The culprits are many. They are often found under layers of paperwork turned bedrock, but in this case the culprit is right out there in front of us and as big as your TV screen.
According to a report in the November 23, 2009 issue of Archives of Internal Medicine, one of the JAMA/Archives journals advertising for the commonly prescribed antiplatelet drug clopidogrel (also known as Plavix), has been associated with increased drug costs and Medicaid expenditures,
Overall prescription drugs are cited as one of the three top reasons for Medicaid expenditure growth, and prescription drug costs have increased by an average of 15.4 percent per year between 1994 and 2004. Meanwhile, spending for advertising has increased more than 330 percent in the last 10 years.
It is important to know that there was no direct to consumer advertsiing for Plavix from 1999 to 2000. But, from 2001 to 2005, U.S. spending on advertsing directly to consumers for Plavix exceeded $350 million, an average of $70 million per year.
"The cost per unit of the drug increased by $0.40 (12 percent) per quarter year after advertising directly to consumers began, leading to an added $40.58 in pharmacy costs per 1,000 Medicaid enrollees per quarter. "Overall, this change resulted in an additional $207 million in total pharmacy expenditures," the report said.
Should health care consumers and policy makers be concerned about advertising that can increase drug costs for publicly funded reimbursement programs such as Medicaid and Medicare?
By Don McCanne, MD
This annual CMS report on health care spending is being celebrated in headlines throughout the nation as demonstrating a slowing in the growth of health care spending. Such headlines are missing the terrible news in this report.
Health care spending is in a crisis mode, and it only gets worse. Congress and the administration must act, but what do they intend to do? They are going to enact laws and regulations requiring us to give money to the private insurance industry to act as stewards of our health care dollars.
Yes, the insurers will be told to do a good job (through regulation), and when they fail (which they will), what will be their response? The same as now: Doctors and patients and hospitals and drug firms and tech firms keep running up the costs, and we can’t do anything about it.
Well, they’re right; they can’t. But the people can, by convincing Congress to enact our own single payer national health program - a program through which we can demand greater value in our health care purchasing.
From the January 6, 2009Group Discussion in Denver about HR-676
The group reviewed the proposed national legislation for Healthcare Reform (HR676) and made the following comments which will be brought to January 10, 2009 Health Care For All Colorado (HCAC) Denver Chapter Meeting:
1. Patient Responsibility. That a simple standard be set forth that engages patients in their healthcare process. For example, that they be educated on issues such as prevention and the cost of the care they have just received in such a way that they are actively participating and informed about their responsibility in the care they are receiving. That the information they receive be based on medical fact in a nationally standardized patient education program.
2. Pre-Existing Conditions. That it is clear that pre-existing conditions are covered and that the coverage for all services is without exclusion.
3. Privacy, Confidentiality and Portability. That it be made clear that the technology used for universal healthcare recipients ensure that patient information be kept private, confidential and portable.
4. Prices. That pricing for all services be made transparent using an existing system such as DRG9 or DRG10.
5. Co-Pays. That a sliding scale for co-pays be considered as a way to reduce the impact on taxes. (Massachusetts has gone 1/3 over the projected budget for their healthcare coverage for all programs since it began in 2007.)
6. Medications. That pharmaceutical advertising on TV, print and radio be stopped as a way to reduce the governments burden of the cost of medications.
Generally HR 676 is broadly written and does not include any exceptions - hence the document is easy to read and only 26 pages in length. In order for Americans to continue participating in the discussions and formulation of the bill the medical professionals involved need to keep the language clear and understandable.
A friend of mine has just been laid off from his job. I know this man. He is a hard working, competent American who has always been willing to do the right thing for his family and his country. He sent me this in response to my question about his health care coverage while he is unemployed. This was his answer:
"For the moment we do have (health care) coverage. I will lose my group coverage from work at the end of the month. However, luckily, my wife was able to get me on a group plan through her company. That is supposed to pick up on the 1st of January. She also has - for now - coverage through GM because her ex husband (deceased) was a GM employee.
The more I think about all this the more depressed I get. This is the second time in as many years, that I've lost a job. The fear of financial insecurity is again hanging over my head. It's nice that I went to a trade school and learned how to work on RV's because that means when the weather here starts getting better I should be able to get a job. But I thought that way when I lost my job in March 07. I'd been a production control coordinator for so long - plus I had taught myself the fundamentals of Lotus Notes database design using Lotus command language, that I thought I'd be quickly employed. Alas, 9 months later I found myself making 1/2 the 50k I'd become used to making. I sit here and just want to cry. Blah, blah, blah. My bit of self pity. Sorry. This too shall pass.
