Fitness and Health Insurance Reform

Q1. Personal Fitness Trackers
Even when personal fitness trackers present the same information, they can visually display the information in different ways. Regardless, the theory behind such trackers, and the ability to see how many steps, calories burned, and activity in relation to the activity engaged in the past, is that people are more motivated when they have concrete evidence of their improvement. What cannot be measured cannot be consciously changed. However, according to a study in The Lancet Diabetes & Endocrinology, in a randomized control study (the gold standard of academic research), using a fitness tracker had no effect on any measure of health or fitness (Finkelstein, et al, 2016). The fitness tracker used in this particular study was a clip-on tracker without a significant graphical interface. It is possible that the results may have been different, had the tracker been more pleasing in its presentation.
But even a study involving the more engaging tracker interface of a Fit Core armband, according to a Journal of American Medicine Study, did not yield appreciably better results over the course of two years in a study of 470 overweight or obese participants. All participants were given a diet and exercise plan; members in the control group simply monitored their diets themselves while members of the experimental group were given fitness trackers which allowed them to track the data visually on their computers (Hill, 2016). All participants exhibited improvements in health and experienced weight loss, but there was not a statistically significant difference between the control and experimental group, despite the use of relatively user-friendly dashboards. Thus both studies suggest that fitness trackers, regardless of the mode or style of dashboard, are not useful in supporting weight loss or other measurements of fitness.
References
Finkelstein, E., Haaland, B., Bilger, M., Sahasranaman, A., Sloan, R. Nang, E., Evenson, K.
(2016). Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial. The Lancet Diabetes & Endocrinology, 4(12) P983-995.
Hill, A. (2016). Fitness trackers may not aid weight loss, study finds. The Guardian. Retrieved
from: https://www.theguardian.com/technology/2016/sep/21/fitness-trackers-may-not- aid-weight-loss-study-finds
Q2. Ideal Healthcare Policy
Although both TennCare and Massachusetts’ health care reform did meet with some obstacles, they also illustrate the challenges of embarking upon a solely state-driven healthcare policy, rather than undertaking comprehensive national reforms. The problem with the Affordable Care Act (ACA), although it has shown to yield some benefits, is that it keeps America’s healthcare model of private and public insurance effectively intact, which creates multiple layers of bureaucracy and asymmetries of care, depending on whether the individual receives a comprehensive healthcare package through his or her employer, or must find an affordable healthcare plan on the open marketplace (Obama, 2016). Unfortunately, people are not always able to anticipate their healthcare needs, and, as a result, America has a very high rate of medical bankruptcies. At minimum, the ability to purchase a national health insurance plan in the form of a kind of Medicare for all, or health insurance that an individual could access, regardless of income or employment status, would ensure more comprehensive coverage, versus forcing people to purchase insurance from state-based exchanges that often have widely disparate rates, based upon location.
Evidence-based results suggest that offering subsidies did increase the number of Americans with health insurance coverage after the passage of the ACA (Obama, 2016). But not all national reform initiatives have shown equal promise. For example, the lack of electronic health records (EHR) is often cited as a reason for poorer quality health outcomes. But while hospital with completely digitized systems generally do have better patient outcomes, when studies comparing those institutions with and without EHR control for factors such as patient income, number of nurses on staff, and other quality-promoting variables, the existence of EHR is not the decisive factor (Yanamadala, et al., 2016). This suggests that EHR is not necessarily a vitally necessary component of a more nationalized healthcare plan.
References
Obama, B. (2016). United States health care reform progress to date and next steps. Jama,
316(5), 525–532. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069435/
Yanamadala, S., Morrison, D., Curtin, C., McDonald, K., & Hernandez-Boussard, T. (2016).
Electronic health records and quality of care: An observational study modeling impact on
mortality, readmissions, and complications. Medicine, 95(19), e3332. Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4902473/