Lifestyle coach in Basic Package

Lifestyle coach in basic health insurance package.

Starting next year (2019), there will be more room for preventive health care in the basic health insurance package. General practitioners can refer people with a health risk due to obesity to a lifestyle intervention (GLI). Providers of a GLI program can claim the costs from the health insurer. Minister Bruins for Medical Care and State Secretary Blokhuis for Health, Welfare and Sport expect that more attention to prevention will lead to less reliance on other forms of care.

Reimbursement of the Combined Lifestyle Intervention (GLI) will definitively be included in the basic health insurance package as of 1 January 2019, Minister Bruins of Medical Care and State Secretary Blokhuis of Health, Welfare and Sport announced on 1 June 2018.

Combined Lifestyle Intervention (GLI).
GLI is aimed at combating obesity by eating less, exercising more and working on behavioral change with psychological support. The GLI program, which is covered by the basic health insurance, consists of eight group sessions, a few individual lifestyle coaching sessions and a number of return sessions. In total, a participant receives two years of guidance.

Eat less, move more
GLI is aimed at combating obesity by supervised;

• eat less,
• exercise more
• and with psychological support

to work on changing behavior.

Minister Bruins: "The reimbursement of the combined lifestyle intervention is an important step. It will improve the health of people who use it. We also expect that the costs of other, more expensive forms of care will be lower as a result. That's great: a win for the patient and a win for the premium payer."

State Secretary Blokhuis: "The government is committed to all Dutch people living longer in good health. This measure contributes to this in a very concrete way. Anyone who needs it will be able to receive proper guidance through their GP in order to live a healthier life. We assume that these people will then also be better able to participate in society. The knife cuts on several sides.

Diabetes extremely expensive disease

Nearly 40 percent of participants in the diabetes program Turn Diabetes2 Around, can still go without medication after a year. A significant proportion of advanced patients can even go off insulin. No modern drug has ever been able to show that result.

Type 2 diabetes is an extremely expensive disease. Not only due to the cost of medication and consultations, but especially because the disease has a high so-called co-morbidity: These patients are significantly more likely to suffer from depression, cardiovascular disease, forms of cancer, amputations, kidney disease and Alzheimer's disease/dementia. Dementia is also referred to in literature as "type 3 diabetes".

According to the doctors and scientists, lifestyle medicine has both a preventive and a curative effect. In their view, far too little medical research is being done into lifestyle medicine.

Lifestyle in relation to disorders

There are enough serious studies that lifestyle can contribute significantly to reducing complaints or even the occurrence of diseases in a wide range of conditions such as bowel disease, heart disease or asthma.

Running therapy can help with anxiety disorders, specific diets can help with Crohn's disease, and belly fat reduction can lead to significant improvement in asthma.

The same is true for the relationship between fast food and depression, for the relationship between meaningfulness, exercise and dementia, for the relationship between chronic inflammation (rheumatism, eczema, psoriasis) and meditation, and for the potential of probiotics in Parkinson's disease and some psychiatric disorders.

Many physicians and scientists are eager to further explore, perpetuate and confirm this therapeutic potential scientifically, but are unable to secure the funding to do so from the market.

Lifestyle medicine in the basic package

The cabinet has now included in its coalition agreement that it wants to promote the inclusion of certain proven lifestyle interventions in medical training and guidelines. Additional research is needed where knowledge about the effectiveness is still lacking.

The advocates see great potential for medical and financial gain. If we want to make a fundamental change in healthcare (costs) in the Netherlands, then lifestyle medicine - in addition to conventional (pharmaco-)therapy - deserves a mature place in the basic health insurance package, in research programmes and perhaps a full-fledged medical specialism: the lifestyle specialist.

The market is still hardly taking up this potential. In the interests of patients, premium payers and the treasury, the Ministers of Health, Welfare and Sport, and perhaps also Parliament, therefore need to be strong enough to realise this. Doctors and scientists are cautiously optimistic about the realisation of this potential. (Source: Zorgvisie)

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