I don't even yet have the RV knowledge to start my own business. And even if I did, right now the weather is bad so nobody's getting work done and no banks are giving loans - especially for a new business and I wouldn't know the first thing about running a business and what's involved.
There I go again. Sorry. I remain optimistic.
D.R."
Another issue to consider as we look to health care reform.
In the 1980s and 1990s U.S. medical schools put a cap on enrollments believing that managed health care, among other factors, would create a glut of doctors. It is now said that we are at the beginning of a doctor shortage which is predicted to worsen as the wave of 79 million baby boomers continues to wash over into retirement age.
It is estimated that the country needs to train 3,000 to 10,000 more physicians a year, in addition to the current 25,000, to meet the growing medical needs of an aging nation. It takes 10 years to train a doctor. Reports that the doctor shortage is already being felt in States heavily populated by retirees such as North Carolina and Florida where patients say they wait weeks or months for appointments and have having difficulties even finding doctors who will accept Medicare payments.
The nation now has about 800,000 active physicians, up from 500,000 20 years ago. The predictions of a doctor shortage represent an about-face for the medical profession. For the past quarter-century, the American Medical Association and other industry groups have predicted a glut of doctors and worked to limit the number of new physicians. In 1994, the Journal of the American Medical Association predicted a surplus of 165,000 doctors by 2000 and in the 1980’s the US stopped opening medical schools because of the predicted surplus.
In 2002 the Association of American Medical Colleges dropped this long-standing view about the glut of doctors with the statement: "It now appears that those predictions may be in error.” It recommended increasing the number of US medical students by 15%.
Some medical policy specialists say the US doesn't have too few doctors, just poor distribution of them and that doctors gravitate to high-paying practices — such as sports medicine and total body scans — that serve the wealthy and well-insured at the expense of Medicare patients and others.
Others worry that more physicians will drive up the cost of medical care, not make it cheaper and more accessible saying that physicians will order more tests, more procedures and more drugs — without improving the nation's health.
If there is a shortage, taking 10 years to train enough doctors would be like chasing water that's already gone over the dam. Perhaps we need to consider having a tiered health care training system.
Other countries use health care professionals who receive less training and perform tasks that prepare patients for medical procedures, educate them, act as advocates and other health care services that are neecssary, but are not considered to have a patient-direct, life threatening impact.
Nurse practitioners (NP) and physician's assistants (PA) have filled some of the more critical areas of patient needs in the US. NP's and PA's work under the supervision of an MD managing the patient's care as a sort of clone of the physican.
In the 1960's in the US licensed practical nurses and nurses aides relieved registered nurses (RN) of some patient care tasks, but those LPN programs have mostly disappeared. Operating room technicians (ORT) still do much of the technical surgical assistance work in US operating rooms with RNs doing the medications, assiisting the anesthesiologist and monitoring the entire surgical process for quality. If health care workers with less training are supported by RNs and MDs the quality of care does not diminish and may even increase and save money.
One Colorado Commuter's Experience
Most people have never heard of an electric motorcycle, but you’ll find one in the parking lot of the Gaiam Real Goods offices in Broomfield, Colorado. Following a dream, Real Goods Renewable Energy Technician Jeff Blamey joined Gaiam in December 2006 and began to convert a gasoline-powered motorcycle to run on electric wall current for his commute to work.
He found the perfect motorcycle on eBay (a 1984 Honda VF 500), devoured a book on electric motorcycles, and spent four months designing the conversion on his computer.
Once the parts were assembled, it took Blamey a month to convert the bike. He removed the engine, transmission, radiator and fan; cut and welded metal trays for the first, second and third batteries; made saddlebag mounts for the fourth and fifth batteries; and mounted the PMG 132 motor and Alltrax controller he bought from Electric Motor Sports in Oakland, California.
According to Blamey’s calculations, his motorcycle commute costs him less than $.10 per day for eight miles, as opposed to $.75 by car or $.53 by gas-powered motorcycle. He estimates the cost of conversion, including the motorcycle, at around $3,000 and figures the batteries could last as long as five years, with replacement packs of six batteries costing around $450.
Yesterday evening I moderated a community discussion group in Denver about Health Care Reform, the Environment and Education. The goal was to identify the biggest areas of concern within these topics and to plan service projects that would address the issues.
