» Fellows Forum

Self-efficacy provides a roadmap for tapping into the power of patients to engage in their own health care. Empowered patients, working in effective collaboration with their providers, can improve their own health outcomes and also become an important force in controlling health care costs. The first change needed is a cultural and attitudinal transformation. We are now transitioning toward payment systems that support effective care and improved outcomes. The opportunity is at our doorstep.

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Managed care organizations and pharmacy benefit management companies (PBMs) aggressively manage prescription drug spending, in large part by focusing on programs that encourage the use of generic alternatives to branded prescription medications. Upcoming patent expirations will provide further economic tail winds that will lower pharmacy spending so is it safe to declare victory in the fight against rising prescription drug costs? Not by a long shot.

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Unhealthy behaviors are the most prominent cause of chronic disease and premature death. Home is not only where the heart is, but where we make many of our healthy or unhealthy choices. Why do we engage in personally self-destructive behaviors and how can we overcome our tendencies? This is a complex challenge which will require a long-term commitment to social change.

However, we do know one of the keys. That is for people to believe they are responsible for their own health. This is an empowering concept and each step in this direction is rewarding. Any action, as simple as walking up and down stairs or appropriately taking an over-the-counter pain relief for muscle aches, starts to re-train the individual toward personal responsibility.

It is also important to provide easy access to information that simplifies the process for making healthy choices. The information must be clear and understandable, and subtly engaging and motivating. Simple steps will keep us on the path to more health.

We at the Foundation for HealthSMART Consumers believe that self-care with OTCs should be viewed as a first-line treatment protocol for common conditions that are easily self-diagnosed. This allows for consumers to take an active role in their health care and to take responsibility for caring for themselves until a health care provider’s expertise is necessary. In addition to being an effective first step in caring for common condition symptoms, self-care can also represent meaningful cost savings for both the health care system and for health care consumers.

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OTCs are sold like any other consumer brands and successful marketing of OTCs relies on building brand equity. Most of the major OTC brands built their equity as prescription medicines with a significant history of doctor endorsement and prescription use. So medicines are consumer brands where serious consideration has to be given to selection and use.

It would be very surprising if the consumer’s decision was made only on price, and it is not. A survey by the Association of the European Self-Medication Industry (AESGP) of US consumers found that such considerations as: “I know it, it works, I have confidence in it and it is safe,” come far above price as a purchase consideration.

The OTC industry needs a broader view of consumer communication media. There are so many new ways to connect with consumers that are more targeted and better linked to educational support and professional endorsement.

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The Foundation for HealthSMART Consumers (The Foundation) supports modifications to the statutory amendments under the Health Information Technology for Economic and Clinical Health (HITECH) Act to strengthen the privacy and security protection of health information, and to improve the workability and effectiveness of the Health Insurance Portability and Accountability Act (HIPAA). The Foundation believes, however, that any modifications provided under HITECH should consider patients’ rights to receive health information and to be provided access to resources that can help them manage their health care costs—two primary concerns as our nation seeks to transform and bend cost trends over time.

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With the passage of the Patient Protection and Affordable Care Act (Public Law No. 111-148) and the Health Care and Education Reconciliation Act (Public Law No. 111-152), the Foundation for HealthSMART Consumers is concerned about the ensuing confusion among consumers and health care professionals regarding medication access, choice and use of health care account funds.

We believe the confusion will build and can drive health care costs out of the consumer market and back into the health care system.

Click here to download the full position paper: Concerns for Unintended Consequences Regarding the Ineligibility of OTCs for Purchase with Health Care Account Funds

Imagine a future in which most Americans are incapable of doing their best work and live shorter lives during which they struggle with numerous health conditions. Sound far-fetched? Not at all. The culprit is the looming national childhood obesity epidemic. Today, according to government estimates, 17 percent of children and adolescents between the ages of 2 and 19 are obese, and another 32 percent are overweight. The proportion of America’s youth that is overweight or obese is 2-3 times greater than it was 30 years ago.

The personal and social implications are huge. Those who are overweight or obese will almost certainly experience diminished health and productivity. It is estimated that 80 percent of type II diabetes and 70 percent of cardiovascular disease is related to obesity. One in four obese Americans will also experience high blood pressure. The U.S. government recently estimated that obesity-related health care costs approach $150 billion per year. Almost lost in these statistics is the enormous psychological and social burden that accompanies obesity. In the midst of this sobering reality, is there reason to believe that we can make a dent on the number of our youth who are overweight or obese? Yes, but only if we apply a fundamentally different approach to daily living, one that is consistent with the principles of self-care.

Individuals practicing effective self-care have the health “IQ” to make sound lifestyle choices and are empowered with the confidence to make decisions that favor healthy living.

The “good news” is that obesity is largely a behavior-driven phenomenon, the kind of problem that cries out for effective self-care practices. We can reduce childhood obesity if we adequately educate and support individuals who seek to change health-limiting behaviors. Knowledge, empowerment and confidence to make healthy choices – children begin without any of these attributes, but are the most likely to adopt a healthy lifestyle if given the chance. It is much easier to adopt the habits of a healthy lifestyle early in life than reverse years of bad habits as adults.

Determined to make a difference, many communities are taking action. Elementary schools are revisiting their curricula and incorporating more physical activity into the school day. Many school cafeterias are undergoing a makeover of sorts, as more nutritious menus are being introduced. Jamie Oliver, the British restaurateur, helped shine a national spotlight on this issue earlier this year through the ABC series “Jamie Oliver’s Food Revolution,” in which he worked with the Huntington, West Virginia elementary schools to introduce healthier food choices to their students. Across the country, grassroots initiatives are springing up to teach kids healthy exercise and lifestyle habits. One novel approach is reaching young children through the animated character Crawford the Cat, in a series of short animated videos that are being used by early childhood educators across the country (www.crawfordthecat.com).

Behavior change is no easy task, especially when it comes to the childhood obesity epidemic. But with a commitment to self-care principles and broad-based community support, America can conquer this epidemic.