King County's Health Care Reform Revisited

Ruby de Luna
02/02/2009

National spending on health care continues to rise. Many public agencies are now looking for ideas to save money. Four years ago, King County launched a new health benefits program that aimed to control spending by changing workers' behavior. KUOW's Ruby de Luna checked in on some county employees and has this update on the program.

IN A NUTSHELL, THE COUNTY'S PROGRAM REWARDS EMPLOYEES WHO MAKE AN EFFORT TO LIVE A HEALTHY LIFESTYLE. HERE'S HOW IT WORKS: EACH YEAR, EMPLOYEES WHO CHOOSE TO, FILL OUT A HEALTH SURVEY. THAT AUTOMATICALLY LOWERS THEIR OUT OF POCKET EXPENSES, INCLUDING DEDUCTIBLES. THEY COULD LOWER THEIR OUT–OF–POCKET SPENDING EVEN MORE IF THEY TAKE STEPS TO IMPROVE THEIR HEALTH. THE COUNTY CONNECTS THEM WITH HEALTH COACHES WHO SUGGEST A PLAN OF ACTION. THAT COULD INCLUDE EATING MORE FRUITS AND VEGETABLES, OR EXERCISING MORE.

SABOUR: "This is a nice walk, actually. They have little gardens, ponds ..."

THE COUNTY'S HEALTH PROGRAM MOTIVATED SHERIE SABOUR AND HER CO–WORKERS TO TAKE WALKING LUNCH BREAKS. SABOUR IS A PROJECT MANAGER AT THE DEPARTMENT OF DEVELOPMENT AND ENVIRONMENTAL SERVICES IN RENTON. THE GROUP WALKS AT A NEARBY TRAIL EVERY WEEKDAY, RAIN OR SHINE. THE PACE IS BRISK. SABOUR SAYS SHE USED TO WORK THROUGH LUNCH, BUT THESE DAYS SHE'D RATHER STEP OUT.

SABOUR: "I like this break because it refreshes your mind, you feel a lot better after you get back from the walk, and it gives you more energy basically."

SABOUR SAYS WALKING AS A GROUP CREATES A NETWORK OF SUPPORT AND SOCIAL PRESSURE TO KEEP UP.

SABOUR: "When I miss a walk during the during the day, we talk and I'm like okay, 'I missed the walk, but I promise you I'm going to the gym this afternoon.' I make up for it."

SABOUR'S CO–WORKER CLAIRE JONSON NODS.

JONSON: "We saw the rain and asked Sherie, 'Are you going to walk today?' And she's like, 'Yeah, I'm going to do it.' So okay, if you're going to do it, then I'll do it."

JONSON SAYS THE WALKING GROUP MAKES IT EASY TO GET HER EXERCISE. OTHER COUNTY EMPLOYEES HAVE COME UP WITH DIFFERENT WAYS TO STAY ACTIVE: AEROBICS CLASS, BIKING, AND EVEN BELLY DANCING. THESE ARE SOME OF THE CHANGES IN THE WORKPLACE THAT HAVE HELPED EMPLOYEES MEET THEIR FITNESS GOALS. BUT EVEN WITH A SUPPORTIVE ENVIRONMENT, STAYING HEALTHY IS A STRUGGLE.

WILLIAMS: "This is the remnants from this morning's oatmeal ..."

THAT'S DOUG WILLIAMS AT THE COUNTY'S NATURAL RESOURCES AND PARKS DEPARTMENT. WHEN I LAST VISITED HIM TWO YEARS AGO, HE HAD LOST 25 POUNDS. BUT TODAY HE'S GAINED MOST OF THE WEIGHT BACK. HE STRUGGLES WITH PORTION CONTROL AND LATE NIGHT SNACKING. THE WINTER HOLIDAYS DIDN'T HELP, AND DURING THE RECENT SNOW STORM AND FLOODING, WILLIAMS WORKED VERY LONG HOURS. THAT MADE EATING HEALTHY MEALS A CHALLENGE.

WILLIAMS: "Especially if we were offsite working somewhere, someone would make a run to get lunch for everybody ... someone would go to KFC and bring back a couple of Colonel Sanders' best buckets, and if you're stressed out that's one of the things you're going to do."

