Should government foot the bill for you to get healthy?

Each January, millions of people around the world make resolutions for the New Year. At the top of that list? Losing weight or maintaining healthier lifestyles. If this is you, a new idea put forward by a health innovation researcher may entice you to stick with your resolution a little longer than January 31.

For every 3500 calories you consume, expect to gain one pound.

Neil Seeman, director of the Health Strategy Innovation Cell at Massey College University of Toronto, suggests the government should provide each Canadian over the age of 16 with a healthy living voucher (HLV) worth $5000 in an effort to reduce obesity rates across the country.

Canadians would spend it on “healthy living options that are agreed to by the patient working closely with his or her primary care provider,” says Seeman in an e-mail.

Doctors and nurses would create a self-regulating body that would determine how the voucher could be used and monitor the program, says Seeman.

“HLVs can be applied to private peer counselling and therapy, nutrition lessons, Bikram yoga, ballet, gardening, golf or cooking lessons, spas, physiotherapy, massage, chiropody, hip-hop dancing, iPods equipped with pedometers or technical applications for glucose monitoring.”

Those using the voucher could pay for what services they wanted, submit receipts and then get reimbursed, but there are also other ways of administering the voucher, says Seeman. 

As for accountability, those using the voucher must meet regularly with their primary care provider.

“The two individuals come to a mutual decision if the HLV is having success, in terms of overall health and healthy living. If it is not successful, the HLV needs to be put to different use. . . Otherwise the voucher is not available to him.”

Additionally, doctors would be compensated for counselling patients in healthy living practices through specialized billing codes, which would be more substantial than what exists now, says Seeman.

But, would doctors want to take on this added responsibility?

The issue is not whether doctors would want to engage in this type of program, but whether they would even have the time, says Dr. Arya Sharma, professor of medicine and chair of obesity at the University of Alberta. 

Similar program sees positive results

Sometimes you have to invest money to see returns and the caveat is, if it's something that could work, the government should try to find the money.

While no program like this has been tried in Canada, the government introduced a fitness tax credit for children in 2006.

It allows parents to claim up to $500 per child in physical activity-related costs on their annual income tax form.

According to Canada Revenue Agency, 1,282,180 people took advantage of the Child Fitness Tax Credit in 2007, which translates into the government spending $643,000 on those activities. In 2008, that number jumped to 1,466,810 and $746,673 in spending.

Available to Canadians of all income brackets, the voucher is different from a tax credit, which can be used only by those paying taxes. 

Seeman stresses the importance of a pilot project possibly targeting low-income groups first, with funds coming from “a two to four per cent cut off the total jurisdictional tax revenues.”

But, he adds, “we are not prescriptive in terms of where this money should come from.”

Idea generates interest

An HLV could entice Canadians to live healthier, says Megan Leslie, health critic for the New Democratic Party (NDP). 

“It piqued our interest because we do have to be a bit more creative because we do have an obesity problem. It’s a nice example of some innovative thinking to try and figure out a solution for a problem facing Canadians.”

The NDP has not had time to do a complete analysis of the idea, but the program is worth exploring, Leslie says.

Satisfy your cravings with sweet fruit, not sweet juice.

“Sometimes you have to invest money to see returns and the caveat is if it's something that could work, the government should try to find the money."

Could it become a reality in next month’s federal budget? A finance department official would not comment “on what may or may not contain future budget measures.” 

A spokesperson for federal Minister of Health Leona Aglukkaq did not address the concept directly, stating in an e-mail the “government is concerned about the rising prevalence of overweight and obesity, especially among children and youth…We also recognize that obesity is a complex issue that requires innovative solutions from government, industry and non-governmental organizations in addition to changes in individual behaviour.”

Still, some say the voucher is not enough to get Canadians to care about their health.

“People who take advantage of things like vouchers, tax credits, what have you, are the people who are already healthy. So it’s not going to entice people to actually start and go [to the gym],” says Sharma.

Tackling obesity

Sharma doubts the voucher system would reduce obesity rates. 

“I think it may improve general health, get people to eat better, but again those using it likely don’t have a weight problem. And it depends entirely on who’s administering it and monitoring it. You can end up throwing a lot of money out the window.”

Still, Seeman insists the government should put taxpayer dollars towards programs that include “choice for the participant” and contribute to their well-being, instead of “‘eat your veggies’ and ‘get moving’ campaigns.”

“We need to experiment to learn. However, I believe meaningful preventive, personalized and participatory care, the promise of HLVs, would make a dramatic difference to obesity rates over the long term.”

Help with being healthy

A new idea may one day let you claim gym memberships and iPods with pedometers under the Healthy Living Voucher but until then, try these simple workouts that can be done at home and require a dumbell or exercise ball at most. Also, follow the nutrition tips to keep your mind alert and your body awake.

Set a goal and make a plan — pick a time, pick a place and get active!