Health care planners are looking to monetary incentives and disincentives to provide better health care and control costs.  This concept is good for federal regulators and hospital managements, but our own health is too precious to be in the hands of regulators and we must make sensible lifestyle choices.

So, can monetary incentives prevail when medical advice and common sense have failed?  Surprisingly, two studies have confirmed that the answer is a resounding YES! 

Two of the most common lifestyle problems are smoking and obesity.  Although smoking rates have declined, the progress is slowing according to the Centers for Disease Control and Prevention.  Obesity rates have continued to rise in America despite attention to the problem.

Smoking
Smoking accounts for nearly 438,000 deaths annually and continues to be the leading cause of preventable death in America, although smokers have access to nicotine replacement therapy and smoking cessation counseling.

Researchers studied 878 employees of a large multinational company to find out if monetary incentives can boost quitting rates.  Half the employees received smoking cessation information and the others received a series of financial incentives that included $100 for completion of a cessation program, $250 for quitting in six months, and $400 if they stayed off cigarettes for another six months.  The results were astounding and proved that ‘paying’ does pay off.  The incentive group was more likely to enroll than the information-only group (15.4% versus 5.4%), and they were more likely to quit within six months (20.9% versus 11.8%).  They were also more likely to remain nonsmokers six months after quitting (14.7% versus 5.0%).

This incentive program cost the company $750 for each successful employee, and saved the company $3,400 a year in increased productivity, fewer illnesses, and decreased absenteeism – now, that is a bargain for the company. 

Obesity
America has seen unprecedented rise in obesity rates in the last decade with nearly two-thirds of the adult population being overweight or obese.  Obesity has severe consequences with increased risk of diabetes, hypertension, heart disease, arthritis, depression, and premature death.  Health care experts predict that if this trend continues, obesity and related illnesses can overtake smoking as the number one cause of preventable death in the country. 

Will financial incentives motivate weight loss in the real world, or is this a concept only for reality television?  Researchers set out to find the impact of monetary incentives on weight loss and recruited 57 obese volunteers aged 30 to 70 years old.  All volunteers had a body mass index (BMI – correlates with body fat, does not measure body fat) between 30 and 40, but otherwise healthy.  Participants had a one-hour nutrition consultation and were given an accurate weighing scale and divided into three groups.  One group did not get financial incentives, one group participated in a contract program that could pay them between $0 and $250 a month depending on how much weight they lost, and the third group participated in a lottery that allowed each member who lost weight to win up to $100 a day. 

At the end of the four-month trial, members of the contract program and lottery had lost significant weight (14.0 and 13.1 pounds respectively) than members of the group that did not receive any financial incentives.  It was evident that people listened when they were paid.

These two studies prove that financial incentives can motivate some people to achieve their goals, but they cannot be the only solution to solve health problems.  Healthy behavioral changes are necessary to maintain optimal health and remain disease-free.

You can promote healthy behavior changes among family, friends, and co-workers and inspire them without financial incentives.  When you exhibit good health and radiance, it may motivate them to join the trend of healthy behavioral changes.  Preaching is not motivating; instead make it pleasurable by stressing that fitness can be fun and a proactive means of promoting healthy behavioral changes.  Organize fitness-oriented fun activities and walking tours in interesting neighborhoods.  Dance classes can be a fun aerobic activity.  Organize healthy cooking classes and introduce herbs and spices that are rarely used in American kitchens.  Introduce the concept of healthy snacking with nuts, fruits, and yogurt.  These are only some of the healthy behavioral changes that can take you a long way on the road to aging gracefully while staying healthy and fit.

In the United States, many people get health insurance through their employers, and often through managed care plans that contract with health care providers and facilities to provide health care at reduced costs to its employees.  You can buy your own health insurance but it may cost you more.  Government health insurance, Medicare and Medicaid, is available to individuals who meet certain criteria. 

The health insurance marketplace can confuse people with ‘insurance jargon’ like deductibles and co-pays.  Less than a quarter of insurance policyholders are familiar with the insurance terminology.  Consumers take short-cuts when they get overwhelmed leading to wrong choice of insurance, or they may not purchase health insurance at all.  Understanding the information is important so that it is not dismissed as unimportant.  A consumer-friendly health insurance market with a simplified application process will increase the number of health insurance purchasers.

Rising Insurance Premiums

Due to rising cost of health insurance, it is out of reach for millions of families and businesses across the country.  The cost of health insurance has increased by an astounding 131 percent over the last 10 years.  President Obama passed the Affordable Care Act in March 2010 to provide affordable care to Americans.  With the passage of the law, several changes have come into effect for Americans looking to purchase health insurance.  The law will benefit millions of Americans and provide insurance for pre-existing conditions.  For the third year in a row, the health insurance companies are recording profits with ever-increasing insurance premiums.  Beginning September 1, 2011, rate increases by insurers in all states will undergo independent review by experts to justify the increase is warranted.  This process of rate review requires health insurance companies to justify the increase per year.  The Department of Health and Human Services’ (HHS) recent regulation will bring scrutiny and transparency to the insurance market through rate review, better information for consumers, and provide support and resources to states to conduct reviews. 

