Lobbying For Physical Activity
Last week I had a great experience participating in the American College of Sports Medicine’s (ACSM) Capitol Hill Day, an event sponsored by the Sports and Fitness Industry Association (SFIA). The primary objective of the day was to lobby congress to support the PHIT act and the PAR act (more on this below). It was my first time participating in ACSM’s Capitol Hill Day, and visiting the offices of various congress members in-person. I met several hardworking, enthusiastic scientists advocating for more physical activity in our country, and even NFL legend Herschel Walker. I want to use this post to highlight what the event was all about and segue into a series on the importance of physical activity, but first some staggering statistics on health care in America:
- In 2015, total national health expenditures were $3.27 trillion (CDC fact sheet). In 2018 this number is expected to grow to $3.74 trillion (CMS.gov)!
- In 2014, 86% of the nation’s annual health care expenditures were for chronic and mental health conditions (CDC fact sheet). As I will discuss in more detail, these costs can be substantially reduced with lifestyle changes, such as increased physical activity. So what are we doing about this?
Lobbying for Physical Activity
To get started, we’ll discuss the legislation we were lobbying for. The Personal Health Incentive Today (PHIT) act is House of Representatives bill 5318 and Senate bill 482 and entails health savings account (HSA) reform. Basically, health savings accounts are pre-tax accounts that can be used for certain medical expenses. The reform under PHIT would allow families to use $2000 per year and individuals to use $1000 per year from their HSAs for expenses aimed to promote physical activity. For example, you could use the HSA money for swimming classes, personal training sessions, to join a rec soccer league, or to pay for your child to play in a sports league. The reform would be extended to other accounts similar to HSAs such as Medical Savings Accounts, Health Reimbursement Arrangements, and Flexible Spending Arrangements.
The other legislation I mentioned was the Physical Activity Recommendations (PAR) act which is House of Representatives bill 1519 and Senate bill 657. The goal for this act would be to have the Department of Health and Human Services (HHS) publish physical activity guidelines called “Physical Activity Recommendations for Americans” that would be updated at least every 10 years. Further, roughly every five years the HHS would update the report for best practices and continuing issues in physical activity research. This all sounds good but what is the catch? Why would we need to lobby for physical activity?
Well, many of the folks actually doing the lobbying were scientists, exercise physiologists, and physicians who are alarmed by the staggering rate of physical inactivity in our country. PHIT would provide families with HSAs and similar accounts an incentive to spend their money on preventative measures (such as going to the gym) versus treatment for diseases that are largely influenced by lifestyle. The return on investment here could be huge. For example, a 2010 meta-analysis performed by researchers at Harvard found that wellness programs reduce medical costs by about $3.27 for every dollar spent on the wellness program. The same study found that absenteeism costs are reduced by about $2.73 for every dollar spent (healthaffairs.org). The PARs would give Americans a centralized source of information regarding physical activity benefits and recommendations, and hopefully lead to more efforts to get Americans moving.
Now for the SFIA, their end goal of course is to sell more product. If more Americans are being active, that translates into more sneakers sold, more bats sold, more cleats sold, more tennis rackets sold, etc. As far as the ACSM, scientists who serve as members would play a large a role in shaping the PARs, and the college may play a large role in directing the recommendations.
Regarding PHIT, the more people that are exercising in gyms, the more people are training with ACSM certified personal trainers. Under the ACSM’s Exercise is Medicine initiative there is a push to develop Healthcare Effectiveness Data and Information Set (HEDIS) measures related to physical activity assessment in everyone from children to older adults. HEDIS measures are essentially a tool kit used in health plans with the goal being to objectively assess performance on dimensions of care and service. Further, there are efforts by the ACSM and the American Medical Association focused on the inclusion of physical activity promotion within the patient-centered medical facilities, development of a private/non-private insurance-reimbursable international classification of disease code related to physical inactivity, as well as reimbursement for physical activity counseling performed by allied health professionals (i.e., health professionals holding the ACSM Exercise is Medicine® Credential). This information is more thoroughly summarized by Dr. Elizabeth Joy here.
I wanted to share these disclosures for transparency, but as I stated above most of the folks there including myself were there because we are genuinely concerned with how sedentary the country is. I honestly believe many of the parties that stand to make a profit are also genuinely concerned with the health of the nation.
More Staggering Stats
Some of the facts I came across while preparing for my trip to Capitol Hill really were just staggering! A couple more that stood out to me below:
- In 2015, half of adults aged 18 years or older did not meet recommendations for aerobic physical activity. In addition, 79% did not meet recommendations for both aerobic and muscle-strengthening physical activity (healthypeople.gov).
- Nine of the top-10 most expensive medical conditions are linked to physical inactivity and account for nearly $500 billion in expenditures per year (business insider).
So with all that being said, I think most readers would agree that Americans need to be more physically active. But just how damning is physical inactivity? In the next several blog posts, we will further explore current physical activity guidelines and what scientific literature reveals about physical (in)activity. Stay tuned!
Thanks to Joe @ josephwatso.com and Sofia for editing.