I've been asked by CBI to speculate about the future of the health club industry over the next 25 years. This isn't as daunting a task as it might seem, because I learned - during my charter membership in the World Future Society back in 1967 - that the long-term future is a lot easier to forecast than the short-term.
Invoking that shibboleth, I now feel comfortable and confident repeating my favorite press quote: "By the year 2050, all able-bodied Americans will exercise; those who don't will be pariahs - like people who didn't brush their teeth every day back in 2006."
Predictions for the year 2030 are just as easy, and there are many to choose from: e.g., the ultimate democratization of fitness (everybody does it); the dominance of kinder/gentler (senior) exercise; undreamed-of advances in club technologies; "magic pills" that obviate the need for diet or exercise (not a good thing); a collective slimming of the American waistline (science-fiction indeed!); and a host of others.
But one edifice of the future soars majestically above all other prognostications. It's visible, unfortunately, only if one employs the most powerful and extraordinary of field glasses-ones capable of seeing, simultaneously, both into the distant future and the distant past. The transforming event of the next 25 years: the inevitable subsidization of fitness services.
New healthcare paradigm
For thousands of years, the practice of medicine has been remedial and therapeutic in nature. The art of healing was invoked only after the patient became ill, injured, disabled, or otherwise indisposed. Traditionally, professional medical care was required to repair broken bodies, cure diseases, or comfort those who couldn't be cured or restored. It was easy for this paradigm to reign for so long, because, as late as the mid-twentieth century, people defined health in very narrow terms: Health was regarded as a purely physical phenomenon, and good health simply meant the absence of disease. It was also the responsibility of doctors - not individuals.
This doesn't in any way take away from the exemplary history of public health, which, through immunization, nutrition, sanitary reform, and scientific advancement, includes - among its many conquests - the scourges of smallpox, typhus, malaria, cholera, tuberculosis, and polio. But just a tiny portion, a small percentage, of traditional medicine was of the preventive variety; and this was passive preventive healthcare, facilitated by scientific progress, infrastructure improvements, and other factors that had nothing to do with the individual.
The modern era of active preventive healthcare, which involves healthy lifestyle behaviors on the part of the individual, commenced in 1964 with the publication of the landmark report on smoking by the U.S. surgeon general.
A values shift of epic proportions finally occurred a few decades ago. The understanding of health expanded beyond its traditional meaning to include the psychological realm; the idea of good health advanced, evolved, to define a higher and better state of being - one that called for mental, as well as physical, well-being. Beyond this basic redefinition, there was another monumental change in medical philosophy: good health became the partial responsibility of the individual - not just the medical profession.
The confluence of these changes led to the birth of the concept of incentivized personal healthcare through healthier living . . . and, subsequently, to the development of a platform of new preventive strategies that are just now being embraced - somewhat half-heartedly - by employers, health insurers, and government policymakers. This new era is still in its infancy.
Decision-makers are finally recognizing that healthier people are more productive employees, file fewer insurance claims, and make fewer demands on already-strapped government funding. Policymakers are being prodded toward subsidized preventive healthcare, but, in many cases, their reluctant homage to this revolutionary concept takes the form of lip service.
Nearly two-thirds of the nation is overweight, and 4 million Americans now tip the scales at more than 300 pounds. The average adult female weighs in at 165, and men are about to burst through a national mean bodyweight of 200 pounds. Despite a quantum leap in our health and fitness consciousness over the past few decades, four out of five people are relatively inactive. The combination of poor eating habits and physical inactivity has produced a grotesque sideshow, in which the term "ugly American"-formerly a political epithet-has been invested with a new, equally disturbing, symbolism.
Evolutionary social change is rarely heralded by headlines, parades, crashing cymbals, or other forms of fanfare. But, lack of special news breaks and flashing Klieg lights notwithstanding, a momentous transformation is currently under way. Increasingly, ordinary Americans, with the help of HMOs, insurers, corporations, and government agencies, are being given the opportunity to take control of their personal health, and to live longer, healthier, more productive, and more enjoyable lives. In the process, they're also helping to tame a wildly out-of-control healthcare system.
This unprecedented paradigm shift - from remedial to preventive healthcare - represents a massive change in American attitudes and public policy, which allows the individual - through personal behavior modification encouraging healthier lifestyles - to share the responsibility for health maintenance with the medical profession. A host of personal incentives, underwritten by major policy changes, are now being created to navigate this sea change in medical philosophy.
This seismic event, I'm convinced, will have a more significant impact on the shape, size, and societal importance of the health club industry, over the next 25 years, than any other single factor.
Entitled to fitness
Two generations ago, the idea that people were "entitled" to certain things for, essentially, "nothing" was endorsed only by a handful of wild-eyed radicals. Eventually, however, that extreme, fluffy notion became the bedrock of mainstream psychology. "Subsidization" and "entitlement programs" were no longer dirty words whispered in secret by crypto-Marxists, but, rather, were elevated to the common, politically correct, lexicon. Just as many luxuries evolved into necessities (e.g., the automobile) good health and its closest surrogates (i.e., healthcare and health insurance) were finally sanctified as inalienable human rights.
By the 1970s, the concept had become an unquestioned principle, and one imbued with moral urgency. Most Americans believed that the government had a legal obligation to help the needy fulfill certain basic human needs regardless of an individual's ability to pay. This belief system, dubbed the "psychology of entitlement," had its roots in the 1960s counterculture, and was popularized by social theorist Daniel Yankelovich more than a quarter-century ago.
