British social security is setting up a financial incentive system to make its policyholders lose weight. For the endocrinologist Jean-Michel Borys, the measure will be ineffective.
Paying to lose weight is the new measure introduced by the NHS, the UK’s public healthcare system. This new government plan to fight obesity therefore consists of paying money (or vouchers) to people who lose pounds, even if neither the amounts nor the pounds to lose have yet been specified, reveal the Daily Mail.
The aim is to tackle the scourge of overweight and obesity which is hitting the British Isles hard: in the UK two-thirds of adults are clinically overweight or obese, and the NHS spent, in 2013, five billion pounds (6.3 billion euros) to treat diseases related to obesity.
Companies should also receive tax reductions if they put in place programs to lose weight in their employees.
“This is not the most relevant strategy”
Attractive on paper, it remains to be seen whether this measure really works. Doctor Jean-Michel Borys is more than skeptical: he does not think that financial incentives are a real engine to improve people’s health.
Listen to Dr Jean-Michel Borys, endocrinologist and diabetologist: ” In terms of prevention, the goal is to put in place something sustainable: to avoid gaining weight, being obese, and having diabetes. For this, the financial incentive is not very effective. On the other hand, to stop smoking, for example, it is an argument that can work. “
He specifies that “it is not very difficult to lose weight if you put in the means; in two to three months we get there. The problem is that the body has a [fonctionnement] forcing him to regain his maximum weight … So over time it is almost impossible to maintain a significant weight loss, unless using surgery ”.
The financial incentive already exists in France
But that’s not the only financial incentive the UK announced this week. The NHS also plans to pay a premium to GPs of 55 pounds, or around 70 euros, for each dementia diagnosis. Many doctors have spoken in the British press to oppose this measure which they consider unethical of their profession.
However, in this area, Jean-Michel Borys believes that this type of measure can be effective. While there is no diagnostic bonus in France, the remuneration of general practitioners based on the achievement of public health objectives was implemented two years ago to encourage better care. .
Listen to Dr Jean-Michel Borys: ” Remuneration based on public health objectives works: the doctors involved in this program have a much higher rate of screening and treatment than before “.
How does this system work? Today, doctors who have joined the system called “remuneration based on public health objectives” have part of their remuneration which increases each year. On condition of fulfilling these famous objectives which concern the reduction of antibiotic prescriptions or work stoppages, the prescription of generic drugs or the realization of seasonal vaccines. In 2013, this “performance bonus reached on average 5,000 euros per year.
Financial leverage is therefore not ineffective. But it must be handled with care. And this kind of initiative cannot in any case be implemented in all areas of health. In the United Kingdom again, where the practice of financial incentives seems to be a fundraising trend, the NHS had imagined in 2011 that it would pay for the funerals of people who donated their organs. Faced with the outcry caused by this proposal, the measure was ultimately not implemented.
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