HHS Chief Asks Insurers to Help Healthy Efforts

Health and Human Services Secretary Tommy G. Thompson, who is on a one-man crusade to bully, cajole and otherwise lead Americans to healthier lifestyles, said Friday he would try to enlist the help of the private health insurance industry.

Thompson called the current policies of insurance companies “wrongheaded” for not doing more to encourage people to stay in shape before they succumb to expensive maladies.

“I’m going to call them all in, the private insurance companies,” and appeal to them to do more to promote healthy living, Thompson told reporters.

In what he hopes to be the defining quest of his tenure, Thompson said he was willing to consider the unconventional in order to accomplish something no one else has: getting Americans to take better care of themselves.

He even is considering tax breaks for people who stay in shape.

“I haven’t figured it out yet,” he said, noting that a tax break to offset the cost of a gym membership wouldn’t guarantee that the membership would be used. “These are all just ideas, but in the long run, we could save a great deal of money, which would to some degree stabilize [health insurance] premiums in this country.”

Insurers Say They Have Worked on Education

Thompson points out that it costs $270 billion a year--the amount of the entire Medicare budget--to treat the many preventable conditions related to tobacco, adult-onset diabetes and obesity. He says businesses would be well served by providing the time and resources for employees to work out.

Insurance industry officials say they have increased efforts in recent years to educate enrollees, and they welcome suggestions about how to do encourage more people to live healthier lives. They know it’s not easy.

“Who hasn’t seen a food pyramid indicating what we should eat? Who doesn’t know that being overweight isn’t good for you?” said Joe Rochok, a spokesman for the Health Insurance Assn. of America. “What [Thompson] is talking about is lifestyle change, and the question is, how do you get people to do that?”

Still, Rochok said he believed the association’s member companies would be receptive to sitting down with Thompson to come up with effective ways to get people to make better choices.

The issue, Thompson admits, isn’t very sexy. But he insists that, in an era of rising health-care costs, it makes more sense to spend money now to keep people healthy than a lot of money later to try to get them well.

For the 60-year-old Thompson, whose father had diabetes and died of a heart attack at age 61, the message that “a little prevention won’t kill you” has had a sense of personal urgency.

So he has led by example, dropping 8 pounds since January and planning to lose at least 2 more. He has challenged his staff of 65,000 to do the same. His cholesterol, once as high as 300, is now 183. He has stopped eating late at night, cut back on starches and increased his servings of fruits and vegetables. This week, he ran nine-minute miles in the 3-mile Capital Challenge.

If he can do it, he said, anyone can; you don’t have to go from couch potato to gym rat in a single step.

Edward Hill, a family doctor in Tupelo, Miss., and chairman-elect of the American Medical Assn., said Thompson might be on the right path.

People know how to improve their general health, but they don’t always act accordingly, Hill said.

“The only thing we have ever found that consistently changes behavior is some sort of tangible incentive,” he said, adding that he would like to see the government contribute to a comprehensive health education program that starts in childhood, with federal funds based on performance.

Health Official Applauds Thompson’s Efforts

Thompson’s call for the insurance companies to do more was applauded by Daniel Zingale, director of California’s Department of Managed Health Care.

“The evidence shows that the benefits of preventive health are stronger than the benefits of treating disease,” Zingale said. “HMOs should know that. That’s supposed to be what they’re about; it’s even in their name: health maintenance. It’s like they got amnesia.”

Zingale said that, in California, health insurance companies do virtually nothing to help people stop smoking and very little to screen for common sexually transmitted diseases.

“They could save us costs as a society because those costs turn up not only in the health maintenance community, but in emergency rooms and at the end of peoples’ lives,” Zingale said.

For his part, Thompson isn’t shy about using fear to motivate the masses.

More than 700,000 deaths a year are attributed to inactivity or smoking, he warned a luncheon crowd this week, adding that a recent federal study found that 7 in 10 adults do not engage in regular physical activity.