Fatty HR writes,
I work for a private company that is going to start penalizing employers through a premium increase if said employers don’t provide vital statistics to the insurance co.’s website. Plus, you have to gain so many points through exercise to avoid the raise in payment. There is concern over this amongst everyone, and personally I think it is a violation of personal liberties. I came across your site by doing a random search on this subject and saw at least one of your articles on this issue. Do you have any recommendations on where to start research to show that Wellness Plans do not work and that they are more or less a scam? PS — I’ve been doing some research and noticed that some of this nonsense complies with HIPAA — as far as I understand it. Still does not make it right in my book.
Fatty, I feel for you.
Look around and tell me if you think wellness plans are working. Are people getting healthier? Thinner? Better looking? No way. If anything, we’re all fatter and sweatier. I’m including myself in the bunch. I almost had a heart attack putting away my groceries, the other night, which included two bags of Utz Chips.
Wellness plans are a temporary, short-term solution. They may lower insurance rates; however, most statistics in medical journals and business magazines are provided by the healthcare industry. We will never know the truth because there’s too much money invested in keeping you on statins, creating a national food policy that revolves around empty carbohydrates & high-fructose corn syrup, and making you feel bad about being fat.
If I were in your shoes, I would consider contacting the ACLU to see if there are existing lawsuits in this space. I would also find a better benefits broker who can offer your company a decent insurance plan without this garbage.
Want another short-term solution to fight the insanity? Tell your employees to lie.
People exercise, eat right, and still drop dead from all kinds of ailments. Why can’t your workforce just say they’re exercising and eating right without actually doing it?
- When a nurse practitioner from the wellness program calls and asks you if you’ve been getting 45 minutes of cardio more than 3x/week, you say yes.
- When you are asked if there is enough fiber in your diet, you say yes.
- When the doctor prescribes Lipitor and wonders why your cholesterol isn’t lower, you shrug your shoulders. Who knows? Bodies are weird.
Personally, if I were an employee at your company, I would lie and pretend like I’m trying to get healthy. Then I would eat like a sumo wrestler and have all kinds of elective surgery covered under the terms and conditions of the insurance plan. I recommend that your employees have every mole removed on their bodies. Fix those hemorrhoids. See the the foot doctor and remove those ugly bunions.
If your employees are smart, they will do anything under the sun to make sure that their insurance costs increase in 2010 under this stupid and unsavory plan. It’s the only way to send a message.
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Show me a bear trap and I walk straight into it.
I’ve confronted with this one before but I’m going to go there again. Health is a major issue for business and for society as a whole. Why is it unacceptable to smoke 20 Marlboro but acceptable to stuff your face with deep fried food?
Businesses have to step up and start taking these issues seriously and not entering into the laissez-faire “do what you want it’s your body attitude”.
If you want to read my opinions in full they can be found here http://myhellisotherpeople.com/2009/07/24/a-weighty-issue/
As for manipulating the system. All that will happen is that controls become more rigorous and schemes become less beneficial. Short term thinking, short term gain.
To deal with issue, we need to tackle it face on. Health, wellbeing and obesity are major time bombs for western nations. You can’t close your eyes and make it go away.
You’ll touch a nerve with this one!!!!
While less intrusive than the program outlined by Fatty HR, my work wellness program was the brick that hit me in the face and told me I was too fat, cholesterol was too high, blood pressure was borderline and my life expectancy was growing shorter the longer I remained fat and lazy.
Did the wellness program incentives get me to change my life. NO!!! A quote from a great boss years ago: “How many old giants do you see?”(I am 6′ 7″ and at my heaviest was nearly 300 lbs.), a desire to avoid medication, and finally a strong desire to be around for my kids and grow old with my wife got me to change my lifestyle. Two years in and lifestyle is changed!!!!!!
There is a cost to every choice in life. The sin taxes get smokers and drinkers saddled with the expense of their habit. Now is time to go after fat people. The method, since it SEEMS to provide the quickest ROI, is for the employer to roll out wellness programs. Lying is an easy way around it and I am sure what many are doing. Want to make people feel the pinch, tax fat clothes. Wait a minute I’ve seen too many pictures on People of Walmart wearing clothes that don’t cover all the parts of the body I wish they would cover. Scratch that clothes tax thing as a bad idea. The wellness program is the lesser of two evils!!!!
Get health insurance out of the hands of employers.
If an employer wants to supply information, supply some discounts and supply access to other wellness resources, good for them. However, do not dicate how I will live.
Penalizing people for not joining or complying with a wellness program is the wrong way to deal with this issue. For the most part, people don’t like to be told that they MUST do something and telling them that they’ll be penalized will be a disincentive and morale killer. Offering a reward for joining a wellness program or for following a workout/weightloss/health program might help or it might not. But a penalty will certainly not help.
Seems a bit punitive for a company that is likely struggling with massive cost increases or a decreased bottom line to put toward employee health insurance.
Here’s what they could have done to really screw their employees:
1. Dropped their health insurance plan
Why not? If their employees are going to try to @#$% them over with it, I say go the punitive route back at them.
Seems kind of silly, right?
Here’s what I don’t get with this response: you’re punishing the wrong people. The conflict between employees and employers should have never existed. Your employer shouldn’t be in the health care business at all. For some strange reason, we’ve decided that you have to have a job in order to have affordable health insurance.
There are bigger issues than companies trying to enforce wellness policies. That’s what’s lost in this whole debate. All of these cost cutting measures that companies are trying to implement (smoking bans, weight taxes, benefit cuts, premium increases) are symptoms of the much larger issue of work connected health insurance.
Until we fix that, none of this will change. We both know this.
So – it’s not ok for employers to shift plan costs, change plan designs, etc. in order to control their costs (which given that many employers pay more than the employee for the insurance menas that their costs go up more) and it’s also not ok for employers to do something – anything – to help control those claims? No wonder insurance goes up double digit rates every year! So, if you, as an employee, complain when your rates go up (and don’t tell me you don’t…) then it is partially your responsibility to do something about it. If the employer offers a wellness program that will help you, all the better.
One should also consider that wellness programs not only can assist in controlling health care costs (both yours and the employers) but can also improve productivity (through attendence, for example…if people are healthier they aren’t as likely to be sick) so both parties should benefit from a well designed plan.
