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Health Care Reform

This is an excerpt from Introduction to Kinesiology 5th Edition With Web Study Guide by Shirl Hoffman & Duane Knudson.

Health care costs, which have skyrocketed over the past decade, underlie many of the decisions made by companies about their worksite health programs. As a result, these costs may affect the types of job opportunities you will have when you begin your career.

The total cost of health care in the United States is considerably higher than it is in other industrialized nations; in fact, it is unsustainable. In a publication titled Health Care Costs: A Primer, the Kaiser Family Foundation (2012) provided the following facts: "In 2010, the U.S. spent $2.6 trillion on health care, an average of $8,402 per person; the share of economic activity (GDP) devoted to health care has increased from 7.2 percent in 1970 to 17.9 percent in 2009 and 2010; and half of health care spending is used to treat just 5 percent of the population" (p. 1). Despite the large annual dollar amount, many people in the United States have not received the health care they need.

Clearly, health care reform has been needed, and it has needed to be sizable. Consequently, and with much fanfare and debate, then-president Barack Obama signed into law the Affordable Care Act in March 2010. The controversial law put into place comprehensive health insurance reforms, with most changes taking place by 2014. One positive consequence of the Affordable Care Act has been a decline in the number of uninsured Americans; specifically, about 16 percent of Americans were uninsured in 2011 (DeNavas-Walt, Proctor, & Smith, 2012), but this percentage had decreased to about 10 percent by 2014 (Smith & Medalia, 2015).

Even with reforms as extensive as these, perhaps the best way to control one's health care costs is to stay healthy. Of course, a good way to stay healthy is to adopt and maintain healthy lifestyle behaviors, including daily physical activity. However, both the rising costs of medical care and the manner in which health care is paid for in the United States have slowed the progress toward offering more preventive services. Health care organizations are so busy developing cost-effective ways to treat people who are sick that they seem unable to focus on developing better strategies for prevention.

Providers are often more motivated to invest money in preventive services when they are confident that they will reap the benefits in future cost savings. For example, consider a person who has a myocardial infarction (heart attack) and is treated with a percutaneous coronary intervention. This scenario is relatively common and typically results in a hospitalization cost of more than $19,000 (Afana, Brinkikji, Cloft, & Salka, 2015). If the person is employed, then a significant portion of their insurance is paid by their employer. Both the health insurance provider and the employer want to minimize the employee's health care expenses. It is becoming increasingly appreciated by most employers and insurance providers that it is cheaper to keep employees healthy than to pay for their treatment when they get sick.

Accordingly, many health plans now offer their members an extensive menu of health and fitness programs free of charge. The rationale is simple: Healthy members are less expensive than unhealthy members. In some cases, this effort pursues the goal of improving the overall health of potential subscribers in a geographic area. In other cases, it is a marketing strategy aimed at increasing the number of people who enroll in the health plan.

Today, for the first time, physical activity is increasingly seen as an integral component of the nation's health care delivery system. The American College of Sports Medicine is working with the American Medical Association to promote physical activity as another "vital sign" that physicians monitor in checkups with patients. It is possible that a perspective more focused on health promotion and wellness will dominate the health care system in the future, thus giving kinesiology graduates improved career opportunities. Perhaps the model hospital of the future will feature on-site fitness facilities and a staff of health and fitness counselors and personal trainers in addition to traditional medical personnel.

Of course, health and fitness professionals must recognize that the addition of insurance-sponsored prevention programs is not the only answer. Creative solutions require not just providing individuals with access to preventive programs and services but also facilitating their participation in these programs. Encouraging people to adhere to good diets and other healthy habits, such as adopting a physically active lifestyle, is just the beginning. The key is to develop and implement effective, outcome-driven programs.

Learn more about Introduction to Kinesiology, Fifth Edition.

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