In France, government could pay for citizens to sweat

PARIS -- Debate begins over whether or not social security should pay for exercise programs in hopes of fighting preventable diseases in France.
Written by Bryan Pirolli, Correspondent (Paris)

PARIS – Yoga class and gym memberships could be the next thing doctors prescribe patients in France. A recent report published by the National Academy of Medicine suggests that exercise should be on the list of prescriptions covered by social security. The report comes as various health groups encourage French business to get their workers moving to improve their health.

For those who chuckle at the idea of needing a prescription to work out, it may not be as outlandish as it seems. Exercise prescription is already in place in the U.K. where, in 2001, officials designed regulations as a preventive measure targeting at-risk patients by getting them moving. By prescribing activity, doctors aim to fight obesity, coronary disease, diabetes, and other related conditions that become more expensive to treat later in life. More exercise leads to better health – far from revelatory. But do the French really need state-funded exercise?

In Paris, for example, a monthly membership to the Club Med gym costs 80 euros, an arguably modest sum, but it adds up in a notoriously expensive city. Factor in hectic work schedules and few late night work-out options, and it’s less surprising that the French were scored among the least active in the European Union in a report found in the International Journal of Public Health.

In another study by the French health educational institute INEPS, 42 percent of respondents affirmed having exercised less than 10 minutes in the week prior to the interview. That's a far cry from the suggested 30 minutes a day. And let’s not even cite the 30 percent of the population that smokes regularly, adding to diseases and health issues.

Could the solution to an inactive lifestyle be found in prescribed and subsequently state-funded sports programs? With public pools and plenty of parks for jogging, the French may need a bigger push. According to the authors of the Academy’s report, it's up to the public powers to remedy the lack of physical activity in France to avoid preventable diseases that weight heavily on social security later in life. And the president, Francois Hollande, doesn’t completely disagree. He suggested that doctors prescribe more exercise instead of medications during a visit to the French National Sports Institute in July.

One study, however, shows that prescribed exercise could be beneficial in the long-run for the heavily burdened social security system. According to Jean-Pierre Davant, president of IMAPS, a French exercise advocacy and research group, the benefits are not just for the individual. "The moment that science teaches that physical activity is the best way to prevent pathologies like cancer and cardiovascular disease, it's erroneous to exclude such activity from the social security system," he said. IMAPS released a study recently projecting that paying just 150 euros in exercise programs for 10 percent of patients with long-term conditions would save the system 56.2 million euros per year.

A little bit of yoga could go a long way.

Parisian student, Marie Lagrue, isn't against state money going to prescribed exercise, as long as programs are monitored. "If it’s for preventative purposes, it could be just fine, but it has to be surveyed or else people could abuse it," she said. Like Davant, she sees the idea as an investment. "Paying for a few yoga classes is better than paying sick leave or disability later on," she said.

American expat Phyllis Flick also sees no problem with the idea, though both said that there are plenty of existing, yet underutilized ways to exercise. Flick’s job at the OECD in Paris offers sports and exercise programs, though French employees aren't necessarily queuing up to join. "We have tons of classes and there’s always something different, but it's mostly the foreign and international workers that take the classes," she said.

For Davant, the problem is not unique to Paris, but everywhere in the country, even if city dwellers are more prone, he said, to sedentary lifestyles in France. Some French doctors in Strasbourg, a major French city, are currently toying with the idea of prescribing exercise like biking and gym classes instead of medication. This month about 50 doctors launched a test program with 400 patients to see how exercise prescription would work in France.

But before any exercise programs are reimbursed nationwide, the government is encouraging employers to focus on sport and exercise programs for their workers. Nipping preventable conditions in the bud seems to be the ultimate goal, but it remains to be seen how the French will get there.

Davant is hopeful that the IMAPS report, in addition to the Academy of Medicine's advisory, will help convince the government to cover prescribed exercise. "It’s necessary to determine the most effective way to approach this," Davant said, "but we must absolutely react, obviously, to evolve our culture, especially this issue."

Photo: Cosmic Smudge

This post was originally published on Smartplanet.com

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