I am not about dictating how you live – by all means, enjoy yourself – just don’t complain when you have to pay more for your coverage or have a lower level of coverage to control costs. Lot’s of claims are behaviorally driven…not all, surely, but why not try to control what we can?
We had something similar at a former company and we lovingly called it the “Fat Tax”. I was in the best shape of my life, doing cardio kickboxing three times per week, and was way too close to the BMI obese rate for my height (5’2″).
However, I do undersand that overweight employees and smokers use more insurance dollars than those that are not overweight and nonsmokers. That makes it a business issue when employers pay for insurance coverage. It’s a tough issue, but I don’t think that paying more (a negative consequence) is the answer to changing behaviors. Wellness programs should be designed to reward positive behaviors, but without support and encouragement, it is not going to work. Behaviors only change when something changes from within – kudos to HRMark!
Get health insurance out of the hands of employers…..However, do not dictate how I will live.
And you think putting health insurance in the hands of the government will mean that nobody will be telling you what to do?
Our company charges you and extra $135 if you are a tobacco user of any sort. Failing to take a health assessment and provide the information to the insurance company will gig you another $100 a month in insurance costs.
I have been in government run health care and it sucked horribly, please leave me out of it, and don’t expect me to pay for someone else.
Lance: “For some strange reason, we’ve decided that you have to have a job in order to have affordable health insurance.”
During the second World War, companies had a maximum wage they could pay workers, so they offered health care as an added incentive to work for them. After the war, Congress liked the idea, so they passed laws encouraging businesses to offer health care. Now, the lobbyists are trying very hard to make sure that insurers can continue to profit from the current system.
Yeah, so, while I agree that punitive measures are crap and maybe wellness plans are pretty much varnish over clogged arteries, healthcare costs will continue to rise and more and more employers will be reducing and/or dropping the healthcare plans. And they may have to. Most businesses driving this economy are the little kids on the block.
And they probably should. I’m not even going to tackle the broader insurance company cost of doing healthcare death star here, but employees should be responsible for their own health and healthcare coverage. If you’re going to clock out every night, go to the local pub, order fries and onion rings, drink lots of beer and smoke cigarettes (damn I miss that), then you’re on your own, Jack.
Really.
Wellness programs are supposed to help improve workforce health, stability and productivity. Without doing the research I do believe those quality programs exist. But folks gotta want to take care of themselves. Those are the people I want working for me.
You’re not happy with gov’t health care? Take action! Speak up! Join an activism group whose ideals match yours! Make your voice heard! Even if you just want to do something like make sure all health insurers become non-profits, that would make huge strides for us in this battle.
Speaking of which, I need to write my senators about capping malpractice awards. Malpractice insurance costs a pediatrician I know $30,000 a year, and apparently malpractice awards weren’t in the version of the bill the house passed.
Yes! A topic so dear to my heart.
Oh Fatty HR, you got it all wrong. Your company is NOT telling you what to do or how to live your life. Not at all. Please, continue to eat what you want, smoke what you want, we really don’t care, as long as you do your job.
However, if you would like to purchase group insurance products that your company offers to you, yes, some employers are going to give discounts to people who participate in wellness programs, complete surveys and otherwise take care of their medical problems — because a diabetic that controls his/her diabetes is not going to cost the plan as much as a smoking, drinking, I don’t take my insulin opps, now I need to go to the ER every few weeks diabetic. Get it?
UT! If you don’t like the rules, you CAN go buy your insurance somewhere else.
Let me say that one more time. IF YOU DON’T LIKE YOUR COMPANY’S INSURANCE PLANS, THEN GO BUY YOUR OWN. Go navigate the private health insurance system. Go learn about pre-ex and guaranteed coverage. Go get individually underwritten. Go learn about state mandates and exceptions. Go learn how much family monthly premiums cost when you can’t get them through a cafeteria plan.
Because, Fatty HR, you are probably right. Typing some data into a website to save $50 a month probably isn’t going to really do anything. Which is why wellness programs aren’t showing the ROI. Personally, we all know it takes something bigger, like a battle against cancer or becoming a parent or losing a parent, that truly motivates us as people to take control over our health and our lives. Until then, we’ll all continue on as status quo.
So Fatty, Take control of your life! Go ahead and lie on your health assessment for the fun of it (don’t worry, we already know you will), and go tell your Benefits Department that they suck. Then go home and get your own health insurance. Don’t forget to let us know how happy you are with your own policy and everyone off your back!
PS – thanks Laurie, for the little soapbox on your blog. You never fail to get my brain going! You rock!
My company offered an optional biometric screening program, if you participated it would lower your employee contribution. It cost the company almost $200 a pop. 100% of the employees opted to take the screening and when the aggregate information came back, 4 out of 100 employees had serious life threatening issues that needed a doctor’s call. All was kept confidential, we just received the numbers not the details. Long story short, it was an optional program that employees did not have to take, but they did to save the money and most employees felt it was a great program. We all know that health insurance has increased by double digits, its starting to become cost prohibitive to employers and if it continues, more companies may consider opting out of it. I’m a healthy woman who doesn’t drink, smoke and I work out regularly. I feel that I shouldn’t have to pay the same premiums as someone who doesn’t give a crap about their health and will more likely need to utilize the services because of such. If you want to drink excessively, smoke like a chimney and eat like a pig then you should pay for those privileges and leave me out of it. Go knock yourself out, but I don’t want to pay more for your selfish excesses.
Dear Precious Little 8 pound 3oz Baby Jesus in the Manger, Please don’t let me get taxed on my fat!
Sadly, albeit logically, the right to self-determination ends at the point someone else is forced to pay for one’s choices.
If you really want to lower healthcare costs, stop hiring those pesky young women who elect to have that expensive pregnancy care. And oy, those old people who get nasty cancers and other expensive age-related conditions. And what about those disabled types whose accommodations cost so much. And the people who are at risk for addictions to booze and substances and prescription drugs. And let’s not forget those young men who drive like maniacs and maim themselves (not to mention any good and virtuous joggers who happen to get in their path) in car crashes. And oh brother, those employees who choose to have so many children, who all get 16 colds and swine flus a year. And those poor HR workers, whose stress levels lead to migraines and irritable bowel syndrome. And… let’s see, the little Asian ladies with their brittle bones, and the African-Americans with their higher levels of everything. And tall people — statistics show they have more health problems than “normal” people.
