Disease prevention and healthy living: Rick Snyder's health care priority for Michigan?
Michigan Gov.-elect Rick Snyder has said disease prevention and healthy living should be a health care priority for Michigan.
Melanie Maxwell | AnnArbor.com
Dig deep into the $14.1 billion budget for the Michigan Department of Community Health and you’ll find it.
The amount the state's Public Health Administration spends on “promotion of healthy behaviors": $975,900.
That figure is dwarfed by the $9.88 billion in federal funds and $4.19 billion in state dollars Michigan appropriates for the Department of Community Health, which oversees the 1.8 million Michiganders who receive Medicaid benefits.
That disparity reflects a limited commitment among the federal and state governments to the concept that a healthier population leads to fewer health care problems — and lower costs for everyone.
But Gov.-elect Rick Snyder, who co-founded an Ann Arbor-based company whose software helps people make healthier decisions, is expected to place a greater emphasis on disease prevention and wellness initiatives.
Snyder was a co-founder and personal investor in Ann Arbor-based HealthMedia until it was sold in a blockbuster deal to Johnson & Johnson in late 2008. He once cut personal checks to pay the salaries of HealthMedia employees when the company hit a rough patch around 2001.
His commitment to the company’s philosophy — that health care costs can be lowered by improving the health of the general population — provides insight into the approach he'll take as Michigan’s 48th governor starting Jan. 1.
“It’s nothing we’ve talked about, but I would be surprised if he doesn’t put an emphasis on wellness,” said former HealthMedia CEO Ted Dacko, who now leads Ann Arbor-based consulting firm Arbor Dakota Strategies. “I mean, he’s the guy who talked me into coming to HealthMedia because he understood this issue 10 years ago. It’s something we as a state need to do.”
Bill Nowling, Snyder's spokesman, said the governor-elect
would take a "serious" look at using his "value for money" budgeting
system to find new funds for disease prevention and wellness
investments.
"Preventative health is going to play a key role because it’s one of
the areas where we can really save money in the long term," he said.
"The key thing is going to be working with the federal government to
secure the waivers we need to administer the programs differently."
Wellness spending
Marianne Udow-Phillips discusses the importance of an increased emphasis on healthy living and disease prevention in an interview Tuesday morning with AnnArbor.com's Nathan Bomey, who is guest-hosting the "Lucy Ann Lance Business Insider" on 1290 WLBY-AM this week:
Michigan’s total spending on healthy living initiatives and preventing chronic disease is scattered through several divisions of the Department of Community Health. The department spends some $30.7 million for its “Chronic Disease and Injury Prevention” division, though $23 million of that is federal money.
Of those dollars, the state says $4.6 million is devoted to smoking prevention, and another $21.2 million is dedicated to “chronic disease control and health promotion.”
A separate division called the Public Health Administration has a $17.8 million budget, though $9.2 million was spent on health records and statistics. And another $5 million spent on “public health projects” came from the federal economic stimulus bill. This department spends $975,900 on “promotion of healthy behaviors.”
The U.S. Centers for Disease Control and Prevention estimate that more than 75 percent of health care costs are attributable to chronic diseases, including heart disease and diabetes.
In a paper detailing his health care policy proposals, Snyder said Michigan could save more than $1 billion “by improving the management of Medicaid, expanding access to care, fielding innovative health IT systems, and identifying health problems and focusing on wellness prevention early, before issues become severe or chronic.”
Snyder has called for the state to consider launching a program in which certain Medicaid patients would be eligible to participate in so-called “patient-centered medical homes,” a concept modeled after similar programs in Texas and New Mexico. The patient-centered medical homes, generally targeted at poor residents with several major health problems, seek to reduce costs by eliminating duplicate medical services and “silos” that cause confusion among doctors and high costs for the state, Snyder says in his paper.
Former HealthMedia CEO Ted Dacko said disease prevention and healthy living is an issue Snyder was talking about 10 years ago.
Melanie Maxwell | AnnArbor.com
Snyder has also called on the state to pursue federally qualified health centers, pilot health projects and public-private partnerships. He’s said the state should spend more on mental health services.
But he regularly emphasizes the importance of encouraging good behavioral decisions to reduce health care costs.
