Wellness a tough sell in Alaska

Soaring health insurance costs are on almost every business manager's mind. Medical costs, which drive health insurance costs and premiums, are rising faster in Alaska than in any other state.

Why is this? I thought I knew the answer.

Health provider costs are higher here, and rising fast, my insurance friend said.

Is it because we have no managed care, and in fact, a state law forbidding it?

Not really, my friend said. Managed care in the Lower 48 has a mixed record in actually controlling costs. This surprised me.

Well, maybe Alaska is just expensive? Is that because of our unique Alaskan lifestyles?

I had in mind active outdoor lifestyles, sports, fishing, airplanes and boating -- all enjoyable but which also spawn accidents and injuries.

Partly. But there's more.

Think couch potato, my friend said, long winters and maybe a bit too much of the suds and fast food. Is this the real Alaskan lifestyle? Sadly, maybe it is.

United Way's latest Community Assessment for Anchorage, released just last week, shows that two thirds, or 66 percent, of adults in Anchorage were overweight in 2007. That's up from 59 percent in 2003.

We now know there's a direct correlation between sedentary living and sloppy food intake and health issues like diabetes and heart problems, which can develop when we don't take care of ourselves.

Health insurers, and many employers, are now alert to this and are trying to spread the word. No matter what Congress may or may not do about health care reform, we can take on a little more responsibility ourselves.

It seems such common sense. Eat right, exercise a bit, watch our weight, and pay less to the doctor. It translates to lower health costs and insurance costs for employers.

But surprisingly, "wellness" has been a tough sell.

One health insurer, Premera Blue Cross, has been actively promoting wellness programs with its customers, even small employers, for some years now. Wellness doesn't mean being an exercise fanatic but just more being aware of the importance of weight, cholesterol and other health indicators and actively managing a health issue if it appears, Premera's Alaska president, Jeff Davis, told me.

Seventy-five percent of all health care spending results from chronic diseases, like diabetes and heart disease, which are heavily influenced by choices people make, primarily smoking, poor diet and lack of exercise, Davis said.

Premera knows being aware of these things and taking action will lower medical costs in the long run, and an increasing number of employers now know it leads to lower insurance costs, less illness among employees and higher productivity.

I'm surprised that selling these ideas has been a challenge. Premera first offered the programs to its small-employer customers a few years ago and got a few takers, but it was slow going. More signed on when the company offered premium discounts.

That's pitiful. Being healthy should be its own reward. Do we have to be bribed?

Part of this is education, I think. Employers need to be convinced -- many already are -- that their employees' health is good business.

Their employees need to understand how getting off the couch, turning off the TV, and paying attention to the quality and not the quantity of what's on the dinner table leads to better health.

All of this is tough, because we're talking culture change. We're now programmed for lethargy, it seems.

It's not hopeless, though. Here are some ideas:

Let's start with public service advertising with respected and well-liked Alaskans, to raise awareness. Advertising firms could volunteer some help -- I sense potential for award-winning material here -- and a little arm-twisting from, say, the governor could lead to media firms airing, or publishing, this material as a public service.

Restaurant owners could take a cue from the liquor industry in promoting responsible consumption. They could have more nutritious and well-prepared items on menus. Smaller portions would help, too. I don't think customers would object to that slab of steak being a little smaller.

Many fast-food chains are already offering healthier items, and we should to encourage this.

The best way to motivate restaurants is to get customers to ask for healthy options, however. This gets us back to individuals taking responsibility.

Government does have its role to play. A question for city planners: Why do we have so few sidewalks? A question for educators: Can we get more physical education into the schools, particularly in the elementary grades?

It's easy to feel that the mess in health care is unwinnable, and that we should just give up. I'm more optimistic. I believe this is quite doable.

If we accomplished a culture change with smoking, alcohol abuse and drunk driving, we can do it for healthier living.

We need to start with small steps, but we need to start.

Our pocketbooks will benefit. We'll live longer, too. That's a big plus, to put it mildly.

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Tim Bradner writes for an Alaska economic reporting service. He also consults for private clients and writes for business publications. His opinion column appears every month in the Daily News.