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Unhealthy lifestyles raise cost of health care


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POSTED: Wednesday, September 02, 2009

For the last 18 months, lobbyist and former labor leader John Radcliffe has been obsessed with health care.

Not his own health - although the political operative will never be mistaken for Brian Clay or Michael Phelps - but Radcliffe wants Hawaii workers to be healthy to save money.

Radcliffe has been a member of the Employer-Union Health Benefits Trust Fund for seven years. The EUTF is charged with approving the health insurance plans for state workers. The insurance plan is a big deal because it handles medical insurance for 225,000 workers, retirees and their dependents. The plan costs $559 million a year.

Insurance payments for active employees are going up between 23 and 29 percent. Radcliffe figures he could slice that by more than half by making state and county workers stay healthy - mandatory wellness.

“;We absolutely know that poor diet and especially lack of sufficient exercise account for 50 percent of an upward-lifting cost of health care,”; Radcliffe says.

Cajoling workers to stay or become healthy has not worked. Radcliffe points to a program for the 110 people with diabetes in the state Commerce and Consumers Affairs Department.

“;Bottom line is after a massive effort, over more than a year's time, there were three people in the program,”; says Radcliffe, noting that chronic diseases such as diabetes are the biggest part of increased health care costs.

So, he reasons, if you can make it financially unpleasant (charge them more) for people who smoke, don't lose weight, don't exercise, or drink too much, you will save tons of money. “;Persistent failure to take better care of one's own health would mean that employees would be responsible for much of the cost of their own premiums,”; Radcliffe told his fellow trustees.

After much hectoring, Radcliffe was able to get the board to study the idea. Then the idea was run by the attorney general and it was spiked because it turns out that making people healthy is unconstitutional.

Ruling that a person diagnosed with diabetes, high blood pressure, obesity, etc., would claim discrimination, the AG suggested that EUTF try a voluntary wellness plan.

“;Attempts to impose a mandatory wellness program with consequences for failure to complete examinations or assessment of for satisfactory engagement in a health enhancement plan would most certainly face legal challenge,”; the AG warned.

So Radcliffe, who trudges the length of Ala Moana Park every morning for exercise, is left thinking like Dickens: “;The law is a ass.”;