Exercise has finally been recognized as important for health. But fitness professionals still get no respect as serious players in the health-care industry.
In recent years, evidence has grown that you can do more for your own health than all the best doctors and hospitals combined, and one way is through exercise.
A pioneering study of London bus drivers and ticket takers, done in the 1950s, showed a clear connection between daily activity and heart disease. Bus ticket takers, who walked up and down the aisles of the buses, had a lower incidence of heart problems than the bus drivers, who spent most of their time seated. Since that finding, many studies have indicated that regular, moderate exercise can increase longevity by lowering body fat and improving lipid and muscle metabolism and bone density. Fitness-related research has now become intertwined with public health, medicine, general physiology, medical pathology, and gerontology research. But we have a long way to go in translating the research results into the daily activities that can give us longer, higher-quality lives.
Despite much ballyhoo over health, no real revolution in exercise for the general public has materialized. There are many reasons, such as a lack of available facilities, the type of instruction available on a mass scale (e.g., qualified health-club workers), and suggestions made by doctors to patients. Although many aspects of rehabilitation include specific exercise routines (e.g., physical therapy, occupational therapy, back-to-work services, recreational therapy, etc.), the concept of exercise has never been part of the physician's practice or an aspect of major medical centers.
But perhaps the biggest single reason for the lack of exercise by most people is that fitness is not, and has never been, part of the health-care system.
As a result of this apathy, 82% of Americans are out of condition, according to recent governmental statistics. But if we can change people's thinking about exercise and exercise programs, there will be a tremendous increase in fitness participation by Americans, leading to an overall change in lifestyle, improvements in general health, and a savings in health-care costs.
Here's how to do it:
1. Exercise and health promotion services should be reimbursable through insurers.
The single biggest reason that most people do not participate in health-related exercise programs may be that few insurance plans pay for them. Although most of us know that even a moderate amount of exercise is beneficial, we don't participate because of costs. One positive sign is that health maintenance organizations (HMOs) are beginning to subsidize health-club memberships and health-promotion programs in a medical setting. California's Pacifi-Care HMO has a program called Senior Fit, allowing senior citizens to participate in a health-club exercise program at a predetermined cost. The program is paid on a capitated basis through the insurer, and a specific cost is reached with individual health clubs. It is a trend that is growing very fast.
Arizona and Colorado fitness networks have negotiated with regional HMOs for health-promotion packages that include traditional services (e.g., stress reduction, smoking cessation) along with therapeutic exercise, physical therapy, prenatal exercise, yoga, and meditation as part of a package purchased by insurers. They feel that this unique concept in "one-stop shopping" for health services is comparable to a medical clinic, where many types of services are performed. Many health clubs are following this lead. Within the next two or three years, it will not be uncommon for seniors, diabetics, and those with high blood pressure to receive a physician's referral to their local health club for a six-month membership in order to work on a specific medical need.
If managed care embraces wellness and health-promotion programs in the next few years, expect millions of Americans to take advantage of certain health programs within their place of employment or from their insurance agent. …