But fat is different. Because everyone *knows* there are many effective and permanent methods of weight loss that you can use to get and stay skinny (which ALWAYS equals fit and healthy). Those permanent, healthy weight loss methods have proven effective nearly 2% of the time!!!
Laurie,
A classy nugget of advice. Your ethics are to be admired.
Interesting comments thus far. I’ll sum up my thoughts in one simple phrase – you can’t have it both ways.
You can’t lament an employer trying to get their employees to be healthier and then complain about premium increases. Premiums are driven by the profiles of eligible participants and underwriters use this data to calculate what an employer and employee will pay. Certain things lead to higher prices which leads to increased premiums.
As opposed to bucking the system to make a point (that will be lost on many), why not think about potential solutions? If wellness programs suck, what else should/could your employer be doing?
Others have covered this, but when you try to apply for individual coverage outside your employer you will realize just how awful things could be. Just my two cents.
@The HRD To deal with issue, we need to tackle it face on. Health, wellbeing and obesity are major time bombs for western nations. You can’t close your eyes and make it go away. I’m not sure weight is an issue. We’ve had data published, recently, that a little extra chub can protect you from a host of illnesses. I also think that we have some nerve pretending like we’re interested in ‘wellness’ when we focus on weight. Weight is one data point. Wellness is holistic.
@HR Mark Listen, I know that we’re all responsible for our actions — except when we’re not. If we want to equate wellness to weight, which I don’t, let’s look at our national food policy. We’re fed chemically modified foods and then shamed into feeling bad about the impact of those foods. What if we had a wellness plan in LIFE that just said — eat what you want, eat healthy foods or don’t, and get a little exercise? And what if we created a culture that encouraged less consumption and more freedom to think, freedom to move, and freedom to choose? I’m glad you’re healthier, now, but it’s not that easy for other people.
@Salescomp Thank you.
@Glen Rewards actually don’t improve participation. Maybe we should ask ourselves, “Why doesn’t anyone want to participate?” I say it’s because these plans are bullshit.
@Lance Be fair. I did suggest finding a better benefits broker. That was my responsible HR voice.
@KTP Lot’s of claims are behaviorally driven…not all, surely, but why not try to control what we can? Because one person’s behavior/choice is another person’s opportunity to discriminate. Also, who says that a wellness program actually works? The wellness industry?
@Bonita I’m not saying that exercise is bad. I think a diet of fruits and veggies and healthy proteins = awesome. Unfortunately, there’s lots of research out there to show that the BMI is actually an inaccurate measurement of health as it hasn’t been updated since the early part of the 20th century and it’s actually a health insurance table used by actuaries and underwriters — not a measurement of actual health. I’d like to suggest that Diana Reeves, Christopher Reeves’ widow, got lung cancer and never smoked. My grandmother was diabetic at an early age even though she walked everywhere, never owned a car, and was never overweight. So it may seem easy to equate smoking and food consumption to health, I think it’s more complex than that. Until we understand nature/nurture a little better, let’s not pretend that a wellness program does anything more than shift health insurance costs for employers in the short-term.
@Class We can protest against the government under our first amendment rights, demand accountability, and throw the bums out of office. We can’t do shit with private health insurance. (PS – Loved your comments about your job & marriage on the Cluewagon blog. Wanted to tell you that!)
@JohnC I had government run healthcare when I lived in the UK. I didn’t die. I survived. Now I can’t get BCBS to pay for my glasses because they said that I didn’t have vision insurance in 2007, even though I *did* and I’ve sent them proof 3x. Fuckers.
@econopete Awesome. Thanks for that.
@Kevin If you’re going to clock out every night, go to the local pub, order fries and onion rings, drink lots of beer and smoke cigarettes (damn I miss that), then you’re on your own, Jack. Kevin, okay, what happens to the big agrifood & tobacco companies that encourage and advertise these foods, appeal to our lizard brains, and make the case that you only have a great life if you consume like a freak? Advertising works. For those who think tobacco and shitty foods contribute to a horrible lifestyle, I challenge you to stand up and make your voices heard where it matters: with those who profit from selling us this garbage. [Kevin I wanna see you eat nothing but onion rings. With me. That would be awesome & fun.]
@econopete How about we lobby against general and professional liability insurance companies who are complicit, lazy, and spread around liability to good doctors instead of working to force negligent doctors out of the system? Stop penalizing my good doctor because another doctor rightly & legitimately had 7 lawsuits against him.
@ReallyHR If you don’t like the rules, you CAN go buy your insurance somewhere else. No you often can’t. That’s the problem.
@LatinaHR I feel that I shouldn’t have to pay the same premiums as someone who doesn’t give a crap about their health and will more likely need to utilize the services because of such. If you want to drink excessively, smoke like a chimney and eat like a pig then you should pay for those privileges and leave me out of it. Go knock yourself out, but I don’t want to pay more for your selfish excesses. So what if I said, “I don’t want to pay for your stupid kids who keep going to school and getting the flu and ear infections?” That’s not so nice, is it? (Not your kids. Just kids.)
@hrU Thank you. Hahahahah!
@Ken We pay for everything. Is it about money — or is it about the right to live without oppressive, stupid, bullshit rules?
@stelzner You can’t lament an employer trying to get their employees to be healthier and then complain about premium increases. I can. Why aren’t companies lobbying for public healthcare? Oh wait, they are. Many of them. They don’t want to be in the nanny-state business of managing health insurance for employees.
@Julie I especially hate the young women who have babies. Let’s stop hiring them right away. Bitches. They’re so expensive and they take off too much time. Also, their kids grow up and get ugly. In fact, let’s put a tax on ugly babies. That will fix America and help to ensure that we only get cute babies in the future.
@Scott I think you’re taunting me.
class factotum: Where did I mention government run healthcare?
++++++++++
A punitive wellness program is not going to eliminate double digit rate increases. Medicare/Medicaid reimbursement rates do not fully cover the true medical costs. Much of this shortfall is pushed into the private insurance rates (aka employer paid coverage). Except for eliminating health insurance, an employer can not influence this big factor.