Needless to say those who attended became overwhelmed and quickly caught up in a haze of thoughts about where to start. Should we look for the person who started these problems? How intertwined is each issue with the next? How do ordinary citizens analyze where the corruption is and take ethical actions to help heal our country and then create new systems? It took a discussion that was sometimes very frustrating, but in the end rewarding, to realize that unless we address the basic needs of food, clothing and shelter in our communities that, among other things, medical care, the environment and education will take care of themselves – people might not survive long enough to need them.
Some of the concrete numbers of those ‘going without” are entirely frightening. An estimated 5 million seniors regularly sacrifice food to pay bills. At least 29% (almost 1/3) of Americans skip medical care to pay for basic food, clothing or shelter.
According to the US Department of Agriculture over 12 percent of Americans (36.2 million adults and children) did not have enough food to maintain active and healthy lives in 2007 and nearly two million US jobs have been lost.
The U.S. Energy Information Agency estimates that this year, heating a home with oil, will increase 33% from last year and is a 117% increase since 2004. The cost of heating a home with natural gas has gone up 30% since 2004. The cost of heating with propane, which heats homes in many rural areas across the nation, has increased 23% in the last year and 73% since 2004.
Foreclosures are up: 1.2 million. This number is a 42 percent increase from 2005. The percentage change in foreclosures is up a 700 percent from 2005 to 2006.
These numbers are not all about those you see living on the streets – they are also your neighbors. Some of them live in my nice, comfortable neighborhood in Denver – for now anyway, until they miss another mortgage payment and receive a foreclosure statement or lose their jobs and begin worrying about food and clothing and then can’t pay their mortgage or rent.
And does it really matter how it happened or who is responsible for fraudulent mortgages or overspending. Not really; not today anyway. The problem is way too big for blame.
What the community group decided last night was to begin a campaign of fund raising to help a family in danger of losing their home. One group, collecting money for one family – simple. Our goal – change. Another group we work with is doing a food drive in January - another action that doesn’t take weeks, months and years of planning, proposals, vetoes and votes. It’s just people helping people. Perhaps that’s where we went wrong way back – maybe we thought people were someone else’s responsibility.
Colorado health care costs higher than the rest of the nation according to this Nov 2008 article in The Colorado Springs Business Journal
The rapidly rising rates make cost the No. 1 concern for employers in the state. "This is going to be a problem with companies migrating to Colorado because typically they do ask about insurance rates and benefits," Lindsey said. "But it also affects our exports. Someone who is manufacturing something in Colorado Springs might have higher prices than someone in a different state with lower health care costs. The product is going to be priced higher -- and it's going to be a problem with competing." Costs are higher in Colorado for many reasons. "Colorado tends to have more small employers than the other states," Lindsey said. "And that makes for higher rates because they have less bargaining power.
Our industry is heavily concentrated in service industry and tourism, and those groups have higher rates." Some insurance plans blame recent legislation for rising costs. A law that forbids insurance companies from offering discounts based on health or past use of health insurance will take effect in January. "We haven't seen really a decrease yet," said Janice Pramik, director of small group sales for Anthem Blue Cross and Blue Shield. "But we've just started working with companies for January renewals. And I'm expecting some companies will drop out of insurance coverage because of the increases."
Anthem plans an 11.7 percent increase in premiums for its small group markets, but with the discount gone, some groups could see increases of 25 percent or 30 percent. "Some of the cost is just the cost of doing business," Pramik said. "About 50 percent of health care costs are attributable to individual behavior -- smoking, alcoholism, obesity. The cost of care is rising every year, and we have to respond." The number of uninsured people also leads to higher premiums, because hospitals and doctors shift the cost of caring to people with insurance, charging them higher rates. Colorado has a higher rate of uninsured than other states, Lindsey said. The cost shift includes higher employee contributions for single and dependent coverage, drug coverage, increasing deductibles, co-payments and out-of-pocket limits.
Colorado is going to have a more difficult time competing on both the national and global stage because its health care costs are higher than the rest of the nation. The state's health plans will raise premiums by 13.7 percent during 2009, according to Lockton "This is significant in that it demonstrates that the rate of increase in the cost of coverage in Colorado greatly exceeds the national average for 2009," said Bill Lindsey, president of Lockton Benefit Group in Denver. "This makes it harder for Colorado employers to compete. Moreover, the resulting plan changes place Colorado workers at a greater disadvantage in terms of higher deductibles, out-of-pocket expense and more significant premium cost sharing than their counterparts nationally."
