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Health & its rewards

Therese Smith Cox (Charleston Daily Mail) -- Anyone who ever took a freshman psychology class knows about Ivan Pavlov's dog salivating when he hears a bell and B.F. Skinner's ideas on positive reinforcement to change behavior.

So could Dr. Kenneth Cooper's idea of rewarding Americans for pursuing healthful lifestyles be all that different?

Cooper, the man given credit for getting us all into jogging, swimming and taking aerobics classes, has been mentioned as the next surgeon general. If so, the man is ready to roll.

He believes Congress should award tax breaks of $250 each for Americans who don't use tobacco; whose combined blood cholesterol is below 200; whose blood pressure isn't over 140/90; and whose body mass index, a function of weight and height, is less than 25.

If you score on all four, you could deduct $1,000.

As a member of the middle class and one who is urgently trying to outsmart Father Time, I'd certainly support such an idea.

Frankly, though, the tax cut wouldn't exactly signal equality for all. Those who are poor sometimes have the worst health. And the poorest don't have to pay taxes anyway, said Ira Allen, director of public affairs for the Center for the Advancement of Health, in a column in Sunday's Gazette-Mail.

And the concept would be challenging, at best, to enforce.

The idea of rewarding positive behavior or punishing negative behavior to save private insurance company or government money isn't new. Back in 1984, Blue Cross of Virginia introduced a non-smokers' discount.

Some 25 percent of large companies, including U-Haul and Texas Instruments, charge smokers higher premiums.

Our own state Public Employees Insurance Agency, starting in July, will cut monthly premiums for families by $10 a month and for individuals by $5 in the preferred provider benefit program if members sign an affidavit saying they don't use tobacco. About 60,000 PEIA enrollees currently use tobacco.

Officials believe it's the first such discount in the nation for a public insurance program.

In another creative approach to prevention for the individual and cost savings to insurers, Mountain State Blue Cross Blue Shield will assist several hospitals in West Virginia in offering a yearlong, intensive lifestyle modification regimen. It includes a low-fat diet, group support, moderate aerobic exercise, stress management and smoking cessation.

For those who qualify, the program costs $7,200 per person per year, funded by the insurance company. But that's a lot less expensive than, say, heart bypass surgery that runs about $45,000.

Not only does the insurer save in the long run, but people get healthier, too. When people get healthier, insurers save even more.

If President George W. Bush does name Cooper as the nation's top doctor, perhaps Cooper should name as his deputy Dr. Dean Ornish -- the nationally renowned health guru who concocted the Blue Cross lifestyle improvement program.

(c) 2001 Charleston Daily Mail

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