“Citizens should be educated and encouraged to get routine vaccinations and examinations, and to make healthy lifestyle decisions concerning nutrition, exercise, smoking, drinking and other factors,” he says in his health care reform paper.
To place a greater emphasis on wellness and prevention, the state needs to consider restructuring its public health division, said Marianne Udow-Phillips, director of the Center for Healthcare Research and Transformation, a partnership between the University of Michigan and Blue Cross Blue Shield of Michigan.
Udow-Phillips, who served as director of the state’s Department of Human Services from 2004 to 2007 under Gov. Jennifer Granholm, said the public health division should remain part of the Department of Community Health but that the Medicaid program should be moved back under the auspices of the Department of Human Services. This would allow public health issues to be given greater prominence, she said.
Udow-Phillips said Tuesday morning on the “Lucy Ann Lance Business Insider” on 1290 WLBY-AM that wellness and disease prevention had “gotten much less priority over the years than I think they deserve.”
“The huge issues in our state really have to do with chronic disease. We are a very high state in terms of our overweight status, we’re higher than the national average on smoking, we have these significant issues with (premature births),” Udow-Phillips said. “These are all public health issues, and they’re all things that need a concentrated focus, and it’s really hard to do that when you’re blended together with the Medicaid program that has its own issues.”
Whether Snyder plans to devote more funding to wellness and disease prevention isn't yet known.
But his “10-point plan” to “reinvent Michigan,” which he regularly cited during his campaign, says he “strongly believes in prevention, wellness and personal responsibility.
“He wants to move Michigan to a more patient-centered model to achieve large cost savings, promote wellness, and improve overall service quality,” the plan states.
The role of software
Reducing health care costs is a key objective of HealthMedia’s health coaching technology, which helps users identify risky behaviors and make better lifestyle decisions.
The firm’s customers include major health plans such as Aetna and several Blue Cross Blue Shield entities and major employers like eBay and Ace Hardware.
Public workers have been customers of HealthMedia, too. Former Republican U.S. presidential candidate Mike Huckabee, for example, turned into a public proponent of HealthMedia after the state of Arkansas adopted HealthMedia’s software for state employees and said it led to “productivity savings of $2,300 per employee.”
Caren Kenney, director of communications for HealthMedia, declined to comment on whether Snyder’s ascension to the governorship could benefit HealthMedia.
But she said HealthMedia would support an increased focus on wellness and disease prevention.
“If that’s part of his platform, that would certainly be something that we applaud,” Kenney said. “It’s not just Michigan. You’re seeing it among employers that are recognizing it as important and investing it in. It’s really a national focus. We applaud Rick and anyone else who places an emphasis there.”
Contact AnnArbor.com's Nathan Bomey at (734) 623-2587 or nathanbomey@annarbor.com. You can also follow him on Twitter or subscribe to AnnArbor.com's newsletters.
Comments
tim
Fri, Nov 26, 2010 : 7:59 a.m.
So what if government tells you what to eat == private companys already do. Priority Health tells us that if you do X it will cost this much and if you do Y it will cost you more if You get sick. Health care providers are trying to save money but at the same time they just might be saving your life.
AlphaAlpha
Wed, Nov 24, 2010 : 9:56 p.m.
Maybe now we'll finally get the pop tax. Extra tax revenue and reducing the consumption of less than healthy drinks. Maybe $0.25 per serving? $0.50? Ka-ching...
Mick52
Wed, Nov 24, 2010 : 2:11 p.m.
The hornet's nest has already been stirred, knocked down, and booted. If you look at research on obesity and other habit related illnesses you will see there is a critical need for Americans to lead healthier lifestyles. Also, habit related health issues are a significant burden to employers and health care providers and insurers. So as long as people are harping on free/more/affordable/govt provided health care, you can expect a lot more pressure, hopefully required, provisions for you to get healthy. And or those of you who think I am goofy and this will not/should not happen, let me share a link from our good friends in England, who have a single payer health care system: http://www.outsidethebeltway.com/uk_smoker_denied_surgery_for_broken_ankle/ Not only this, but they do a lot of nasty things to you in England in re to HC if you are unhealthy. When govt becomes involved in HC, this is what you can expect, especially when public funding is involved. They will tell you what to eat. I do not care how much wallop tobacco companies have, smoking should be illegal or people who smoke should be denied health insurance at normal rates. If any part of the govt thinks HC is a right, a la Senator Stabenow, they should be promoting such in order to make HC more affordable, which is what they say they are trying to do. The fact that they are not pushing for more healthy lifestyles to me is an indication they are not being honest. I have no problem with those of you who want the govt out of your habits, your kitchen and what you inhale, but don't expect low health care costs or govt provided care if you feel that way. Kudos to First Lady Obama for her push for more healthier school lunches and fitness of children. It is long overdue.
