Health Insurance Blog

Now that our children have begun another school year, a serious health threat may await them — the school day itself. Increasingly, students are attending schools where less time in physical education and easier access to high-sugar snacks and drinks have become the norm.

As a result of unhealthy habits, one in four Massachusetts high school students is now considered overweight or at risk of becoming overweight, according to the Massachusetts Youth Risk Behavior Survey. Those students are more at risk for heart attacks, strokes, diabetes and other serious diseases later in life. Nationally, obesity kills 100,000 people every year and costs more than $90 billion in medical bills.

Curing childhood obesity will require an approach that is correspondingly broad. Here are some first steps:

- Return to a mandated minimum amount of physical education in the school system. A mandate of at least 90 minutes was eliminated by the Board of Education in 1996 to make way for more academic time. It was a well-intentioned goal, but ultimately a mistake. According to the Youth Risk Behavior Survey, the number of high school students participating in physical education just once a week is now less than 60 percent. Various bills have been introduced to require students of all ages to spend more time in physical education. Passing one of them should be a legislative priority this year.

- Prioritize funding of athletic programs and reduce or even eliminate user fees. This is a tall order given the financial pressures schools already face, but we must look at school sports as not merely an extracurricular activity, but an integral part of the school experience.

- Set uniform nutritional standards for drinks and snacks sold in school vending machines, as has been proposed by Sen. Moore. The bill would limit school vending machine beverages to water, fruit juice, sport drinks, no-calorie beverages and non- and low-fat milk. Snacks could contain no more than 190 calories for elementary schools, 225 calories for middle schools and 250 for high schools.

- Begin factoring financial incentives for “healthy” decisions into health insurance. For example, Fallon Community Health Plan has begun to use tobacco use in setting premiums for its own employees, offering financial rewards to non-tobacco users. Why not similarly reward exercise and healthy eating by using certain factors, such as body mass index. Our experience has shown that having financial “skin in the game” leads health care consumers, both individuals and businesses, to focus on their health care choices. With everyone now required to buy health insurance in Massachusetts, such an option becomes even more important.

- Start modeling better behavior around our kids. Parents cannot rely on the government or the health care system to teach our kids healthy habits. Those systems are already stretched thin, and they are not as effective communicators of values as parents anyway. We can’t expect our kids to choose an apple over a cookie if we don’t. We can’t expect sports and exercise to become their habit if our own idea of a big sports day is watching the Patriots from the sofa.

Much of this will not be easy or cheap. Adding gym teachers and after-school sports is expensive and will ultimately fall on taxpayers. But the financial cost of not acting is more expensive. By some estimates, obesity leads to $93 billion in additional medical costs, including an average annual $180 per taxpayer for higher Medicare and Medicaid costs. It also leads to more missed work days and even the consumption of more fossil fuel.

Not all solutions need to cost money — just a little creative thinking. Many school nurses throughout Massachusetts have begun free walking, yoga and other clubs that meet before or after school.

The lives of our children depend on it.