Last week I drew a distinction between health plan members and patients. Members are not always patients. In fact, 9% of our members account for 60% of the plan’s medical spending. I argued that a good health plan has a unique opportunity, whether its members are involved with the health care system or not, to help them make lifestyle decisions that would improve their health and wellbeing.

A case in point is the problem of childhood obesity. It is well understood that obesity increases the risk of coronary heart disease, diabetes, cancer, and hypertension. A recent post on “The Health Care Blog” by Dr. James S. Marks, a senior vice president at the Robert Wood Johnson Foundation, argued that we need to “look beyond health care…and focus on our health” and used as an example the need to guarantee daily physical activity and nutritious meals in our schools to counter an obesity epidemic among our children.

These are not medical interventions, nor is obesity something we can expect the health care system alone – the “repair shop” as Dr. Marks calls it – to fix. Yes, routine body mass index (BMI) screenings in the doctor’s office are a good thing, but the problem really needs to be addressed where people live.

Health plans are able to reach and engage members and their dependents where they live. Harvard Pilgrim subscribers (in fact anyone who logs on, whether a member or not)receive assistance for themselves and their dependents through telephonic weight management coaching and counseling as well as online interactive tools like BMI, target heart rate and calories burned calculators, eating journals, food diaries, and meal planners. An educational DVD called “Access Healthywood” will help children and adolescents understand in an entertaining way the importance of healthy eating and exercise. Equipment discounts and fitness club cash reimbursements are also available to members of the plan.

Our Foundation has launched a ten-year $10 million “Growing Up Healthy” initiative to promote healthy weight for children ages 6 though 12 in Massachusetts, Maine, and New Hampshire. Working with policy makers, schools, community programs, and businesses, we partner with statewide programs like Mass in Motion in Massachusetts to support multi-faceted, community-based efforts to prevent childhood obesity.

These activities go well beyond the routine medical coverage, disease management, and care management functions performed by the plan, all of which have weight management components. In the case of childhood obesity and similar lifestyle-related problems outreach and decision support activities are important tools for building a foundation to help avoid the need for future “repairs” by the medical community.