THE health-care-reform debate has been conveniently reduced to whether we can we afford its costs. The price of care is important. However, this debate ignores a crucial question: How much skin in the game should an individual have in managing his or her health?

Unless we ask that question, we will remain embroiled in a health care debate without any true progress.

The discussion we need to have is how to hold individuals responsible and to engage them in their own personal health. How do we get people to start eating foods that are good for them, not just convenient? How do we create communities that encourage people to walk, ride a bike, run and swim? And for people with chronic illness, what role do they have in managing their conditions?

Federal, state and local governments, in addition to creating healthier and safer communities, can play a big leadership role in creating healthy communities and rewarding personal responsibility for health.

Individual responsibility for ones health may seem radical, but King County employees, in partnership with the unions that represent them, are already doing it. As a part of King Countys nationally recognized Healthy Incentives program, each year employees take a written wellness assessment and complete an individual action plan to improve or maintain their healthy behaviors. Those who complete the wellness assessment and their individual action plan qualify to contribute less for health care cost sharing.

Under the current employee agreement for Healthy Incentives, employees are reducing costs to the public in four ways: They use health-care services less often; they pay higher co-pays; they choose less-expensive generic drugs; and more of them enroll in the Group Health plan, which his less expensive than the countys preferred provider plan KingCare.

Over the past six years, King County has saved the taxpayers tens of millions of dollars by engaging employees in their health and health-care choices. In the proposed 2013-2014 budget, the county expects to save $14 million in health-care costs.

King Countys Healthy Incentives program can be a model for engaging participants in other private- and public-employer health plans, including Medicare and Medicaid.

I want everyone to have health insurance, but those who blithely ignore the consequences of their lifestyle should not be totally subsidized by those willing to manage their illnesses, eat well and remain fit. Individuals should pay a higher price for poor decisions and personal indifference.

Personal responsibility and accountability cannot be demanded of individuals without the tools to make educated decisions, such as publicly reported data on the quality and price of health-care services. We love our doctors, but having detailed data will help individuals determine if their doctors are providing value-based care. If not, employers should have the right to ask individuals to pay more for doctors providing subpar care.

Visit link:

Op-ed: Individual responsibility in managing health-care costs