Speechless
Wed, Nov 24, 2010 : 2:07 p.m.
Healthier lifestyles and diets are good for people, and long-term benefits are self-evident. The choices we make now will affect us later on. We know this. But there's political co-optation going on here. Not that this is in any way original to Snyder, as it's been happening for at least the last twenty years. Over the last two decades, the need for major health care reform grew increasingly urgent. The medical industry have responded by adopting healthy lifestyle campaigns as a significant element in their public relations counterattack against reform proposals. That is, they tell us that if we each take greater responsibility for our diets and health, then reform of the cruelly flawed medical system will (by magic) become entirely unnecessary. All along, it seems, we've been "bad" people who bought the junk food, the liquor & cigarettes, and couch potato lifestyles that advertisers sold to us. By this medical industry narrative, we have no one to blame but ourselves. The greedy health insurers and the inflated medical costs have little to do with the sad fate for the many tens of millions in the U.S. who have either poor health coverage or none at all. Healthy lifestyle campaigns used to be associated primarily with non-profit public advocacy groups who sought reform in the food and agriculture industries, among others. These kinds of campaigns have also played a role in environmental justice work, as a means to increase corporate accountability. But, more recently, for-profit medical interests and health insurers have co-opted them to distract attention from the continued need for further major reforms.
SemperFi
Wed, Nov 24, 2010 : 1:54 p.m.
Damn Cash! Complain much? Snyder is the Governor elect. Some of us actually like to read articles about our state's leaders. If Gov-elect Snyder can promote disease prevention and healthy lifestyles, I'm all for it. With all the bad choices being made by citizens about their long-term health, there needs to be a voice to promote good decision-making. As long as the government(taxpayers) is picking up the tab for Medicaid/Medicare, it's in all of our best interest to get the word out about managing ones health. Since the government took up the anti-smoking campaign, there has been a steady decline in the smoking population. No one was forced by the government to stop, but when faced with honest information time and again, people choose to not smoke. It'll be the same thing with a long term approach to disease prevention and heathly living. Snyder clearly has some expertise in the field from running HealthMedia. I support the effort 100%. I believe that the people of Michigan can benefit from strategic thinking like this, rather than wondering where the next pot of gold is coming from to pay bills. No one said it would be easy to change the current paradigm. If he is to become the leader he professes to be, he will need to stand up to well-healed lobbyists among others. So, give us this day our daily "healthy" bread.
KJMClark
Wed, Nov 24, 2010 : 1:47 p.m.
Wasn't there an article not too long ago about candidate Snyder talking down a bike/ped bridge? So one of the more effective ways for people to get exercise as part of their daily activities, walking or biking for transportation, is a good idea as long as we don't have to provide infrastructure? I hope he can work that conundrum out somehow. Now I wonder what that software recommends for exercise.
Tree Logger
Wed, Nov 24, 2010 : 11:46 a.m.
Rick believes in prevention, wellness, and paying for million dollar procedures with a minimum wage paycheck. What better way to dump the sick than to blame them for their own predicament?
Nathan Bomey
Wed, Nov 24, 2010 : 11:45 a.m.
I just adjusted the story to clarify Marianne Udow-Phillips' comments. She wants Medicaid to be placed back under the auspices of the Department of Human Services and she thinks public health should stay under the Department of Community Health. This would allow public health issues to be given greater prominence, she said.
Keven Mosley-Koehler
Wed, Nov 24, 2010 : 10:38 a.m.
