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The Politics of Prevention

As the 2008 presidential race builds steam, candidates are telling the public what they want to hear, and that includes talk about health care reform. It's no wonder they are taking up this cause. U.S. health care costs are expected to jump from $2.1 trillion last year to $4 trillion by 2016. The University of Baltimore Obesity Initiative estimates that direct medical costs stemming from the obesity epidemic cost the country $130 billion annually.

Talk about health care isn't new for presidential candidates, but this time around, many of them are focusing at least some of their healthcare rhetoric on preventative care and its role in lowering health care costs. Some candidates are espousing ideas such as offering tax breaks and paid days off for people who demonstrate healthy behavior.

This talk is all well and good, but is it all just talk? Possibly. After all, state and federal legislatures are responsible for introducing and passing the laws that could spur many of the proposed preventative measures. In fact, sitting right now in Congress are two bills that could give the public an incentive to exercise. The Workforce Health Improvement Program (WHIP) Act would allow employers to deduct health club membership costs for their employees without classifying it as additional income to employees. The Personal Health Investment Today (PHIT) bill would allow the cost for exercise and physical activity (i.e., health club memberships, exercise equipment and sports programs) to be paid for from tax-favored investment accounts. If preventative care talk becomes a large enough topic in the presidential campaign, it could trickle into Senate and House campaigns and eventually lead to the passage of one or both of these bills.

Often, however, action is most effective at the state level. In fact, when Mike Huckabee, current presidential candidate and proponent of preventative measures, was governor of Arkansas, the state implemented a program in which state employees received discounts on health insurance premiums if they lived a healthy lifestyle.

Other states are also implementing measures that could decrease obesity rates and eventually lower health care costs. Unfortunately, it seems to me that the state efforts are still lagging. Last month, the Obesity Initiative released its third national assessment grading states (partially based on state legislative efforts) on their efforts in the obesity fight. The group offered a measly six “A's” (California, Illinois, Oklahoma, Pennsylvania, South Carolina and Tennessee) for legislative and public-policy work last year to control obesity in children and a pitiful three “A's” (California, New York and Tennessee) for efforts across all populations. Nevada, Utah and Wyoming earned “F's” while Idaho, Minnesota, Montana, North Dakota, South Dakota and Wisconsin earned “D's.” That leaves a lot of states doing middle of the road work.

So the federal and state governments as well as presidential candidates are focusing on preventative care. Now, what do we do? We must ensure that our voices are heard. It's time to get political. We have a network of 30,000 fitness-oriented businesses. Think of what our concerted efforts could do. Contact your state and federal legislators to push for the PHIT bill and the WHIP Act. Look closely at the candidates and determine who is really pushing for the health of this country. Most importantly, when it comes time, get out and vote.

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