Coaches need to coax better health outcomes

Everyone has been part of a flippant conversation about life expectancy. It ends with the inevitable shrug and acknowledgement that when it happens it happens. In reality though, most of us set our own date, by making daily diet and lifestyle choices with life-long consequences.

Apart from the quarter of us who succumb to injuries, accidents, mental afflictions or rare diseases, it’s the way we eat and exercise that determines the quality and duration of our lives.

So given that almost all of us can afford to eat well and stay fit, it’s important to understand why so many of us exchange great health for inactivity and unhealthy food.

Behavioural experts remind us that short term pleasures trump delayed gratification. The best example is the rush experienced with smoking. There is no greater predictor of bad health than cigarettes.

Talk to any person struggling with their health and they will single out motivation as the key. Australia’s fee-for-service system delivers over eight GP visits and nine prescriptions per Australian per year.

But even that is failing to motivate enough of us to lose the girth, the kilos, unclog our arteries and control our blood pressure.

We also know that around nine million Australians don’t fully comprehend health advice, medical information and discussions with clinicians. Mainstream health providers have so far struggled to get messages through to those with low levels of health literacy.

Ultimately, the State hospital systems pick up the tab for bad health choices and the poor understanding which underpins it. They battle both the moral hazard that health expenses are ultimately paid by others and the adverse selection which leaves the sickest patients in the public system.

Economists are a dry lot; often joking that it is not when you die but how that matters. Dying quick and cheap saves the system, while slow debilitating conditions requiring intensive support throw our health budgets into overdrive.

Private health insurers know this too. They are in the business of finding ways to intervene in this cycle of decline. They know that beating bad health is equally about living longer and dying cheaper. Keeping your mobility and avoiding hideously expensive cardiac operations are good examples.

Short of financially punishing bad health choices with larger gaps, higher fees or fines, health planners are desperate to develop new carrots to drive healthy behaviour however they can.

Now, insurers and State governments are hiring third parties to do the extra coaching.