As we discuss how to make Michigan a healthier place to live, learn, work, and play, it's important to discuss health within its appropriate context - - individuals do not make decisions in a vacuum. In fact, we know that our environments influence our behavior daily, including how we are raised; personal relationships (family, peers); extent of access to healthy choices within our neighborhoods and local community; the policies and practices of schools we attend (eg, foods offered, physical and health education, or after-school recreation); the pervasive media we contend with every moment as it tries to sell us its products; and local and state policies and legislation. Indeed, local and state policies drive an entire community's ability to make the healthy choice the easy choice. For example, communities that apply "Active Living" concepts through make the area more walkable and bikeable, or that implement strategies to increase the ratio of fresh healthy food to fast food venues, understand how much our environment (and its associated policies) shape individual health. Everyone, everywhere should be able to, every day, "make the healthy choice the easy choice". As we move forward in our attempt to improve individual health, let us not forget that we have the ability to apply policies and modify our built environments across all sectors of society to work FOR healthy decisions, not against them!
Technojunkie
Wed, Nov 24, 2010 : 9:58 a.m.
One thing Snyder could do, maybe, is to clean up Michigan's school lunch programs. school-lunch.org/school.html is a good place to start. Spend a little more to provide real food and watch the number of ADHD cases drop. Ban synthetic food ingredients from being provided by schools and other government-run institutions. But looking at the insane food advice given by the federal government at the behest of agribusiness and manufactured food giants I'm not hopeful that even this small step is politically possible.
Cash
Wed, Nov 24, 2010 : 9:37 a.m.
grye, Where have you been the last 60 years or longer? Do we not yet know that corporate America really runs this country???? Do you think they would allow government to control their sales? The tobacco industry is still strong in the south and middle America....and has a powerful lobby. Liquor and beer industry whipped the sales on Sunday people in Mich legislature around til they got exactly what they wanted. I'm actually doing Snyder more of a favor than a lot of others....trying to get people to recognize he is NOT a savior. The same mistake was made regarding President Obama. Now people are disillusioned. I think it's much more wise to stop the illusions and face the reality. Corporations will fight to the death to maintain their power...and folks like Pres Obama and Rick Snyder will be causalities. To suffer from illusions of grandeur hurts Snyder more than helps him. He will try to make change. When he takes on corporate lobbies....best of luck.
oldrustynail
Wed, Nov 24, 2010 : 8:53 a.m.
It has always been my impression that health insurance providers did not wish to pay for "preventive medicine" procedures. We will all die from disease and a healthier person lives longer and therefore cost more money. It is simple finanical matter to those companies, nothing personal.
grye
Wed, Nov 24, 2010 : 8:48 a.m.
Cash: Talk about jumping the gun without knowing anything that Rick may want to do to help reduce health care costs. The first thing you think is that unhealthy food will get taxed so we are forced to eat what the govt wants. Hopefully Rick will promote programs that encourage healthier choices, programs to help obesse individuals to lose weight, program to help smokers kick the habit, etc. Government shouldn't force us to do what we don't want. Most things in moderation are ok. It's making people understand at an early age that excessiveness may lead to an unhealthy lifestyle. Give the guy a chance. He may make a difference.
Truffledog
Wed, Nov 24, 2010 : 8:44 a.m.
Sincerely hope Snyder can make headway in this vital area. Granholm's decision to loot future tobacco settlement funds to push government spending on playing venture capitalist instead of smoking cessation programs amounted to mass murder.
Cash
Wed, Nov 24, 2010 : 6:43 a.m.
Give us this day our daily Snyder article......... At any rate, the minute you talk about "healthy" lifestyle and governments role, you stir up a hornet's nest. Should the government tell us what to eat? Tax us based on what we eat? What are employer/state rights to nose into your habits (drinking, smoking exercising etc)? Snyder will find out just how long "Rah Rah Rick" will last when he steps into this one. It will get ugly. The big bucks are behind the food and beverage industry. (Anyone sick of seeing the nice lady shopping for her groceries while she says that the government needs to stay out of her life?) I have nothing against healthy lifestyle proponents. I'm just saying that the other side of it is "bad PR" for alcohol, tobacco industry, soda industry, sugar beet industry....need I go on? Mark my words, Snyder will wonder what hit him when he runs into lobbying, corporate dollars and the powers behind them. He's now on the other side of the fence.