Then you have a small population of people that are generating a large portion of the expense. These type of programs might help prevent some people from joining this group but this small group still drive a huge share of the cost.
These broad-based health initiatives do not generate huge saving because the vast majority of the employees are not driving the costs. If management wants the additional ROI to come from improved morale, decreased absences, and improved corporate culture; this approach does not seem to be doing it.
if well designed and implemented, wellness programs do work. health-risk assessments help organizations determine where there is disease of risk and at the very least allows them to target communications, education, and disease management efforts. i think you’ll be hard pressed to find (reliable) research out there that suggests the opposite. even if they end up helping only a few employees, that translates into lower claims, and that translates into lower actuarial assumptions as to the plan’s cost (whehter your company has a fully-insured or self-insured plan). all this talk about ACLU…don’t listen to it…it’s bullshit. if you don’t want to take the HRA, then don’t. and i say its just fine for the employer to assess a “surcharge” for your not willing to play along. be careful, Fatty, about taking advice from people who don’t make employee benefits their business and most likely haven’t been intimately involved in a plan design for years…
I have been in the workforce for over 25 years. I have had health insurance for all but the last year of that 25 years. In that time, I have had no major usage of my insurance. I have had a couple of minor same day surgeries, a few short stints with physical therapy, one MRI, 2 sinus infections a year (like clockwork), and my annual gyn exam.
I have remained single and childless that entire 25 years, so no one has used my insurance benefits but me.
I am an insurance company’s dream. I have been amazingly healthy my entire life and I have no one but me to consume my benefits.
In that 25 years, one could say that I have paid for hundreds of coworkers’ spouses and children to have major surgeries, cancer treatments, hospice care, etc. (I am not complaining. Just stating fact. I am glad that I could contribute to the health of others.)
So don’t tell me that my lack of good eating and exercise habits are costing YOU money.
Currently, I am overweight. It is the result of a busy lifestyle that compels me to pay less attention to myself than to the bazillion other responsibilities that I have. I remain surprisingly healthy, even though I probably consume more cheeseburgers than Laurie does Utz (probably a good thing we don’t have those in OH). I have a part time job and growing self employment. I cannot afford to pay $200-300 a month for insurance that I am probably not going to use. I am hoping that my health will hold out until my government can find some way to lower the cost of individual insurance policies.
Yeah, my government. I trust them more than I do these jerks who are making millions in private industry off of the woes of others. As Laurie said, at least I have a voice in elected officials’ job security.
If you want me to change my lifestyle, quit making people work harder for less. Develop a national food policy that makes it more affordable for the food industry to make healthy food more available to me at a reasonable price. And develop universal health care so that I can be seeing a doctor regularly who can harangue me about my weight and get me into a decent wellness program.
But do not limit my right to eat and do what I want to do on my personal time outside of work.
Mmmmm….last time I checked smoking was a choice, eating the cheeseburger was a choice…while this may not prevent you from getting lung cancer or being overweight, it certainly is a contributing factor. Otherwise, let me start smoking again since apparently it has no chance of making me sick…that would make me happy as I quite enjoyed it.
I like BZTAT’s point in the reference to this being a structural issue rather then one just about health insurance. But, do what you want just understand that you may be asked to pay more if you choose to act in a way that raises your risk and our cost
You know what?? I like playing my belly like it was a set of drums!! How dare you try to take that right away from me!! This is an OUTRAGE!!!!
You know what happened when we started a wellness program at my company? The 10-20% of the employees who have the diabetes/heart disease/high blood pressure conditions didn’t participate (and none of the covered spouses did). So we get 70 to 80% participation, and everyone says “YAY! Success!” Bollocks.
AND a good 30% of our serious health conditions (cancer, mostly) were employees who weren’t overweight, didn’t smoke, no obvious risk factors. Life sucks, folks. Be careful what you say about “those people” who are driving our rates up. You could find yourself with prostate or breast cancer and then you’ll be glad that others are paying for your share of the insurance use.
And guess what? Despite the wellness intiatives, our premiums increase anyway! And you know what else? Group premiums go up because we are paying for our fellow citizens who can’t get coverage and have to use the Emergency Room for regular medical care. Anytime someone says that health care reform is going to harm employers, I’d like to hear how they think that group premiums increasing of 15% a year isn’t harming employers. Gah, this whole system makes my head explode.
My advice is the same when forced into a wellness program: LIE. But then please do try to take care of yourself and be healthy on your own terms because there are people who love you and want you to stick around for a good, long life.
This does not sound like the Wellness program that Laurie has railed about which involve Health Risk surveys, health coaching, brown bag lunches about broccoli, or giving employee pedometers and encouraging them to walk. Those are the “soft” programs where the research is questionable. I am actually in charge of that line of business at my health insurance company and it’s a marketing tactic. We don’t believe that it saves costs.
What this does sound like is the growing movement around getting people to put some skin in the game around their health costs. Being told to excercise is not wellness, it’s the next step before being told to lose weight or pay more. Next step will be plan designs where you get worse benefits if you don’t lose weight. What’s looming on the market is plan designs where you pay more if you go to the ER when you could have waited 2 days for a doctor appointments, you pay more for 3-D CAT scans when an X ray was sufficient, etc. Doctors are going to have to understand the costs of the procedures that they prescribe.
The alternative is $5000 deductibles and scrimping on Laurie’s glasses. Basically, the uninsured have subsidized great health insurance for seniors and some employer groups. If we want to cover the uninsured, it’s not just the health plans that are going to face the costs. We are all.
This is the beginning of a new health care system. Our previous health care system offered great innovative and invasive care and paid for it by not covering 15% of the population. That system doesn’t work anymore and there’s a limited way to spread around the dollars.
And it really doesn’t matter if your employer pays for it, the government pays for it, you pay for it, or China pays for it.
This is all very interesting – love the post and comments. I’m torn, because a) I’m anti-ins co and pro-single-payer system; I’m also b) I’m pro-wellness and c) pro-cake.
When you look at what drives high claims, it’s easy to pick smoking, drinking and eating as the culprits, but i agree with you Laurie. Trying to live a healthy lifestyle is hard work, especially when our government supports the industries that are killing us (high-fructose corn syrup, cow hormones, GMO, pharmaceuticals, radiated food, pesticides! Oh, I could go on).
