Affordable Care Act / Constitution / Economy / Healthcare / Labor Force / Politics / Regulation

The Problem With Wellness Initiatives

In an attempt to decrease health care costs, wellness initiatives have become increasingly popular programs offered by corporations. Health and wellness is an extremely important issue and when it comes to health care reform there should to be a larger personal responsibility component. Unhealthy lifestyles, such as inactivity, poor nutrition, tobacco use, and excessive alcohol consumption, increase one’s rate of chronic disease, such as diabetes, heart disease, and chronic pulmonary conditions. These chronic and preventable conditions can lead to premature death, disability, and increased health care costs. If Americans are healthier then health care costs could be curtailed. If Americans are healthier, then health care costs could be curtailed. Luckily, achieving a healthier population is a reasonable aspiration because many of the Americans receiving costly medical treatment have preventable conditions.

Individuals, not their employers, should take more measures to improve health. Employers should have little to no role in improving employee health. Wellness initiatives’ ability to lower health care costs in the short term is unproven. Initiatives are more likely to be a violation of privacy, confidentiality and anti-discrimination laws. Just because improving employee health is a laudable goal, it does not necessarily mean the way in which many employers pursue this goal is equally laudable. In some cases wellness initiatives are mandatory and have the potential to cause more problems than they solve – just ask the Scotts Company. Although the company received a favorable ruling in court, the case took two years to resolve and the company’s decision to ban employees from smoking on and off the job was subjected to public scrutiny. The Scotts Company’s decision to test for nicotine and treat smoking like illegal drug use sets a dangerous precedent, one that extends far too deeply into the private lives of employees. If smoking bans reduce health care expenses, cost-conscious employers might be tempted to justify even more intrusive policies under the guise of a wellness program. If employers make it a policy to reject or fire employees who engage in risky but legal behaviors on their own time nonetheless, where will employers draw the line? What about overeating or drinking too much alcohol? An extreme example this precedent allows for is private businesses hiring based on genetics. In that case, genetic predisposition to a costly disease could be grounds for termination.

Voluntary wellness initiatives are subject to scrutiny too. According to one report based on a survey of health and wellness managers from 378 organizations, 86 percent of employees fail to participate in voluntary wellness initiatives offered by their employers. The RAND institute studied the effectiveness of wellness initiatives and found mixed results. According to RAND, in instances where initiatives are voluntary, only the most motivated employees participate. And even then, RAND found the employees who did participate spent on average $2.38 less per month on healthcare than non-participants in the first year of the initiative and $3.46 less in the fifth year. According to RAND, these savings are not statistically significant and could have been due to chance, not the initiative.

Whether or not wellness initiatives are effective matters because this year, the ACA will allow employers to reward employees that participate in workplace wellness initiatives with subsidies equal to 30 percent of the cost of insurance premiums or about $1,620 annually per worker. If wellness initiatives do not reduce healthcare spending (as the evidence suggests), some employees could suffer financially.

Providing financial incentives to corporations that sponsor company-wide wellness initiatives is misguided, especially considering the lack of hard evidence supporting their cost effectiveness. A better solution would be to institute conservative, minimally intrusive and inexpensive changes to the work environment that are proven to have a positive impact on employees’ health. For example Dow Chemicals promotes employee health by providing healthier food choices in their cafeteria, making walking paths outside the building and encouraging employees to use the stairs instead of the elevator. Although many employers are private businesses, meddling with employees’ health beyond the aforementioned ways would be inappropriate.

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