, the Cenek Report....

Railing against the evils of nicotine addiction is in vogue - and there’s little risk of being ostracized in public for doing so. After all, few quibble with the notion that smoking is an unglamorous vice, an outright public health calamity.

Business and government have joined the fray, eliminating smoking in the workplace, and sending most Hack Raspkoffs into the parking lots or smoking kiosks. Some firms discriminate against smokers in hiring; others charge extra for health insurance.

Smokers should pay more for insurance – but so should sunbathers, boozers and rotund men and women who spent more time working out at the training table than at the gym. Our society probably needs an equivalent of the fake cough for the buffet line.

More than half of Americans are overweight. Researchers say this obesity epidemic poses a major threat to public health due to the clear connection between obesity and type 2 diabetes, heart disease, and cancer. Obese or overweight people paid more in health care costs than those of normal weight. In 1998, overweight and obese individuals paid an average of 11.4% and 26.1% more on out-of-pocket medical costs.

More organizations need to turn up the dial in focusing on health in a more wholistic manner, and to widen their focus on encouraging employees to adopt a healthier lifestyle. Smoking is bad; but so are a host of other lifestyle habits that seem to go unnoticed or unchallenged.

robert edward cenek, RODP

Don Levit said...

Of course, I agree that lifestyle is a determinant of health. That's why I am fortunate to have enough time to go to the gym 4 times a week.
Others are more time-challenged, and, thus, may not have the luxury that I have.
Also, I believe that people are much more in tune with their emotions and the need to live a whole (holy) lifestyle. And, because we are more aware of our shortcomings than prior generations, we are, thus, more miserable.
This misery leads to more self destructive habits than in years past.
We are more miserable than our ancestors, and we know it, and refuse to deny it!
Don Levit

Dan Buckle said...

You may find the link above contains more specifics on the scope of preventable disease. here is a sample;

Health insurance aims to spread the cost of care among an entire insured group. But 10 percent of the U.S. population generates between 70 percent and 80 percent of health care costs, through large claims from serious illnesses such as cancer, strokes, diabetes and heart disease.

That means the other 90 percent of the population is paying a share of the costs disproportionate to its consumption of health care. But 70 percent of cancer, 71 percent of cardiovascular disease and 92 percent of adult-onset diabetes can be avoided if people change their behavior, said ClearPoint managing partner Kevin Overbey, citing journals of occupational medicine.

By the way Kevin is a Group Guy I worked with at UNUM.

Don Levit said...

If 90% of the population pay a share of its costs disproportionate to its consumption of health care, we need to figure out plan designs which will keep the 90% in the pool.
It seems to me that the environment has been skewed toward the sick, when it is the healthy that sustain the system for all.
One interesting highlight was the HRA non discrimination provisions recently issued. There, we find that employees can have different HRA balances, as a result of claims made the prior year.
Don Levit,CLU,ChFC

Dan Buckle said...


There are plan designs which will incent the right behavior across both the sick and the healthy populations. It's sometimes referred to as value-based insurance design. Watch for an upcoming post on this very topic or simply reach out by phone or email.