Will strict limitations – such as those used to regulate alcohol sales – be the next step in addressing the nation’s problematic obesity rate?
Research indicates overeating, or eating the wrong things (even when better options are available), is more prevalent than lack of exercise and more strongly correlated with weight gain. For this reason, some policymakers and health experts have long wondered if strict regulation would curb unhealthy food and drink choices, similar to how the state controls alcohol purchase and consumption. Although the opinions on the long-term value of such a policy vary, both on the health and the political costs, the research shows it may be viable public policy option. So, actions such as Mayor Bloomberg’s soda ban are likely to be somewhat common, somewhat soon (but hopefully nowhere near a Primanti Bros.).
Study Citation: Cohen D, Rabinovich L. Addressing the Proximal Causes of Obesity: The Relevance of Alcohol Control Policies. Prev Chronic Dis 2012;9:110274. DOI: http://dx.doi.org/10.5888/pcd9.110274.
With yesterday’s Supreme Court decision on the Affordable Care Act as the last (judicial) word, the government is ramping up implementation efforts while pundits and the press are postulating about if it will help or harm the country. In the middle is the citizenry, and they continue to struggle with healthcare costs as evidenced by a May 2012 survey conducted by the The Henry J. Kaiser Family Foundation that found the costs of medical care and services were a chief worry among adults, regardless of their age. In fact, coverage/cost was such a concern, that it played a key role in determining whether or not respondents would see a doctor.
According to the tracking poll, over a quarter (26 percent) of Americans are themselves struggling to pay medical bills or have a family member in that situation. Nearly 60 percent of those surveyed reported that they avoided or delayed medical care due to concerns with the financial costs.
Data from the poll is presented and discussed in the June 2012 edition of the Health Security Watch including,
- 64 percent of those polled were worried about having to pay more for health care and insurance,
- 52 percent of those insured privately reported a recent increase in premiums, and
- 41 percent were worried about losing their health insurance.
Price increases, not increased utilization, are a primary factor behind higher health care costs according to a report from the Health Care Cost Institute (HCCI) an independent, nonprofit organization formed in 2011 as a clearinghouse of sorts for data related to health care costs and utilization in the United States.
The paper, Health Care Cost and Utilization Report: 2010, presents trends in health care cost and utilization for persons younger than 65 covered by an employer sponsored, private insurance plan during 2009 and 2010. Findings include,
- Out-of-pocket spending by plan beneficiaries rose by just over 7 percent in 2010 for all service categories, ranging from a 3 percent increase for prescription drugs to a 10 percent increase for outpatient services.
- The average price for a visit to the emergency room rose 11.0 percent between 2009 and 2010 – from $1,195 to $1,327.
- Between 2009 and 2010, prices increased for nearly all inpatient, outpatient and specialty visits, admissions and procedures, including – mental health and substance abuse inpatient admission (8.6 percent), outpatient surgery (8.9 percent) and an office visit to a primary care provider (5.3 percent). The average price of an admission to a skilled nursing facility declined by 3.2 percent during the same time period.
- Utilization rates decreased for inpatient admissions (medical 5.2 percent, surgical 4.9 percent), emergency room visits (5.3 percent), and primary care provider office visits (5.2 percent).
- Utilization rates increased for mental health and substance abuse inpatient admissions (5.0 percent), skilled nursing facility admissions (7.2 percent), and outpatient observation (5.3 percent).
Overall, the data indicate that utilization rates decreased while prices increased. The paper also calls for a closer examination of variations in hospitals costs, including the possibility of cost shifting; and why mental health and substance abuse services increased more than other areas of healthcare in inpatient utilization, average lengths of stay and cost between 2009-2010. I’ll be keeping an eye on future analysis from HCCI, after all, more and better information on healthcare utilization and pricing might bring a bit of transparency to the debate on what is driving the ever-growing cost of healthcare.
Last month the United Way of the Laurel Highlands announced the results of their 2011 Community Needs Assessment Survey, an endeavor used to inform their own strategic planning process. It is also a helpful resource for nonprofits, foundations and businesses operating in or around Cambria and Somerset counties in Pennsylvania.
The report identified the following priory issue areas for the region:
- Helping Children Succeed, including use of alcohol and drugs, parenting issues, family and domestic violence and school readiness.
- Supporting Vulnerable and Aging Populations, including affordable medical care, mental illness and emotional issues, gaps in family support systems and social support systems, and affordable and appropriate housing.
- Strengthening and Supporting Families, including affordable medical care and insurance, unemployment, drug and alcohol abuse and domestic violence.
- Promoting Self Sufficiency, including unemployment and under-employment, job training, drug and alcohol use, criminal histories, credit histories and personal savings.
- Promoting Health and Wellness, including obesity, unhealthy lifestyles and affordable medical care and health insurance and drug and alcohol abuse.
The report contains demographic, education, economic and health profiles on Cambria and Somerset counties as well as a discussion of methods to best support and empower individuals and communities in the Laurel Highlands. It is available for download on the United Way of the Laurel Highlands website.