Uninsured Unable To Pay Hospital Bills

Approximately 50 million Americans are uninsured, and most of them have very little savings.  A new report shows that very few uninsured families can afford to pay more than 12 percent of their medical bills.  “One of the most enduring myths in American health care is that people without health insurance can get care with little or no problem.  Nothing could be farther from the truth,” said HHS Secretary Kathleen Sebelius. “The result is families going without care – or facing health care bills they can’t hope to pay.  When the uninsured cannot afford the care they receive, that cost must be absorbed by other payers.  This is why expanding access to affordable health insurance under the Affordable Care Act is so important.”  Under the new law, businesses and families get additional benefits, some of which include: 

• Up to 4 million small businesses are eligible for tax credits to help them provide insurance benefits to their workers.  The first phase of this provision provides a credit worth up to 35% of the employer’s contribution to the employees’ health insurance.  Small non-profit organizations may receive up to a 25% credit.
• Under the new law, young adults can stay on their parent’s plan until they turn 26 years old.
• Pre-Existing Condition Insurance Plan:  The Affordable Care Act creates a new program called the Pre-Existing Condition Insurance Plan (PCIP).  Under this plan, you are eligible for health insurance if you have been previously denied coverage by insurance companies due to a pre-existing condition.  With this program, you can get coverage until 2014, after which you have access to affordable health insurance choices through a new competitive marketplace called an Insurance Exchange.  The exchange cannot discriminate you based on a pre-existing medical condition.

You can get additional information regarding everything you want to know about health insurance here.

Benefits of Biking

There are far more advantages of biking than there are disadvantages:

• Improves mood and sense of well being. Pushing those pedals creates plenty of those happy hormones “endorphins” leaving you with a great sense of well being for a few hours after you have finished riding.
• Suitable for all ages.
• Suitable for all fitness levels. Biking is one of those activities that you can start at your own pace. Build up slowly until you are riding at the speed and intensity that you aspire to.
• Can be enjoyed by those with joint problems. Since cycling is considered a low impact sport it can be ideal for those suffering from arthritis and other joint conditions.
• Great for burning calories.
• Improves muscle tone, especially in the legs.
• Reduces risk for weight related health issues such as diabetes type 2.
• Can be used as a form of environmentally friendly transport.
• Low overheads. Riding a bike is a lot less costly than being a member of a gym.
• Can be enjoyed by all members of the family. Put the whole family on bikes and head for the nearest bike park or track for some seriously healthy outdoors exercise.
• Great form of aerobic exercise. Cycling is an extremely effective workout for the heart, lungs, and major muscle groups of the body.
• Can be as social as you wish. There are cycling clubs all around the world if you don’t like the thought of riding on your own. Cycling clubs can range from competitive to social to cycling vacations.
• Saves on transport and fuel costs. Once you have paid for your bike, there will be no paying for gas or transport fares.
• Fast. Traveling around on a pushbike is a lot faster than walking or jogging. Use the pushbike for visiting the local shop, instead of driving the car, when you don’t have enough time to walk. 

Preventing Biking Injuries

You can help reduce the risk of injuring yourself by following these simple instructions:

• Ensure that the bike is the correct size for you. A bike that is too small or too big for your height will be extremely uncomfortable and result in poor riding posture and lower back pain.
• Wear a bike helmet. Most cycling injuries are caused by cyclists falling off their bikes or running into objects (like trees and parked cars). Give your head as much protection as it deserves. Your helmet should be stamped to show that it meets health standards.
• Warm ups, cool downs and stretches are all important for keeping muscle strains and injuries to a minimum.
• Wear proper shoes. Bare feet, sandals, and flip flops are not going to protect your feet and toes in the case of an accident.
• Don’t wear baggy clothes that can get caught in the moving parts.
• If you are riding at dusk or dawn you will need to have lights on your bike and wear reflective clothing.

Careful!

• Those who have health problems or haven’t exercised for a while, or are over 40, should seek advise from their doctor before hopping on their pushbike and starting a marathon.
• Sun smart. If you are going to be riding around in the heat of the day you will need to be wearing sunscreen.
• Early morning bike rides can be a better idea as the sun’s rays are not so intense, and there is less chance of suffering heat exhaustion.
• Fluids. Riding a pushbike is hot and sweaty work. Make sure you take water or sports drinks with you, and that you have had plenty of fluids to drink before you start out.
• Fuel up. Lean proteins ans complex carbohydrates will help keep your muscles in shape, and provide energy for your body to burn.
• Maintain that bike. At the very least, you will need to keep air in those tires, and regularly check the chain and brakes.
• Road safety. If you are taking your pushbike out on the roads with the cars it is vital that you follow the rules of the road.
• If you are riding alone it is always a smart idea to carry your cell phone with you. You don’t want to be stranded in the middle of nowhere with no contact with the rest of the world.

Conclusion

Biking or cycling is a great form of exercise that is not only healthy for the rider, but for the environment as well.

Resources

Explains the medical health benefits of biking.
http://www.mydr.com.au/sports-fitness/cycling-to-health

Great tips on biking and links to further information.
http://www.randallshansen.com/biking-primer.html

A recent study into the impressive health benefits of biking.
http://www.news-medical.net/news/20090902/Walking-and-biking-raise-health-and-fitness-levels.aspx

A great and inspiring article on continuing biking in a very cold winter.
http://bikewinter.org/tipsAndResources/ginstips.php

A must read for anyone planning on riding their bike anywhere near cars.
http://bicyclesafe.com.