A Healthier Nation

Andrew Lansley, the Shadow Health Secretary, recently launched the Conservative Party’s green paper on public health - A Healthier Nation.

The Green Paper outlines how the party will tackle Britain’s public health crisis by completely overhauling the system of dealing with public health.

Much greater responsibility for tackling problems like obesity, drug use and teenage pregnancy will be devolved to communities on a new payment-by-results basis, with extra rewards for improving the public health of the poorest. In spending their dedicated public health budgets, communities will be obliged to partner with local bodies, including schools, businesses, councils and GPs.

There will be a new focus on innovative strategies, with national campaigns harnessing the latest behaviour change research and delivered by providers who are paid by results.

A Conservative Government will work with business to draw up new responsibility deals designed to prevent irresponsible activities and extend restrictions on unsuitable marketing to children throughout the media.

Much of the content is about health prevention and campaigns, but a few points are relevant to health insurance in the wider context:

• Local health bodies must innovate and partner with local bodies to promote healthy living

• There will be a new Department of Public Health focused on prevention of illness rather than cure

• People do not respond to government and other authorities (or insurers) simply telling them not to do something unhealthy, or to become healthier

• Innovative business strategies are also emerging that show how direct financial incentives can yield strong behavioural changes that reduce costs without restricting choice eg life and health insurers offering lower premiums for healthy lifestyles and free/discounted gym memberships or health screening

• Although the US health system is a mess, within it are golden nuggets such as a health organisation (roughly equivalent to a private health insurer) that uses tools that can analyse existing healthcare information to identify individual needs based on history and clinical condition. Offering individuals and companies personalized targeted campaigns and products.

Rough translation - insurers should fit products around what individuals want and need, not shoehorn them into what the insurer wants to offer:

• Employers will be encouraged to invest in the health of their employees based on wellness and prevention. With a healthy, well workforce, such investment by employers is rewarded in output/profit of three times what it costs them

• Too few employers invest in health as they look at costs and benefits on a short-term micro basis, rather than on a long-term macro basis. As they do not pay for healthcare costs, many care little about the effect, as all they see are costs for doing something

• Employers will be encouraged to invest in health and wellness. Lots of ideas are discussed such as occupational health schemes and links with sports and fitness companies

• Germany is used as an example of how health insurance costs can be cut, with employers offering bonuses for taking part in check-up programmes, dieting, smoking cessation, yoga and sports participation. Bonuses are not money, but vouchers for sports equipment, health books, and event tickets

And: Some bonuses can be redeemed for cash or reductions in insurance premiums

And:Secondary bonuses offered for sticking to agreed treatment programmes to reduce obesity, stop smoking etc – bonuses being reductions in insurance co-payments, so if the individual has to claim on the health insurance, they pay a smaller share of the cost than those who do nothing about their health.

Comment: This is not an endorsement or comment on the view of a major political party, but is a suggestion that whoever wins in May, insurers and businesses better start thinking out of the box on how to link health insurance with health – and this does not just mean copying other people on discounts!

Original thought - not committee agreed lacklustre compromises - is needed now.

Health insurance: Hot topic: February 2010