Millions across the country are breathing a sigh of relief after the Supreme Court ruled in favor of keeping the Affordable Care Act (ACA) in place. The ACA was built on three fundamental pillars – non-discrimination of individuals with chronic conditions; a mandate that each individual purchase health insurance (paid or subsidized); and the creation of an online marketplace to purchase health insurance. Many states opted out of creating online marketplaces, so the federal government stepped in and created them, resulting in millions of new enrollees. The states who opted out were outraged that their residents were using state-appropriated subsidies to purchase health insurance from federally-created insurance exchanges. And as you may or may not be aware, politics in Washington are no joke, especially around the ACA. This case worked its way up to the Supreme Court and I wouldn’t be surprised if another part of the ACA is in contention at the highest levels in the next year.
In the real world, where people are dealing with real issues rather than politics, we can breathe a sigh of relief. But let’s not forget that health and well-being is more than our interactions with the healthcare system. Health insurance provides us with access to appropriate preventive and healthcare when we need it. The key word I can’t stress enough is access. And access, unfortunately, is not the magic bullet in the health and well-being equation. It’s only a part of the solution.
What you do, or don’t do, on a daily basis adds up. Your health behaviors, which include seeking health and preventive care, as well as your dietary habits, physical activity levels, stress management and substance use, among others all play key roles. Genes do also play a part, but our behaviors are still within our control; it’s the one thing we can be accountable for. When I worked at the Department of Health and Human Services (HHS), I had the privilege of working alongside then Acting Surgeon General RADM Boris Lushniak and his staff. On many occasions, he led by example, encouraging acts of patriotism through individual accountability of our own health and well-being. RADM Lushniak understood health from the macro-level all the way down to an individual’s health behaviors.
One of my responsibilities at HHS was lifestyle coaching. I acted as an accountability partner for a handful of employees with specific health goals during a 12-week program. We tackled many of the issues I outlined above – diet, physical activity and stress management. I made sure to emphasize that changing behaviors is a gradual and continuous process. Working with people on a 1-on-1 basis on changing their health behaviors was one of the most fulfilling things I’ve ever done. The moment when someone understood health in a larger context is inspiring. It’s one of the reasons why I started this blog. My goal is to empower as many people as I can to see the bigger picture – that health and well-being is more than access and use of the healthcare system. It’s about realizing that our health is our resource for living. It’s about seeing our health as an investment, which needs daily attention. It’s about “flipping a switch” on being proactive to our own health and well-being and being accountable to ourselves, families, communities and our nation. We all need to be a part of this movement. And it starts with each and everyone of us.
One tool that we can each leverage to improve our health is an app called Dacadoo. Based on a handful of questions, you’re given a health score on a scale of 1-1000. And as you add more data inputs – sleep, emotions, physical activity – your score fluctuates in real time. It’s also compatible with various types of wearable technology.
Why is this a big deal? Dacadoo quantifies the various components of an individual’s health behaviors and updates in real time when you do, or don’t do, health-promoting activities. Think of it as a FICO score for your health. Just as we would monitor and take steps to improve our credit score, we can also do for our own health. I had a conversation with one of Dacadoo’s staff yesterday and I told him several times that I wished I had this when I provided lifestyle coaching at HHS.
With Dacadoo and other wellness apps, I believe our country is going in the right direction. There’s a greater understanding that we can’t rely on the healthcare system to solve all our problems. There’s a shift to being more proactive, rather than reactive. Healthcare providers are now more versed in public health, health education and promotion. If our country as a whole had a Dacadoo score, I’d say our score were improving incrementally.
But we have a lot more work to do.
“Efforts and courage are not enough without purpose and direction.” — John F. Kennedy