Having said all that, I work for a mid-size organization and we implemented a low-key, low-cost, no-pressure wellness program because we thought our employees would enjoy it and might benefit from it. There’s no premium-inducements/penalties, just information, wellness-fairs and free optional biometric screenings. Oh, and stress-reduction seminars – my people love those.
The fact is, unless you’re in a large company, much of what goes into calculating your premiums occurs outside of your control. We have a relatively young and healthy group who stays in-network and buys generic. Still we’re faced with a 20% increase in premium because almost 1/2 of our rate is based on a community rating – people outside of our organization – and our community sucks. Smaller companies are 100% community rated. Getting one or two people to quit smoking or lose weight is probably not going to impact our rates all that much.
Car insurers raise your rates when you have accidents, get a DUI or get caught driving too fast. Home insurers lower your rates when you install a burglar alarm, deadbolt locks and implement other security measures. Why is it so intrusive when a medical insurer offers incentives for people to lower their risks in a health plan or penalties when a person makes lifestyle choices that increase their risk of health problems?
The philosophical issue of whether medical coverage should or should not be linked to your employer is a whole other matter. For what it’s worth, The more I think about it, the more I support basic universal coverage for life threatening illness, preventive care, and pediatric care that is in no way tied to your employer. But that’s not what’s on the table here. We’re talking about the obligations a privately-held business has to its employees and whether an employee’s off-the-clock behavior or habits should have an impact on the employer’s delivery on those obligations. I don’t see any evidence that the employer is infringing on any rights. The employer is not firing people for being fat or drunk, smoking or cliff jumping in the Caribbean. It seems to me that the employer is saying, “if you do stuff that makes your insurance more expensive, I’m not picking up the tab.” I don’t really see that as a violation of civil liberties.
You know me. I am all about root cause discovery. We blame fat employees and nanny companies for the problems. The problem is systametic and big.
Btw, broker changes are short term solutions. If your group costs money, it will come back to you. Insurance companies almost never lose. I’ve done the merry go round insurance in HR and hated it. And my employees hated it.
@scottthekyhrguy; How does noy supply your vital stats or not earning the exercise points increase your health insurance usage?
A point system indicates a prescribed approach. Unless it is going to be based upon the honor system; you will need to prove your exercise. What’s the necessary proof? – An attendance record at a mega-gym? Videotaping yourself, everytime you take a dog on a walk or go on a bike ride?
SalesComp –I think you miss my point entirely. I’m not suggesting that you should be penalized for opting out of a voluntary program. I’m suggesting that more expensive insurance for those who are not willing to take a more proactive role in their health and wellness is a perfectly reasonable thing for those selling that service to seek.
I never mentioned a point system. The insurer or employer engaged in the process needs to decide what metric they’re going to use to track that. If they’re using metrics that don’t equate to real improvements in wellness or reductions in back end payments, they’re making a bad business decision and deserve to suffer the financial consequences for making a bad business decision. I’m not proposing those metrics here, though I think a smart incentive program would be based more on outcomes than activities. (e.g. – improvements in cholesterol levels, smoking cessation, weight loss, etc…)
An employer that institutes an unpopular initiative must wrestle with the issue of attraction & retention vs. cost savings. If I save 10% of my cost, but piss off 20% of my employees so badly that they quit or start producing less have I made a good business decision? I’d say no. But me making a bad business decision is not an infringement on anyone’s rights or violation of their civil liberties.
Everything I have read here is based on opinions, beliefs and anecdotal evidence. No one has produced valid statistics to back up their point of view, including myself. Although Fatty HR may have no interest in bringing a lawsuit, it may behoove him/her to contact the ACLU, who I am sure has done their homework and has some research to back themselves up in court.
We all need to be wellness conscious. We all need to focus on our health and improve ourselves. But shaming, blaming and penalizing people is not the answer. There are oogles of mental/behavioral health research studies that validate the ineffectiveness of these tactics in changing behavior.
@laurie ” No you often can’t. That’s the problem. ”
You are right. So if it wasn’t for the employer’s group guaranteed issue policy, that same policy Fatty is thumbing his/her nose at, Fatty most likely would join the ranks of the uninsured.
It sucks to be in a place that the only hand you can bite is the one that feeds you. That is not the place we want to be in. Yet, that’s exactly where Fatty is.
Dudes, we are all awesome HR professionals. I think we can put together some better recommendations for Fatty then to lie and call the ACLU. Because if we can’t, then we’re all in trouble next open enrollment.
@Lance I know how you are, and I know that brokers can’t offer much beyond a short-term option. I guess that’s the issue. It’s all short term. Then we die. ((wah wah))
@scott Car insurance is the biggest crock of shit. That’s another post. No fault insurance? F–K YOU CAR INSURANCE.
@cowtowngirl I remember when we gave out 4% merit increases and apologized because insurance premiums were going up 6%. Those were the good old days.
@Deadhedge I hope we can do better than some of the tough, tough realities you outlined in your comment. Sad. Also, f–k China.
@H.Aria This is such a great comment and reason #450 why you should blog. I’m glad you are on the pro-lie bandwagon.
Also, yes, everyone listen to H Aria and take care of yourselves.
@MattyMat I can make my belly smile. It’s an awesome party trick.
@KTP Is smoking a choice? That’s a good one to think about. So we pick up cigarettes when we’re 12, get addicted, and struggle to quit. I dunno. Some choice. But I get the whole free will debate. I think free will is overstated.
@BZTat Thank you. I’ll buy you a cheeseburger.
@Charlie Dude, just because I haven’t been in Corporate HR in two years doesn’t mean I don’t know anything about benefit plans — and it doesn’t mean that people who currently design plans know anything, either. Let’s not make those soft assumptions. i think you’ll be hard pressed to find (reliable) research out there that suggests the opposite. even if they end up helping only a few employees, that translates into lower claims, and that translates into lower actuarial assumptions as to the plan’s cost (whehter your company has a fully-insured or self-insured plan). I think you’d be hard pressed to find real, solid, actuarial evidence that people who participate in wellness plans have long-term success results that fundamentally and positively impacts the actuarial tables. That data doesn’t exist. People lose weight, gain weight, eat right, don’t right, and die. Living costs money. Why are we such whiners and babies about this? Why are we as a country so puritanical and quick to make sweeping assumptions about health insurance? Sheesh. It’s immature. We are a dumb country, sometimes.