The rapidly rising rates make cost the No. 1 concern for employers in the state. "This is going to be a problem with companies migrating to Colorado because typically they do ask about insurance rates and benefits," Lindsey said. "But it also affects our exports. Someone who is manufacturing something in Colorado Springs might have higher prices than someone in a different state with lower health care costs. The product is going to be priced higher -- and it's going to be a problem with competing." Costs are higher in Colorado for many reasons. "Colorado tends to have more small employers than the other states," Lindsey said. "And that makes for higher rates because they have less bargaining power. Our industry is heavily concentrated in service industry and tourism, and those groups have higher rates."
Some insurance plans blame recent legislation for rising costs. A law that forbids insurance companies from offering discounts based on health or past use of health insurance will take effect in January. "We haven't seen really a decrease yet," said Janice Pramik, director of small group sales for Anthem Blue Cross and Blue Shield. "But we've just started working with companies for January renewals. And I'm expecting some companies will drop out of insurance coverage because of the increases." Anthem plans an 11.7 percent increase in premiums for its small group markets, but with the discount gone, some groups could see increases of 25 percent or 30 percent. "Some of the cost is just the cost of doing business," Pramik said. "About 50 percent of health care costs are attributable to individual behavior -- smoking, alcoholism, obesity. The cost of care is rising every year, and we have to respond."
The number of uninsured people also leads to higher premiums, because hospitals and doctors shift the cost of caring to people with insurance, charging them higher rates. Colorado has a higher rate of uninsured than other states, Lindsey said. The cost shift includes higher employee contributions for single and dependent coverage, drug coverage, increasing deductibles, co-payments and out-of-pocket limits. "Nearly 39 percent of employers reported that their plan deductible is $500 or greater," the survey said. "The results indicate a growth in HMO plans to 44 percent of those surveyed, up from 37 percent in 2007."
Higher deductibles are one way insurance companies are trying to keep costs down, said Jean Baker, executive director of sales for Kaiser Permanente in Colorado. "We're also going with more cost-sharing," she said. "It's part of a trend, and it means more out-of-pocket expenses when you use health care, but it also keeps premiums down. And there are protections on the upper end -- we have maximum out-of-pocket limits." Kaiser is focused on affordability, but Baker admits that prices for health insurance could rise as people's economic fortunes suffer because of the lagging economy. "There are a lot of drivers for costs, but we can't make plans unaffordable," she said. "And in most cases, we don't seem to be. We don't see people leaving small group markets in the state; it's been pretty stable this past year."
Another significant change is the number of employers offering high-deductible health plans, which increased from 3 percent to 14 percent during 2008. Employers also are switching to HMO plans. According to the survey, the number of employers in an HMO plan increased to 44 percent this year, up from 37 percent during 2007.
Most employers, however, still offer PPO plans with higher deductibles and out-of-pocket expenses. "I'm not surprised because people tend to turn to HMO plans for the best value for their dollar," Baker said. "And when prices of other plans rise, they look at HMO plans." Anthem is trying to offer a wide variety of choices to combat higher prices, Pramik said. "We are trying to keep as many people insured as possible," she said. "New small group plans offer more affordability on the front end, with higher deductibles. New individual plans focus on providing insurance for major medical needs, but not so much the day-to-day care for people who are healthy."
Credit: Amy Gillentine
The Colorado Springs Business Journal
Date: Friday, November 7 2008
Read this article by Egan Sanders, a “HyperMiler”....
Save Gas to Help the Economy and Your Finances by Hypermiling
I’m sending out this email to offer some effective tips for people to save money on gas. If you find that they work for you, please share them with as many people you can. Saving gas saves us money and is good for our economy and the environment.
I’ve been experimenting with these “hypermiling” techniques for the last few months. My 1997 Toyota is only supposed to get about 23 miles per gallon. By hypermiling I get on average 35-38 miles per gallon – over a 50% increase! Most of my driving is in the city which usually wastes more gas. If you have a newer car that already gets higher gas mileage then this will likely boost it even further.
Even though the price of gas has come down recently that doesn’t mean that it’s going to stay there. At this time I see no logic in the stock market and in the trading of commodities like gas. Also, the more gas we use, the more of that money goes overseas - often to countries that don’t like the U.S.; like Venezuela, Russia, and Iran.
Lessening our dependence on foreign oil is also a matter of national security. We are funding countries that are not truly democratic with our oil money. Saving gas is patriotic and these techniques are life-long habits that will pay dividends for many years to come.
Our national debt is also out of control and saving gas is one way we can ease it. By reducing our use we can help our own economy and be an example to other countries.
