A blog about Policy

…in the battle against diabetes. A wonderful example of how combining incentives with information dissemination and counseling can lead to an effective public health policy.

For the past 10 years, the city of Asheville has given free diabetes medicines and supplies to municipal workers who have the disease if they agree to monthly counseling from specially trained pharmacists. The results, city officials say, have been dramatic: Within months of enrolling in the program, almost twice as many have their blood sugar levels under control. In addition, the city’s health plan has saved more than $2,000 in medical costs per patient each year.

…..Asheville’s public health experiment is something of a ray of hope, an example, however modest, of the kind of house-to-house, block-to-block battle that can win results and save lives in the face of a disease that has resisted quick-fix solutions.

Do read the whole thing.

A recent study seems to indicate that majority of Americans support public policies and government-induced incentives that can potentially reduce adult obesity.

A large majority of Americans say they support changes in public policy to stem the rising tide of obesity among adults, a new survey shows.

“There is a lot of support for employer and health policies aimed at preventing obesity,” said lead researcher Bernard Fuemmeler, an assistant professor in the department of community and family medicine at Duke University Medical Center, in Durham, N.C.

“This study provides tangible evidence that people support wide-scale policy changes that can affect obesity in the U.S.,” Fuemmeler added.
…..
The new telephone survey of 1,139 adults found that 85 percent supported tax breaks for employers who made exercise space available to employees.

In addition, 73 percent said they’d support government incentives for companies that reduced the cost of health insurance for employees who had healthy lifestyles and shed extra pounds. Seventy-two percent said they would support government policies requiring insurance companies to cover obesity treatment and prevention programs.

“There is growing public advocacy for these kinds of policy changes,” Fuemmeler said. “There is also advocacy in the research community for large-scale policy changes. With some push, we might be able to get some changes that would help us better address the obesity epidemic in the country.”

Health insurance and other incentives (such as providing subsidized gym membership) are probably a good way to go towards tackling obesity. It will take a while though to figure out the effectiveness of such programs. Also, as the article itself suggests, incentives are no guarantee that employees will take advantage of them:

However, “It’s not clear what will motivate the employees,” Kolasa said.

One problem is misinformation about weight loss. “Most individuals that present for nutrition counseling have significant amounts of misinformation about food and beverages that prevent them from being successful in weight loss or weight management,” Kolasa said.

“Also, people continue to say that it costs more money to eat healthy, when it has been demonstrated time and again you can eat healthy at no greater cost,” Kolasa added.

Baby boomers are spending a higher amount caring for their elderly parents. As the average life expectancy increase, this cost will only go up.

 Ms. Rodriguez is among the legion of adult children — more than 15 million, according to various calculations — who take care of their aging parents, a responsibility that often includes paying for all or part of their housing, medical supplies and incidental expenses. Many costs are out of pocket and largely unnoticed: clothing, home repair, a cellular telephone. Adult children with the largest out-of-pocket expenses are those supervising care long distance, those who hire in-home help and those whose parents have too much money to qualify for government-subsidized Medicaid but not enough to pay for what could be a decade of frailty and dependence.[link]

Couple of months back, BongoP’o'ndit had brought to our attention, the  New York’s Board of Health’s decision to ban use of Trans fats in restaurants. Much discussion ensued and we were supposed to write a post on it. As it usually happens, laziness intervened and we never got around to writing it.

Anyway, now the debate has been joined by two eminent scholars, Professors Richard Posner and Gary Becker of the acclaimed Becker-Posner blog. Firing the first salvo, Professor Posner concludes that the ban is justified. He bases his argument primarily on cost benefits. Using back of  envelope calculations, the professor attempts to prove that the ban would actually save money-in the form of health costs and saved lives. I wasn’t too impressed by this logic, primarily because while cost is an important factor to be considered in any public policy intervention, it requires careful research. Professor Posner’s calculations can easily be demolished by another  set of crude calculations which Professor Becker actually does in his rejoinder.

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The recent decision by New York City’s Board of Health to ban the usage of trans-fat in all restaurants (and catering units) in the city bothers me. Ever since I heard about the initial proposal few months ago, I have not been able to decide whether it is a good or bad idea.

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