Reader's View, health care: Living healthy can be the biggest cost saver of all liney

June 11, 2013 

Gov. Butch Otter should be commended on his request for more personal accountability in Medicaid.

While it is true that providing health insurance can offset expensive emergency room visits, it is also true that one of the biggest cost savers is personal accountability. Personal accountability is part of the health care cost equation, but not always easy to create.

Accountability is normally viewed as being responsible - giving an explanation of your actions - to somebody for something; ideally this is to yourself. Personal responsibility and accountability is a complex notion when it comes to health. Unhealthy habits are one factor in disease, but so are social status, income, family dynamics, education and genes.

Let's look at the top diseases in Idaho: heart disease, stroke, cancer and obesity, which can be the precursor to the other three. Specifically, 9 percent of Idahoans have diagnosed diabetes (many more go undiagnosed); 38 percent have high cholesterol, 29 percent have high blood pressure, 62 percent are overweight, 27 percent are obese, 82 percent don't eat five servings of fruit and vegetables per day and 21 percent don't get regular exercise.

Do you see a theme here? Personal accountability for one's health begins with diet and exercise, but that is just part of the picture. People need coaches.

Every one of us has received some sort of support from a coach over the years - whether it be from a best friend, spouse, athletic coach, clergyman or teacher. There are times when we all need someone to help us get started, or to get back on track or stay on track! When it comes to behavior-change models, those of us in health care know that coaching is one of the key elements to accountability.

When it comes to making dietary changes, registered dietitians are in key positions to provide nutrition and diet coaching. We have more than 500 licensed dietitians located throughout Idaho who can help make a difference. We have experience in motivational counseling, education and are the only ones licensed in our state to provide medical nutrition therapy. Reducing the average body mass index (BMI) in the state of Idaho by 5 percent could lead to health care savings of more than $1 billion in 10 years and $3 billion in 20 years.

Nutrition services need to be included in Medicaid and other third-party insurance packages if we are to provide the necessary intervention and support models to reduce health care spending.

This is not about having beach bodies …. but providing education and support for sound, permanent healthful eating and exercise habits, which can reduce the risk of the most common diseases.

Registered dietitians are the nutrition experts and the licensed professionals able to help Idahoans make healthy changes and become personally accountable.

SeAnne Safaii, PhD, Rd, LD, is president of the Idaho Academy of Nutrition and Dietetics, and is an assistant professor at the University of Idaho.

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