Until electric vehicles are widely available, we also have to realize that burning fuel harms the environment. Global Warming is a reality. Do we really want our children and grandchildren to inherit a more polluted and harsher environment? While I’m hoping our new president will put new programs into place, we all have to our part. We are all part of the solution and we can act now.
Okay, enough with the commentary…here are the basic techniques. More information can be found on the site for the man who invented hypermiling, www.cleanmpg.com
1. If you can avoid driving – do so; walk, bike, carpool and/or take public transportation. I live close enough to my bank that I can walk to it. If you commute to work see if you can carpool with a coworker at least once a week.
2. Reduce your car’s weight. The heavier your car is, the more gas you use. Clean out your car and remove unnecessary objects. All that stuff in your trunk is wasting gas. Also, don’t fill up your gas tank all the way – a full tank adds more weight to your vehicle.
3. Properly inflate your car tires. Familiarize yourself with your car’s proper tire pressure and montor it regularly.
4. Search for the cheapest gas prices online by visiting www.gasbuddy.com. I was surprised about the wide difference in prices even within a few miles of where I live. The larger chains generally charge more than other independent stations.
5. Drive five miles under the speed limit. Right away you reduce your gas use by 10%! If you try this you’ll find that you get to places on time. At the most you may lose a few minutes, but I found myself often meeting up with the same people at the next stop light who had sped past me. Driving slower is relaxing, too. If no one is on the road drive ten miles under the speed limit. You will get to where you are going in about the same time at a slower speed. Less traffic means fewer red lights because most stop lights are automated. When traffic is low they stay green or change quickly.
6. Avoid wasteful idling. When you turn you car engine on – go; when you get where you are going, turn off the engine immediately. Most cars nowadays are fuel-injected and don’t need to be warmed up. Shut off your engine if you’re stopped for more than 10 seconds to save even further on gas. So, if you stop at a drive thru ATM, turn off your engine. Some stoplights are over a minute or two. Why burn gas while you wait?
7. Combine errands. Before you head out to drive ask yourself, “Is there anything else I need to do while I’m out?” Instead of driving to do just one thing, combine errands and plan your route in advance. You can grab a coffee at Starbucks, go to the post office and then stop at the supermarket all in one trip. This kind of driving saves gas and also creates less wear on your car. It only takes a moment to plan your route. To drive fewer miles UPS has their drivers plan their routes to avoid left turns, and instead make as many right turns as possible.
8. Pay attention to how you accelerate and decelerate – braking. Have an anticipatory focus and be a smart-braker! Flow with the traffic and try to brake as little as possible. Every time you rapidly accelerate, or break hard to slow down, you waste gas. Try to keep a consistent speed and stay in one lane. Rather than braking, gently ease up on the gas pedal when coming to a red light and avoid a full stop - if you can. If you time it right the light may turn green and then you can slowly re-accelerate without having to do so from a complete stop.
9. Avoid additional gas wasters like running the air conditioning/heat and driving with the windows down. If you need to run the a/c or heat, turn it off a few minutes before you arrive at your destination. You can also use the vent or fan to intake and circulate air inside your car.
I know this initially takes effort, but if many people started to do this it could make a huge impact. I found with a little practice it becomes easy and automatic to do.
Thanks for hypermiling.
Egan Sanders
New York's Governor Paterson will present a proposal today (December 16, 2008) for a 15% Obesity Tax on non-diet soda drinks. A 15-percent tax on non-diet soda could net the state somewhere around $400 million. The budget deficit facing New York for the upcoming budget is estimated to be near $15 billion.
The governor's plan targets regular sodas, but does nothing for other drinks in the same cooler, like Hawaiian Punch, which has just as much sugar and calories as a soda does.
The statistics in the United States are approaching 60 percent overweight and obese, children included. So the numbers are just growing more and more says Dietitian Phyllis Woodson, of the EVMS Strelitz Diabetes Center in Norfolk, Virginia.
Increasing consumption of fructose has coincided with the increasing incidence of obesity and the metabolic syndrome over the past 2 decades. In the United States, the largest single source of fructose in the diet is from added sugars, half of which is in the form of high-fructose corn syrup, a major sweetener in sugar-sweetened beverages (soft drinks and fruit drinks).