@really If we could put together better plans, our profession would be testifying before congress and SHRM would be providing the solutions to the healthcare crisis. We are awesome HR professionals, but I think lying and calling the ACLU (for research — that’s what I recommended) might be okay options.
@scottthekyhrguy But me making a bad business decision is not an infringement on anyone’s rights or violation of their civil liberties.
No, but offering an inequitable compensation benefit based upon discriminatory factors is an infringement on rights and violation of civil liberties.
I expect that the ACLU will have great ammunition to demonstrate that offering a benefit to some and not others based on whether or not they participate in a wellness program is discriminatory. Is it a good business decision to taunt them or others who may be looking for someone to make an example of?
produce said (reliable) evidence, laurie, and i’ll be happy to consider it. “soft assumptions”? i don’t follow you there. and my caution to “fatty” to be careful about listening to those who aren’t involved in designing benefit plans was not necessarily directed at YOU. she obviously came here for advice and it’s fair to say not everyone here knows what the hell they are talking about (myself included). Punk Rock HR is the last place that someone should come for reliable and meaningful data concerning something as important as benefit plan elections/participation. debate, good commentary, humor, etc…sure. but the “ACLU”…give me a freakin’ break.
@Charlie 1. You produce reliable evidence and I’ll consider it. The burden is on you, as someone who makes claims about wellness programs, to back them up with independent data. 2. Fatty HR is a man, for what it’s worth. 3. Also, I dunno, I like the ACLU for the work that they’ve done with civil rights and personal rights. They appeal to the libertarian in me. Who am I supposed to recommend? The Heritage Foundation? ((eye roll)) That being said, I’m glad you’re here because we all get smarter with multiple points of view on this.
I think you’d have a hard time making the case that offering wellness incentives is an infringement on anyone’s rights. If you’re not allowing older workers into your medical plan… that’s an equity problem Paying overweight employees significantly less than physically fit employees for comparable jobs with similar results? Sure. That’s an equity problem. What are the discriminatory factors here?
I don’t see the connection with pay and benefit equity here. Not even a little bit. The writer doesn’t indicate that overweight, older or smoking employees are being denied access to a fringe benefit. He’s saying that the cost for employees who do not participate in a wellness program is higher than for those who do participate. If that’s an infringement on rights, is it also inequitabel and a violation of civil liberties for employees who produce more to get bigger raises than those who do not?
Laurie — I agree with you on car insurance. I’m not so fond of the insurance industry as as whole. But that doesn’t make their practices illegal or validate the position that any of this is a violation of any person’s civil liberties. I’m not a skinny guy. I probably wouldn’t qualify for any incentives under a wellness program. I’m ok with that. The cinnamon roll I ate for breakfast this morning would have been worth an extra couple of bucks paid toward my premiums. Every time I pass the gym and head straight home I make a choice. If I’m less attractive, my healthcare costs are higher, or I don’t feel as well because I made that choice I only have myself to blame.
i know you are but what am i
First, I would not look to HIPAA for help on this one. As far as I can remember, and it has been awhile since I have last read the HIPAA document, it only applies to three three types of organizations and unless your company is one of these three types it doesn’t apply. Also it states that the holding company of the Health Information has to provide you access to it, but that isn’t much help either.
As far as Wellness Programs go, they actually do work and there is a multitude of research outside of the health industry that will support that. I would take a look at the Johnson and Johnson study done in the 80′s and 90′s for a reference point. It is dry reading but helpful.
When it comes to measuring vitals, there are only four measurements that are worth while and accurately describe the overall health of an individual. Resting heart rate, blood pressure, % body fat, and cholesterol level. If your company wants to use BMI, I would call BS on that one. I am 6’1, well a little under, and 180-184lbs. According to the BMI charts I am almost overweight. Also I am not a big fan of point systems to influence increased wellbeing. They diminish the importance of making these changes for you as an individual as well as the fact that they need to be a lifestyle change and not a quick fix.
Now I am little out of my knowledge area on this one, but I do not think that a company can require you to submit this information. For a company to ask you to do so would require them to show a vital business need.
I’m on the fence. The smoking, drinking, junk in the trunk side of me says screw your wellness plan – gimme a smoke. However, tomorrow my director will sign the papers to make our health insurance plan self-funded. The hope is that we can better control the fate of our insurance plan than the insurance companies, but it’s a risk.
So, do we all have skin in this game? Hell yes! And can a wellness plan, or perhaps the awareness a wellness plan brings coupled with the fact that we all now have a vested interest in being better healthcare consumers sound promising? Well, yeah. It also makes me want another cigarette. So, perhaps I’m not the person you want an opinion from because for me it all comes down to a system – whether you blame insurance companies, providers and hospitals that won’t negotiate, employees who don’t really understand the true cost of going to the emergency room when they could go to an urgent care clinic, or the long term costs of cigs, beer, and pizza – that is incredibly dysfunctional.
I guess I don’t really disagree with either view, but I have yet to see how a wellness plan, or the lack of a wellness plan, pans out in anyone’s favor under the current system.
@jackbuilt sounds like you are aligned with lance — looking for better answers, being realistic, etc. I want more pizza.
@Matt J&J is a pharma, medical devices, and consumer products company that wins no matter what. I don’t trust anything they do.
But I’m glad we agree on the BMI.
@Scott I don’t deserve reasonably-priced care because I pass the gym? What if I can’t afford my gym membership?
A big part of the problem is excessive costs for just about everything in the healthcare system – technical machines (CAT scanners, etc.), drugs (way to build profit, drug companies, by raising prices in anticipation of the healthcare legislation), insurance, hospital stays (take a Crystal Cruise – it’s cheaper), you name it. Check out costs in Canada – way lower. Mexico – way lower. Japan – way lower for MRIs and CAT scan machinery.
One-pay, universal coverage cuts out the middle man (insurance companies), provides fair access and reels in costs. Not perfect, but better than what we have now.
Great topic, Laurie – kudos to everyone for the lively discussion!
