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Health Focus: Individual Responsibility In Health Care

The importance of taking charge of one's health.

At a recent panel that I moderated a prominent local health care executive commented that we have an excellent medical system but a poor health care system. In general I agree with this assessment, especially when it comes to taking individual responsibility for the health of ourselves and our family.

Consider this sobering conclusion from a recent study - If the level of obesity continues the current generation may have a shorter life expectancy then their parents. Even more troubling is if we don’t change, one in three babies born today will develop diabetes in their lifetime. Every American should be alarmed and frankly embarrassed that we are so adversely affecting not only the length but the quality of our children’s future health.

But the obesity epidemic is also sweeping through the adult population, this same study also projects that by 2020 81 percent of men and 78 percent of women will be overweight or obese. While most of us know the strong link between being overweight and high blood pressure, heart attacks, stroke and diabetes, the American Cancer Institute warns that increased weight also leads to a heightened risk of cancer.

Our lifestyle choices like overeating and smoking tend to accelerate the prevalence of chronic diseases such as diabetes, heart disease, and lung cancer which have become a huge financial burden. Today three of every four dollars spent in the U.S. health care system is for treatment of chronic disease and for those of us who have one or more chronic conditions the expense is five times greater than for someone without any chronic disease.

But changing lifestyle choices is difficult, even physicians have only a 10 percent success rate when they advise patients about altering their habits. This resistance to change can be readily seen as the ‘quit rates’ for smokers linger around 2 to 3 perent a year and despite a surfeit of best-selling diet books our waistlines continue to expand.

Wellness programs and financial incentives are now being tried to encourage lifestyle changes. In the health care reform legislation, the Affordable Care Act (ACA), there is a provision that allows employers to offer employees ‘up to 30 percent of the cost of coverage for participating in a wellness program and meeting certain health-related standards’. Unfortunately this doesn’t take effect until January 2014.

Researchers are gaining a better understanding of how positive incentives (payment for good behavior) and negative (fines for bad behavior) can lead to change. For example, positive reinforcement is linked to one-time good behavior like showing up for disease screening, while it is believed that negative reinforcement may be longer lasting and more powerful, significant proof is elusive.

As we look for our employers to incent us, researchers to discover better ways to motivate us and lawmakers to craft programs to help us change our lifestyles, let’s keep in mind our role as parents and grandparents; that this is a battle where our children are at risk and we have an obligation to become active participants in ensuring that they have a long and healthy future.

John Sardelis is an Associate Professor of Health Administration at 's Long Island campus in Patchogue.

Patchogue Patch encourages our readers, writers, political officials and anyone in the Patchogue-Medford area to submit their personal views on current events and issues as articles for our Opinion section. Articles submitted should not exceed 500 words, and all submissions will be considered. Please note that these pieces are not necessarily representative of the opinions of Patchogue Patch and represent that of the author. Submissions should be sent via email to michael@patch.com

Joan O'Rourke April 29, 2011 at 03:55 PM
I don't agree that employers or the goverment (our tax dollars) should have to give us incentives to stay healthy. It has to be every indivduals responsibility to want to be healthy. Education has to be provided so everyone is given the opportunity to understand and make healthier choices but after that the individual needs do the right thing. Yes I agree changing your habits is very difficult but when it interferes with life or death the individual has to get onboard no one can make them change.
anthonia onyemem April 30, 2011 at 04:20 AM
I think it’s our individual responsibility to take care of ourselves. Americans are not concerned with their eating patterns and the damage it does to their health. For example, the people who you see obese are the same ones you see always patronizing fast food restaurants. Healthy choices are not even on their agenda probably because of the addictive nature of these foods. I think providing incentives to people to take care of their health is a good idea because it will help reduce some of this health problems related to our eating habits and also be a cost saving strategy for the federal government since healthcare inflation is on the rising.
Louanne Charles April 30, 2011 at 10:40 AM
Though it is every individual's responsibility to take appropriate measures to ensure that they live healthy lifestyles and maintain good habits to promote longevity, it is a difficult struggle for some to accomplish, and may seem easier said than done. In every aspect of life, there are people who are stronger than others and need help and motivation from others to help them along the way. Although there are services provided to help individuals, not everyone has the courage to seek out help on their own. I think that ethically, having people on the outside take the initiative to help others before they ask is the type of push we might need to improve the health of the people of this generation, and for generations to come. I'm not sure if financial incentives are the best approach, but I do believe that some type of incentive would be a beneficial drive. As I've mentioned before, if the government is willing to pay physicians to perform, and for meaningful use, they can offer incentives to people who can benefit for healthier lifestyles.
Sandra Boddice May 04, 2011 at 03:14 PM
I agree that individuals are accountable for following healthy dietary practices; however when there is no consensus as to what is a healthy dietary practice it is extremly difficult to stay on track. During the past few years there has been disagreement within the Medical community; beginning in the 1980s the macronutrient 'fat' was demonized and was touted as a major factor in causing heart disease. The American population reduced their fat intake and the statistics show an increase from 1980 to the present day in heart disease. The medical community does agree that eating more fresh fruits/vegetables/lean protein and exercising on a consistent basis is integral to maintaining good health. However the general population is tharted in their attempts at following these guidelines; take a look at the television adverts promoting 'fast processed food' and encouring the consumer to buy double the amount by offering discounts, the film 'Super Size Me' is a wonderful example of this tactic. Have you ever been into a 'poor' neighborhood and looked at the availability of fresh fruits/vegatables/lean protein and whole grains? I have and I can attest that there is a limited availability of this produce. Yes we can continue to be critical of the unhealthly and obese but lets not forget that they are supported and encouraged every day by 'big agro' and in some part by the medical community who let's face it get paid for the number of 'sick' people they care for.
Barbara Hutchens May 06, 2011 at 02:18 AM
Great article. It is about time we start taking some personal responsibilty for our health. As the article stated it is not always an easy task but something we need to continue to work on. I would love to see lower copayments for people who are compliant and striving to improve their health. NSLIJ has been working toward improving employee health. This year they are offering financial incentives to employees who don't not smoke, those who go for an annual check up and those that take a health risk screen which creates an EMR for the employee. We need more employers to get on board and provide wellness programs. Not only does it decrease employee sick time it reduces the insurance rates.

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