Sugar-sweetened soft drinks contribute 7.1% of total energy intake and represent the largest single food source of calories in the US diet. Coincidentally or not, the rise of obesity and type 2 diabetes in the United States parallels the increase in sugar-sweetened soft drink consumption. Several studies have found an association between sugar-sweetened beverages and incidence of obesity in children. In one study, the odds ratio of becoming obese increased 1.6 times for each additional sugar-sweetened drink consumed every day. Sugar-Sweetened Soft Drinks, Obesity, and Type 2 Diabetes Caroline M. Apovian, MD. JAMA. 2004;292:978-979.
What do you think? Would an obesity tax on some sugared drinks work to reduce obesity and the health problems excess weight causes such as orthopedic and musculoskeletal problems and Diabetes Type 2?
Another choice might be to give incentives to schools who go "Sugar-Free" and stores who eliminate sugared products from the check-out line at the supermarket where the candy selection seems to be well positioned for unsuspecting impulse buyers.
excerpt from Dec 15, 2008 article Wall Street Journal
By Ezekiel J. Emanuel and Ron Wyden
Today, health-care costs are increasing at twice the rate of inflation. To stay in the black, companies are forced to raise their employees' premiums and deductibles, opt for cheaper insurance plans, or worse yet, drop health benefits altogether. Since 2000, the percentage of employers providing health insurance has declined by nearly 10%.
For too many, the employer-based system is inefficient. Each employer purchases health insurance separately. According to a recent estimate by the McKinsey Global Institute, this adds more than $75 billion in underwriting, marketing, sales, billing and other administrative costs that offer no health benefits. More than half of all American employers who offer health-care benefits don't offer their employees a choice. Consequently, most Americans don't have the option of giving their business to insurance companies that treat them well and only cover what they need. This prevents the usual market forces from holding down costs.
Workers are the ones paying for this waste. The money that employers are spending to buy health care for their employees could otherwise go to workers in the form of higher wages, empowering individuals to make their own health-care choices.
The currently available alternative to this employer-based system is even more horrifying. Individuals buying insurance don't have the same purchasing power as large businesses and end up paying much higher prices to cover administrative costs and risks. They also don't get the tax breaks that employers get for buying health insurance. In most states, insurance companies have the right to discriminate against individuals by denying coverage or charging astronomical prices to anyone with a pre-existing condition. It is no surprise that, when given the choice between the employer-based system and buying health insurance on their own, the vast majority of Americans reject the latter. (A Kaiser Health Tracking Poll this summer, for example, found that only 17% of Americans said they would prefer to buy insurance on their own.)
But this is a false choice. It assumes that the current system is the only option. Why can't Americans have the best of both worlds?
end of excerpt
Never before have Americans been asked to participate directly in future decisions that will be made about health care reform, sustainable energy choices, ethics, education, the economy and a host of other topics that will change our lives and lifetsyles. Having a collective voice from your individual opinions can now replace our confusion and sense of helplessness over issues that previously appeared to be too big for us.
Many grassroots movements such as The Coalition to Advance Healthcare Reform and others who have made their voices heard are already participating in the bigger picture.
Join the Denver event, December 18 and be heard in by the Oabama-Biden Transition Team who have asked for the opinions and ideas that you generate at that event. We look forward to seeing you and our local and state politicians at the event.
I'll be posting the thoughts and ideas submitted by those working on the new health care plan design we are working on in Colorado. The basic model for the design offers rewards to those who take charge of their health by following health recommendations such as participation in early detection screenings and making behavioral changes that reduce risk factors for illness and disease. Taking health education classes is a third way health care consumers could earn rewards and incentives such as dicounts on products at participating vendors like grocery stores, movie theaters and public transportation entities. Some of the other rewards suggested are listed below:
1. Reward those whose make behavioral changes that reduce risk factors known to contribute to disease and illness. For example - losing weight, stopping smoking, exercising, practcing meditation or other stress reduction practices, etc.
2. Offer incentives to those who complete an online course that teaches them about their identified areas of risk, such as heart disease, high blood pressure, aging and diabetes.
3. Award incentives to those who participate in this campaign (i.e. health educators, those who attend events and participating vendors who provide product vouchers and discounts)
4.Publicly acknowledge the first communities and states to attain certain healthly benchmarks.
5. Incentivize those who repeatedly acquire preventable illnesses when they participate in a health education class either online or through designated health educators.
6. Reward schools that remove concentrated sugar products from their premises.
7. Incentivize grocery stores to remove concentrated sugar products from eye level and impulse shopping areas in their facilities.
8.Reward those who maintain their health through health screenings and other preventative measures by reducing their health care premiums or out-of-pocket payments.
more later...
