We have to start with our children if we want to lower the rate of obesity in the Keystone State.

Obesity is tipping the scales as one of Pennsylvania’s biggest health challenges. Over the last 20 years, the percentage of the state population that is obese has increased from 12.5 percent to 28.3 percent.

That’s an alarming trend, and it’s playing out in communities across the Commonwealth. According to the 20th Annual America’s Health Rankings™ released recently, if current trends continue, nearly 41.8 percent of Pennsylvanians will be obese within the next decade, costing our state a projected 13.5 billion – or $1,455+ per adult – for state health care spending. Most of that spending comes from obesity-related health conditions such as heart disease and diabetes.

We have to do more in Pennsylvania to reduce the prevalence of obesity in our communities, especially for our youth, among whom the rates of obesity have more than doubled in the last three decades.

Overweight adolescents have a 70-percent chance of becoming overweight or obese adults and are far more likely to face risk factors associated with cardiovascular disease such as high blood pressure, high cholesterol, and Type 2 diabetes. Experts increasingly agree we must intervene early in life, if we are to reverse the trend in obesity rates in our country.

Research has shown that young people who participate in service-learning programs improve their academic performance and critical-thinking skills, increase their confidence and sense of potential, and accept leadership roles. Such programs are a crucial part of the solution to the serious dangers posed by our growing waistlines. That’s why we started our UnitedHealth HEROES grant program, which helps young people, working through educators and youth leaders, to create and implement local hands-on programs to address the issue of childhood obesity. As I detailed in a blog a few months back, many HEROES grants have been awarded to organizations across Pennsylvania.

We should commend the young people in our area who are already making a difference and join them in taking action on this important issue. Our physical health as a community, and our fiscal health as a nation, depends on it.

Cooperative marketplace reform is making health care more affordable and accessible.

I’ve been talking a lot recently about how marketplace reform can and is already improving the health care system, as insurers, employers, physicians and health care facilities work together to implement new programs and initiatives. One last example involves the cooperation of employers and insurers to actively engage employees in making health care decisions: the high deductible-health savings account (HSA) combination that is catching on like wildfire across the country.


A high deductible plan is typically the least expensive healthcare insurance option for a business, while the HSA enables employees to pay for their share of health care with pretax dollars. The HSA empowers people to become better health care consumers by gaining a greater understanding of the actual cost of their health care.

The HSA concept is great, but to make it work as well as it can requires both insurers and employers to step forward. Insurers have helped make HSAs more affordable and beneficial to employees by offering plans that do not make people pay for preventive care such as annual physicals and pap smears as part of the deductible, thus encouraging people to get the tests needed to identify health problems in their earliest stages. And many employers are contributing funds to the HSA accounts their employees open to encourage the employees to get started.

The result has been rapid acceptance of the HAS concept. Recent America’s Health Insurance Plans (AHIP) studies report that in the past two years, the number of people enrolled in HSA plans has grown by 90% and now stands at 6.1 million nationally. AHIP reports that 27% of people with HSAs in employer-based plans were previously uninsured.

HSAs, closed networks, crunching clinical data—some may find the improvements I’ve been talking about to be piecemeal, but they represent just the tip of an enormous iceberg of marketplace innovation that is reshaping health care.

Insurers, employers and doctors working together will bring marketplace reform to health care.

In my last blog entry I made the point that employers, insurers, physicians and health care systems are working together in various combinations to develop innovative ideas that raise the quality of care or cut health care costs or both. I call it marketplace reform and I believe that over time it will do as much if not more to improve health care as legislation.

The example I gave last time was of insurers working together with employers. An example of insurers working with health care providers to improve health care is in the collection and analysis of clinical data to determine the best treatment options.

As I mentioned a few weeks back, UnitedHealthcare recently announced that we have launched our Oncology Care Analysis (OCA), the first program to combine clinical and claims data to gauge the quality of cancer patient care based on approved treatment guidelines from the National Comprehensive Cancer Network (NCCN), an alliance of 21 leading cancer centers. Our cancer registry includes clinical and claims data from more than 2,600 oncologists and 8,600 patients across the country with breast, colon or lung cancer.

OCA represents a true collaborative venture that would not be possible if UnitedHealthcare was not working hand-in-glove with health care systems and physicians. UnitedHealthcare provides the claims data and number-crunching capabilities; the medical community provides the clinical data and clinical standards.

We are sharing the results with participating oncologists to help improve the quality of cancer care and lead to better outcomes for patients. And it goes without saying that in doing so we’re complying with every privacy law.

Marketplace reform may improve the health care system more than the new law does.

The federal legislation recently signed by our President aside, changes to our health care system are occurring every day in the marketplace. Employers, insurers, physicians and health care facilities are communicating and collaborating to come up with new programs and policies that lower the cost of health care and increase the quality of care for those who are already covered.

Take, for example, UnitedHealthcare’s new Diabetes Health Plan, which I wrote about a few weeks ago.

Employers saw that a rise in obesity and unhealthy lifestyles has caused the numbers of diabetic and pre-diabetic employees to spike, increasing sick days and raising health care costs. To meet this growing workforce challenge, we developed a first-of-its-kind health insurance plan that rewards diabetic and pre-diabetic employees who routinely follow steps to help manage their condition – such as regular blood sugar checks, routine exams and preventative screenings – and use wellness coaching.

By working together to implement the Diabetes Health Plan, employers and insurance carriers are helping employees better manage a personal health condition and improve their quality of life. This collaboration not only saves employers and employees money, but also helps lower overall health care costs by increasing the use of preventative care and disease management initiatives.

Marketplace reform is always incremental: someone gets an idea and tries it out. If it works, others imitate and improve. If it fails, the market moves on.

I’m not saying that there is no place for federal reform. But I don’t think anyone should underestimate the power of the market to lead change. Each small step in the market carries us closer to a more ideal health care system that insures more people and does it more cost-effectively.

On a side note, I want to take a moment to thank all of you who contributed to our March of Dimes "March for Babies" walks. We raised $2,778.00 to improve the health of babies! I really enjoyed walking this year and sincerely appreciate your support.