WILLIAMS' GOAL FOR THE NEW YEAR: CONTINUE HIS EXERCISE ROUTINE AND SIGN BACK UP WITH WEIGHT WATCHERS. INSPITE OF LAPSES LIKE WILLIAMS', KING COUNTY'S HEALTH PROGRAM IS WORKING. RON GOETZEL STUDIES THE HEALTH AND ECONOMIC IMPACTS OF EMPLOYERS HEALTH PROGRAMS. HE RECENTLY ANALYZED KING COUNTY'S PLAN. HE FOUND THAT WORKERS MADE SIGNIFICANT IMPROVEMENTS IN AREAS LIKE CHOLESTEROL, BLOOD PRESSURE, AND MENTAL HEALTH. THIS MIGHT SEEM MINOR, BUT COLLECTIVELY, ALL EMPLOYEES WORKING TOWARDS LIVING HEALTHIER LIVES, IN THE LONG RUN, IT HELPS CONTROL HEALTH SPENDING.

GOETZEL: "Many of the things that King County has done are done outside the doctor's office because once you enter a doctor's office, it becomes very expensive."

SO FAR, KING COUNTY HAS KEPT ITS HEALTH CARE COSTS UNDER THE NATIONAL AVERAGE. GOETZEL SAYS IT'S THE OVERALL CHANGE IN THE WORK CULTURE THAT'S DRIVING THIS.

GOETZEL: "If you tell someone to quit smoking and lose weight and eat healthy and all that, that's not very effective. But if you solicit from the person what are the things you can do, what's manageable, what's the goal you might set, making them in charge of their own health, that's actually quite effective."

GOETZEL ADDS IT'S NOT ENOUGH TO JUST PROMOTE HEALTHY LIFESTYLES IN THE WORKPLACE, LEADERS NEED TO SET AN EXAMPLE,TOO.

RON SIMS: "I thought weight gain and lack of fitness was somebody else's problem, not mine."

THAT'S KING COUNTY EXECUTIVE RON SIMS SPEAKING IN THE SUMMER OF 2006. SIMS HAD AN EYE–OPENING EXPERIENCE AFTER HIS FIRST HEALTH EVALUATION. HE WAS OBESE, A CANDIDATE FOR DIABETES AND HEART DISEASE. HE CHANGED HIS EATING AND SEDENTARY HABITS AND LOST 40 POUNDS. TODAY SIMS CONTINUES TO BIKE TO WORK AND GOES TO THE GYM REGULARLY. OVERALL HE'S LOST 53 POUNDS. SIMS SAYS FINANCIAL INCENTIVES ALONE DON'T CHANGE BEHAVIOR; PEOPLE ALSO NEED INFORMATION TO MAKE SMART CHOICES. EACH MONTH THE COUNTY SENDS OUT A NEWSLETTER THAT INCLUDES HEALTH TIPS AND PEOPLE'S SUCCESS STORIES. SOMETIMES THE NEWSLETTER HAS INFORMATION THAT MANY WOULD RATHER NOT HEAR.

SIMS: "The newsletter talked about colonoscopies, colonoscopies, colonoscopies. I wouldn't take one; I said I didn't need it."

SIMS RESISTED EVEN THOUGH HE WAS TOLD TO GET ONE. THEN ONE DAY, HE ASKED HIMSELF WHY HE WAS AVOIDING THE PROCEDURE.

SIMS: "I didn't want to take it because I was worried because they would find a tumor. Well, duh! An early diagnosis of a tumor is much better than having a colorectal situation where the tumor was allowed to flourish."

SIMS EVENTUALLY GOT A COLONOSCOPY. THERE WERE NO TUMORS. THE GUYS IN HIS SECURITY TEAM WERE SO IMPRESSED, THEY GOT SCREENED TOO.

SABOUR: "How you doing Paula?

PAULA HAMMONDS: "I'm fine. I'm just mad at myself that I didn't bring my tennis shoes, but I feel fine."

BACK IN RENTON, THE WALKING GROUP IS HALF WAY THROUGH THE TRAIL LOOP. FOUR YEARS AGO THIS GROUP DIDN'T EVEN EXIST. THEY STARTED TO WALK TOGETHER AT FIRST TO SAVE MONEY. BUT NOW IT'S MORE PERSONAL, IT'S ABOUT THEIR HEALTH AND EVERY SO OFTEN, THERE ARE OTHER BENEFITS.

SABOUR: "Look at that. Look at the blue heron sitting up there."

A LONE HERON IS PERCHED BY THE POND, SOAKED BY THE RAIN.

SABOUR: "You really get to see things in the nature, sometimes frogs even."

SOMETIMES SEEING NATURE IS ONE MORE REWARD TO BEING HEALTHY. I'M RUBY DE LUNA, KUOW NEWS.

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