@Bztat, if you google or bing info on Safeway’s health plan, you’ll see the tough, lose weight or get worse benefits approach that I described. That’s the one fact that I have in there. My others are just the math about how health care costs are 16% of GDP and growing faster than inflation.
@ Laurie, the system doesn’t have to be draconian as I described. Massachusetts is getting close to figuring it out. They got everyone covered and the next planned step was to get the hospitals and providers on a budget through capitation or bundled payments or whatever you want to call the fact that they will be given X dollars/person and that’s it. However, we have to get real with our expectations of health care. When people say, MediCARE for everyone, I say, it will be more like MediCAID for everyone.
I have a girl crush on Julie. She’s funny and sarcastic and smart as all get out. Too bad I don’t know you, Julie. I’d ask you out for coffee.
Fat people eat too many twinkies and clog up their hearteries. Joggers trip over rocks and break their friggin ankles. Pregnant ladies expect me to subsidize those black and white photos that make me pretend I can see a baby. Good, old fashioned, upstanding Walmart shoppers get cancer out of the blue and need expensive drugs.
Sheesh, people. Everyone will experience some sort of health issue at one time or another in their lives. Penalizing lifestyle is silly. It’s not compassionate. It isn’t how we will provide sufficient (not extravagant) healthcare for everyone.
I don’t know the answer. But I do know that it’s wrong to slap a Twinkie tax on me, when Mommie Dearest gets off scott free, and Mr. I-Inherited-A-Congenital-Catastrophic-Illness-that-will-Drain-the-Self-Funded Plan pay less than I do.
Personally, I just want to get my hands on some LaTisse. I have short eyelashes. I finally worked up the nerve to ask the doctor and learned that it’s not covered. WTF?
Julie — cawl me!
BRAVO!!! God, if I had a dime for every single time our “Wellness Guru” announced another initiative that we eventually all forget was ever introduced, I would no longer be in HR. It’s a total waste of time. Plus, the degradation that my fellow employees are put through everytime he comes up with another brilliant idea makes me want to punch a baby. The problem is, the powers that be are totally fleeced. They think it’s totally acceptable to dictate what we should eat, do on our time off, and look like!
I have taken a personal stand by refusing to participate in any healthy screenings, Weight Watchers meeting, or any general enthusiasm whatsoever about our Wellness programs. I am in the minority, though.
The last straw was when our Benefits Dept decided to stop covering gastric bypass procedures for obese employees because that was taking “the easy way out”. Even though it has been scientifically proven that the procedure is cheaper than paying for diabetes and HBP meds for a lifetime. This is just another way for us to judge each other.
Laurie — I never said those who don’t proactively manage their wellness should have no care. I don’t think it is fair, equitable or even reasonable for people who do take a proactive approach in managing their health to pay an equal share of the cost for managing the extra expense incurred by those who do not. Healthy people get cancer. Healthy people break bones. I get that. But the actuarial tables are pretty good at predicting commensurate cost for commensurate risk. And, for what it’s worth, I’d be in the group that would have to pay more. I don’t exercise frequently enough, I don’t get enough sleep, and I travel more than 50% of the time, so I eat a lot crap I shouldn’t eat. But I also recognize that my choices have consequences and I don’t feel like someone else should bear the burden of paying for my bad decisions.
As for not being able to afford a gym membership… geez, you can walk around the block when it’s nice or walk around the mall when the weather sucks.
I don’t have data in front of me . . . and as we know, statistics always tell the truth, right? Yeah, sure they do.
Wellness programs lead to lower insurance premiums, and wellness (from a holistic standpoint), helps people live longer and healthier lives.
It all comes down to the individual – instead of sitting around complaining about how they don’t work, how about we accept responsibility for our health for a change.
It’s just too easy to sit around pointing fingers at what doesn’t work and who/what is to blame . . . instead of getting off our asses and actually trying to do something about the problem.
Wellness programs aren’t the enemy – complacency and groupthink is.
Does anyone like that picture with this post? It cracks my shit up.
@Marsha Thanks. I’m all about universal healthcare. Great minds think alike on this one.
@Deadhedge I wonder if this country is too stupid and doesn’t deserve better healthcare. Even Massachusetts.
@Peopleshark I’m totally introducing you to Julie on Facebook. Stay tuned. She is awesome and amazing. Also, you could write one hell of an appeal letter and see if your insurance will cover Latisse. I did that with my hyperhidrosis and now I get botox in my armpits — but that isn’t doing the trick and the dermatologist suggested that we lipo out the sweat glands, LOL. I’m seriously thinking of asking BCBS to pay for that. Fuckers.
@UTDIVA The last straw was when our Benefits Dept decided to stop covering gastric bypass procedures for obese employees because that was taking “the easy way out”. Even though it has been scientifically proven that the procedure is cheaper than paying for diabetes and HBP meds for a lifetime. This is just another way for us to judge each other. I hate how weight loss and weight, in general, is viewed in such a snobby way. I’m white and petite. If anything, my life is all about the easy way out. Sometimes I think everyone else should get a break because my life is so damn good.
@Scott Who decides if you’re proactively managing your illness? Is the decision made my committee? Who’s on that committee? Can I appeal?
@Josh Stats suck. There hasn’t been enough research in this field to prove which one of us is right — but I’ll wager to guess that you’re right in the short-term and I’m right in the long-term. Also, I agree that wellness programs aren’t the enemy. Nanny corporations are the enemies. Let’s get wellness out of corporate America and into the hands of our citizens. PS — someone, and I can’t remember who, made a good point to me that maybe we aren’t getting fatter and sicker as a nation but maybe the population looks different when our numbers grow and we have a better opportunity to measure the population. We’ve never been able to see our country (through travel, surveys, technology) like we see it RIGHT NOW. Better economy + better technology = more data points. I dunno. Something to think about.
actually the picture really grossed me out…
FYI, folks, her first diet began when she was six.
http://www.huffingtonpost.com/2009/11/20/precious-star-gabourey-si_n_365925.html
Obviously it’s a moral failing and Gabourey Sidibe should be focused on WELLNESS PLANS and DIETS and EXERCISE because she obviously isn’t focused enough on her weight.
