Forced to be 'fit'

Part one of Katie Couric’s CBS news special this week, “Forced to be Fit,” profiled employers mandating that their employees “get healthy or else.” Employees at Benton Company (home to Walmart) who refuse to submit to health screening and are unable to pass certain health indices are charged higher health insurance premiums. “Being fat is going to cost,” she reported. Smokers, the fat, and “unfit” are having to paying $2,000 higher deductibles.

The rationale? Because, according to this news report, “the cost of providing health care coverage for them was getting out of hand.” Benton’s human resources director was quoted saying, “it was about a bottom-line issue.” Purportedly, these employees cost companies more for healthcare.

Note to Mrs. Couric:

Health insurance rates charged by insurance companies are not the same as health care costs.

Another story angle might have investigated how insurers are coercing employers and their employees to into their (not their doctors’) health appraisals and “wellness” and weight loss programs that have no proven effectiveness, put some at higher risk, while not actually lowering healthcare expenditures for employers. They do, however, make money for insurers.

Worse, health risk indices — from BMI, blood pressure, blood sugars to cholesterol — are fraught with myths and been shown to be largely genetic and related to aging, and not significantly malleable with “healthful” diets and lifestyles. To put it bluntly, these employer/insurer wellness initiatives are age and health discrimination, lifestyle control and compulsory medication. They also violate employees’ privacy. Growing numbers of attorneys are catching onto the science and the discriminatory aspects that are setting employers up for legal liability.

Now, that would have been a great story.

Another employer ‘wellness’ program in the news

This week’s news also brought a Business Week article, “Sweat more, pay less.” It wrote of a new initiative by Principal Financial Group in Des Moines, Iowa (another member of the National Business Group on Health). Employees with the company’s enhanced coverage must submit to screening and those whose scores don’t meet certain criteria must work with a plan-provided ‘health coach’ to improve their scores. “If they don't take the tests, won't work with a coach, or slack off on, say, an assigned exercise regimen, they'll get higher co-pays and deductibles,” the article reported.

Business Week also quoted Sharon Cohen, Watson Wyatt's group and health-care benefits counsel, saying: “The more aggressive the plans become, the greater the chance...for litigation.”

UnitedHealthcare (another member of NBGH) was also reported as trying to launch a more aggressive program. But only two employers have signed up so far.

Yes, despite Mrs. Couric’s glowing news coverage and the intense media marketing proclaiming everyone is happy with these wellness initiatives, the reality appears different.

The article mentioned the newly-released survey conducted by the Employee Benefit Research Institute, whose members include the country’s largest insurers. Interestingly, despite the source, the findings were not favorable towards employers or insurers managing employees’ health and lifestyles. It noted that employee acceptance of wellness programs decrease sharply as plans get more involved with health screenings. Specifically, it found that about two-thirds of employees said “they would be extremely or very comfortable if their employer were to offer lower-cost opportunities for health screenings and programs.” Nearly half surveyed were extremely uncomfortable with programs that sent reminders of checkups, screenings or prescriptions due; and those that offered reduced insurance costs for taking physicals, “even if workers in poorer health or with at-risk behaviors could qualify by agreeing to take steps to manage their illness or lower their health risk.”

The largest numbers agreed that employers offering wellness programs were only concerned about their bottom line and were intruding on worker privacy.