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Your Take: Company “Wellness” Too Invasive?

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The first company I worked for had a dedicated department, of maybe two or three employees, focused entirely on “employee wellness.” They offered services like body fat analysis but didn’t go as far as this company in requiring them. Personally, I think the motivations are good but I can see how people would think that’s invasive.

My company didn’t require you to participate in their programs but they did provide incentives for doing so. The medical insurance provider was called Lumenos and they offered a program in which you were given $1,500 a year to cover your medical costs. If you didn’t use the funds, it was rolled over into the next year. If you did and your costs exceeded $1,500, you covered the costs up to $2,000 (an additional $500), and then traditional health insurance would kick in (10% co-pays, etc.) beyond $2,000. It worked fantastically well for young professionals who, in general, have little in the way of medical costs. They incentivized participation in wellness programs by offering medical coverage money. Fill out a health survey and get $20. Participate in this program, get $25. It wasn’t required, you didn’t really get “paid,” but it boosted participation and got people thinking about wellness.

I think requiring it would’ve caused a backlash.

Either way, wellness programs are boosting the bottom lines at businesses by cutting medical costs. Everyone knows preventative care is cheaper than treating illnesses or conditions on the other end, everyone including prescription drug and treatment companies (fire away!). This was the topic of a Marketplace segment a couple weeks ago and they found that at Gilsbar, costs are lowered when you introduce preventative care measures. Here’s a quote from the segment:

Doug Layman (executive VP at Gilsbar): Our health plan costs are 6 percent lower than they were five years ago. Our prescription drug costs, which everybody complains about, is 45 percent lower than they were five years ago. And 85 percent say their benefits package is better today than it was five years ago. Yet we’re paying less, and we have happier, more productive people.

That’s one of the reasons why countries with nationally subsidized health care programs pay far less than we do – preventing something is cheaper than curing something. It’s a big joke that Americans pay the most for health care yet don’t find themselves with the best care (in fairness, I’ve heard the argument against that is that our best of the best is far superior to other countries but the “average” care received any one member of the population is below other countries).

Getting back to the wellness programs, does your company offer something like this? If so, do they require anything or is everything optional? What would you think about being forced to do a body fat analysis? What if you had to pay more based on the status of your health?

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7 Responses to “Your Take: Company “Wellness” Too Invasive?”

  1. Brandon says:

    Our company has a wellness department, but pretty much everything is optional. Last year, they were giving a small credit equal to about 15% of the health insurance premium if you regularly filled out a “health assessment” which was basically just a questionnaire on your health and habits. Sadly, they fazed that out this year.

  2. My company uses Cigna for its health insurance and gives some very strong incentives to a) cease tobacco use ($12/month savings) and b) have an annual physical with blood work ($50/month savings). Those numbers double for married couples. The tobacco use is verified through the physical and you also have to sign a form swearing that you haven’t used tobacco products for the previous 12 months.

    Result? 80% participation in the tobacco program and 100% in the physical. We have 1,250 people at my company and I’ve heard stories of people getting physicals for the first time in 20 years. They’ve detected early stages of cancer, diabetes, heart disease, and other ailments and have been able to intervene early to start the fight against the problems NOW.

    I think it’s been a fantastic success. But a body fat analysis? Required? I don’t think I’d want HR knowing my numbers on that!

  3. Dave says:

    My wifes company does this, and she participates. Couple of bucks here and there as a rebate/return for taking surveys and health tests. Given that she is insurance, she explained a few things. First, she said that it needed to be rebates because doing it the other way (charging more for -not- taking advantage of survey or test) could be illegal and discriminatory. So by charging everyone the same but giving money back later its abit safer. At the same time, you also dont have to worry about waste on the side of the participant. Say a company gives 30 a month for gym membership. Well if you take the money, sign up, but never go – all that money is wasted. Rebating prevents that waste.

  4. At the last company I worked for, we saved $20/mo. for not smoking, but that was just about it. I’m pretty libertarian when it comes to these things, so the idea of body fat analysis being required seems pretty Orwellian. But I’m all about incentivizing people to make good choices. I could use to stand a few pounds. Maybe some cash would get me moving!