Laurie, sorry for the late reply! You have exposed my ignorance on this issue (malpractice insurance). I have two clarifying questions for you, though: do doctors that make serious mistakes repeatedly pay the same rates as doctors that don’t? And why do they keep their license? I honestly don’t know, but if that’s how the system really works…well, I’ll just say that I concur.
One more thing: you said companies are lobbying for healthcare reform. Is there an article somewhere that summarizes what’s going on with that? I think I saw even WalMart is lobbying for reform. Is it a “hush-hush” thing for fear of retaliation from insurance agencies? Or is it just not getting all the media attention that everything else is?
@econopete I think the licensing community is separate from the insurance community. From what I remember from my brief time at Kemper, the # of claims impacts whether or not you’re insurable — but licensing is a completely different route. The two are often disconnected. Insurance companies often penalize the field (i.e., obstetrics) instead of aggressively weeding out those doctors with the highest claims. It’s a fucked up and inefficient process.
Also, here are some articles.
http://thehill.com/homenews/administration/67607-tensions-brim-between-gop-and-ceos-over-healthcare-reform
http://www.huffingtonpost.com/carl-t-camden/why-health-care-now_b_209382.html
http://www.huffingtonpost.com/andy-stern-and-jeff-kindler/why-healthcare-cant-wait_b_169202.html
Thank you sooooooo much Laurie! This will allow me to beat down my enemies’ defenses as to why we shouldn’t have health care reform. (My enemies being my two/three Republican relatives who are horribly outnumbered by the rest of us dirty, elitist liberals. And a few people on Facebook that I argue with just to keep my mind fresh.) It just gets so frustrating when people cry, “zomg! socialism!” Being only about ninety minutes from Niagara Falls, if it was easy to become a Canadian citizen, I would’ve bolted for the border a long time ago!
The company I work for has an employee wellness program that’s been in effect for about 2 years now. There are 3 requirements: enroll in a “Quit For Life” smoking cessation program, get a physical once every 2 years, and fill out an online health assessment that tells you what health risks you should be aware of. If you don’t do those 3 requirements, your only option for medical insurance is a higher-deductible plan. It may sound cruel to some of you who don’t support this type of thing and don’t agree with employers being involved with employee health in that capacity, but I really don’t think that’s asking a whole lot of people. Companies need to keep costs down. I think it’s a good way to encourage healthier behaviors. In addition, employees who participate can get up to $300 back the following year by doing healthy things, such as going to the dentist or participating in a stress-management course [these things are given point allotments & are tracked on a website]. It’s all really simple, and hell, I’m getting $200 next year for doing little things that are beneficial to my health! I think it’s a good tool for motivating employees to make better choices for themselves. Again, I can see the other side, but I’ve seen the program my company has as something fairly progressive without being too overwhelming.
JL : ]
@Econopete
@JL Thanks for the comment. Companies don’t need to keep costs down — they need to make money focusing on their core business principles. I dunno. The more I think about it, the more I’m just offended by private health insurance. But to your point — I’d like to keep my $200 in the first place. Lower my health insurance premiums.
Okay, so I dont know much about this topic,. But I do know that one way to make employers, and employees happy, and help them both cut costs and save money, is for employers to self fund, go with a high deductible health plan, and pair the plan with an aggregate wrap as well as a HSA/ HRA.I also read about a medical travel plan.
Below Is a link to a video I found on you tube. I hope this info helps…
Youtube link:
http://www.youtube.com/watch?v=CzTmC-m2bII
Brilliant! Behavior can only be changed by others, governments, and institutions when it is enforced only by the taking away of the corporate cheese or by the business end of a gun. Fatty HR’s company should realize that WE THE PEOPLE change our own behavior when we are tired of being fat, stupid, ugly, or too nice.
Our company has Free Donut friday. Try taking that benefit away and make the fatties count their steps! Right!
Wellness programs are now widespread in both the public and private sector, created to achieve cost-savings and improve employee health. The programs should be designed for broad participation. As Feifei Wang, PhD, expresses, “Most of the wellness programs reach only a small portion of the target population.”
Wellness program advisors express a consensus on strategies to build effective plans. Most importantly, they believe that a target population should be the source of ideas concerning the development of program activities and incentives. Every participant should be awarded incentives in an individualized, non-competitive manner. Appropriate rewards may be time off; reduced health insurance co-payments; recreational equipment or facilities; and discounts for recreational health activities.
A wellness program that rewards individuals only on narrow criteria as body mass, blood pressure, and cholesterol is flawed. According to the Texas Department of State Health Services, any wellness program should avoid rewards for biometric data and competitive incentives.
A program that only rewards participants with a “normal” BMI below 24.9 excludes participants. Currently, about 55% of Americans exceed BMI 25. If they perceive that attaining BMI 24.9 is unrealistic, individuals from whom costly medical risks arise will reject the program.
Historically, the range of “normal” BMI extended to 25.8 for women and 26.4 for men. Steven Halls, MD, estimates that “normal” BMI for men should extend to 27. Furthermore, increased medical and drug costs begin at BMI 27, according to a large-scale study by Feifei Wang, PhD, et. al. The steepest increases in costs are below BMI 19 and above BMI 30.
Medical cost increases are approximately 4% per BMI from 27 to 45. Drug cost increases are estimated at 7% per BMI unit. Therefore, any improvement saves money and should be rewarded.
Blood pressure levels provide another example. Lowering the average blood pressure of participants may be a noble goal. However, requiring a participant to achieve a blood pressure reading less than or equal to 120/80, perceived as a “normal” standard, is not helpful. Prehypertension, blood pressure between 120/80 and 140/90, may affect one-third of the population. However, medical studies indicate that prehypertension is misdiagnosed in up to 43% of patients due to errors such as variations in readings and the elevated pressure created by “white coat” syndrome, measuring in a clinical setting.
According to Laura P. Svetkey, MD, changes in diet and exercise can lower blood pressure 7 points; weight loss of ten pounds can lower systolic pressure another 4 points. Therefore, an attainment criteria of 120/80 forces health care providers to become drug pushers, increasing health care costs and endangering the health of patients with pressure readings only slightly above “normal.”
Therefore, any successful wellness program will reject specific biometric criteria. The attainment of improved health among the members of a group is dependent on the infusion of ideas and participation from the bottom to top of an organization, not unfunded mandates from aloof comptrollers on high.