  5. CK says:

    I think these programs are great. If you think they stink then don’t work for a company that uses them.

  6. Jim says:

    My company is pretty big on wellness lately. Its not what I’d consider invasive and everything is optional. But I see so many internal messages and newsletter type items on health and weight that it is bordering on obnoxious at times. Its almost like they are nagging me to go on a diet or something. I understand the benefit to it of course but the way they’ve been doing it leaves something to be desired in the way the messages are delivered.

    Jim

  7. kitty says:

    We have a couple of rebates – one for exercising and another is preventive care. Thankfully, both are optional. I take the first one but I refuse the other one out of principle: I believe that which tests I take and what my cholesterol level is is between me and my doctor. I belive we have a right to a) refuse medication b) decide which tests we want or not. Moreover, there is ZERO(!!!) evidence – I challenge anybody to find any – that any measure other than non-smoking and not being morbidly obese saves healthcare costs. With some measures – there is evidence to the contrary. Incidentally, what will prevent the company to select an employee with some risk factors e.g. high cholesterol (most often genetic) for the next layoff? What else can a blood test reveal? Some genetic desease? Do you want your employee to know this?

    You claim in your post that”it is obvious that prevention saves money. Unfortunately real evidence from real peer-reviewed medical journal says otherwise. This is the article from New England Journal of Medicine: http://content.nejm.org/cgi/content/full/358/7/661 where they actually looked at health care costs and prevention. Unlike politicians or company policy-makers, the authors of this paper actually looked at real evidence. Their conclusion – some preventive measures save money, others are very expensive. See for yourself.

    How can prevention not save money? In order to understand it, you need to understand two concepts in epidemiology – Number Needed to Treat (NNT) and Number Needed to Screen (NNS). This will explain to you why it is not at all obvious to most doctors and epidemiologists that preventive care saves money. This is wiki page on NNT: http://en.wikipedia.org/wiki/Number_needed_to_treat
    I strongly suggest that you learn it. You see, yes preventing an illness in one person is cheaper than treating it in that person, but it is often the case that in order to prevent illness in one you need to treat or test hundreds, even thousands for many years. And this is far from cheap.

    There are also unintended consequences, like someone who over-exercises may have higher rate of injuries, or someone who goes on prescription drugs because of the blood test that this company requires having side effects.

    from the referenced article “… It also conducts annual blood, vision and hearing tests.”
    An yearly blood test for everyone isn’t even recommended by USPSTF, and neither is annual physical:(http://findarticles.com/p/articles/mi_m0815/is_7_30/ai_n14858621. Why are company bureacrats more qualified than USPSTF – an organization that includes a number of experts in the field actually qualified to look at the evidence? If there is no evidence that benefits of a test even outweight the risks, how can it save money?

    One other problem with company requiring tests, any tests, is that contrary to popular belief tests aren’t risk-free. None of the tests is perfect, so there are false positives. In some cases – many false positives. After 10 years of yearly tests the risk of having at least one false positive may be very high. An example: if the risk of a false positive after a test is 10%, the risk of having at least one false positives in 10 years is around 75%. False positives aren’t harmless. Aside from anxiety, they lead to more invasive tests. These invasive tests may have real and serious risks of pain, long-term effects, even death. As one cardiologist friend told me – “nobody dies of a stress test, but stress test has false positives, false positives are evaluated with cardio catheterization that has 1/1000 risk of stroke”. This is just one example. Then there are CT scans and radiation. While these risks are usually small, when you start testing a large number of symptomless people, the probability of benefit is very small as well. And if you talk about cost – how is testing a thousand, even tens of thousands of people, evaluating numerous false positives to prevent one case of serious desease saves money? Then there is an issue of “overdiagnosis and overtreatment”, but you can look it up yourself. Google for it. It is really fascinating. Do you know that with some deseases more screened people are diagnosed than non-screened? Do you know the effect screening programs have on incidence of a desease? Look it up. How would having more people treated for a desease than without a test save money?

    Mind you, I am not telling you shouldn’t have test. Some tests may indeed save your life. But you and your doctor should be the ones to decide if a test makes sense for you based on recommendations, your age, risk factors, and your personal preference. Not your employer.


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