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Old 12-03-2014, 12:54 PM   #61
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Government Says Bosses Can't Force Workers To Get Health Tests : Shots - Health News : NPR

Above is a link to another lawsuit (third one) filed in October by EEOC against a firm (Honeywell in this case) and their "voluntary" wellness program.

In this case, Honeywell considers program participation "voluntary" but, according to the article, "In the Honeywell wellness program, employees and their spouses are asked to get blood drawn to test their cholesterol, glucose and nicotine use, and also have their body mass index and blood pressure measured. An employee who refuses is subject to a $500 surcharge on health insurance premiums and could lose up to $1,500 in Honeywell contributions to a health savings account. A worker and spouse are also each subject to a $1,000 tobacco surcharge if they refuse to do the screening. That means a couple could face a combined $4,000 in financial penalties."

Is that really voluntary?

In the concluding sentence of the article, "Despite employers' enthusiasm for wellness programs, "there's no good research that shows these programs actually improve health outcomes or lower employer costs," says JoAnn Volk, a senior research fellow at Georgetown University's Center on Health Insurance Reforms." YEP! That is believe.

This still annoys the heck out of me.
Would it make you feel better if they re-framed it so that non-smokers got a $1,000 discount and employees who get certain tests done annually receive up to $1,500 in HSA contributions and a $500 discount on their health insurance premiums?

I have no issue with employers providing incentives for good health choices to share with employees their health care cost savings (real or imagined).
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Old 12-03-2014, 01:37 PM   #62
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Originally Posted by Live Free View Post
In the concluding sentence of the article, "Despite employers' enthusiasm for wellness programs, "there's no good research that shows these programs actually improve health outcomes or lower employer costs," says JoAnn Volk, a senior research fellow at Georgetown University's Center on Health Insurance Reforms." YEP! That is believe.

This still annoys the heck out of me.
Quote:
Amid soaring health spending, there is growing interest in workplace disease prevention and wellness programs to improve health and lower costs. In a critical meta-analysis of the literature on costs and savings associated with such programs, we found that medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent. Although further exploration of the mechanisms at work and broader applicability of the findings is needed, this return on investment suggests that the wider adoption of such programs could prove beneficial for budgets and productivity as well as health outcomes.
  1. Katherine Baicker is a professor of health economics at the School of Public Health, Harvard University, in Boston, Massachusetts.
  2. David Cutler is a professor of economics at Harvard University.
  3. Zirui Song is a doctoral candidate at Harvard Medical School.
Workplace Wellness Programs Can Generate Savings

Anyone can find credible sources/studies to support a POV these days. But that alone doesn't move the ball forward for anyone either.

Employee wellness is but one of many challenges related to health care cost increases.

Healthcare costs are/have been a serious issue for decades, companies have no choice but to try to control all their costs, especially a significant expense like healthcare that has risen disproportionately for decades (based on my career experience). And health care if more expensive in the USA than any other country by a wide margin, making it an even bigger issue for US companies. Unfortunately they'll make some mistakes, but they're being forced to confront expenses from a field (sometimes completely) outside their industry areas of expertise (unless it's a healthcare provider). I can assure you, most companies would love to stay out of employee healthcare issues/costs if only they could. It would be irresponsible for them to do nothing.

Again, you can't complain about the cost of health care and at the same time complain about the company's efforts to fight cost increases.
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Old 12-03-2014, 02:04 PM   #63
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Group health insurance regulation are in CFR 45 part 146. Wellness programs are described in the code. There are a number of examples relating to this topic. Section 146.121 deals with discrimination for health factors

45 CFR 146.121 - Prohibiting discrimination against participants and beneficiaries based on a health factor. | LII / Legal Information Institute

See paragraph (f) for wellness programs

As I read it, they can offer a wellness programs and give discounts for participating. Participating is voluntary. They can not charge you more for a specific health factor ( like cholesterol > 200 ), they are allowed a tobacco surcharge. I don't think they can surcharge you for not participating but then you give up any discounts offered.
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Old 12-04-2014, 08:21 AM   #64
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They cannot charge you more for a specific health factor ( like cholesterol > 200 ), they are allowed a tobacco surcharge. I don't think they can surcharge you for not participating but then you give up any discounts offered.
There are some grey areas here, though. My former employer's plan gave a discount on the health insurance (nearly $1K/year for DH and me) if we accumulated enough points to be classified as "engaged" in the program. I think we needed 12,000 total and at least 3,000 had to come from DH. At one point I was offered 800 points if I got my total cholesterol below 200. (It's borderline high but my "good cholesterol" is very high and overall I eat healthy and exercise a lot). About the only way to reduce it would have been statins- which I tried before and they gave me tendonitis. (I do use fish oil supplements and CardioTabs.) Others who were overweight were offered mega-points for losing weight. There are other ways to get points: the blood work, exercise, taking on-line courses, etc.

Still, couldn't someone who would have been "engaged" with the extra points for lowering cholesterol or losing weight claim that they were surcharged for high cholesterol or being overweight?
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Old 12-04-2014, 09:30 AM   #65
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I don't need or want a nanny looking over me. I don't care if it is the government or a company that is forced to take its place. I never participated in the enticements offered by my company. I always felt the company having access to that information could only come to no good.
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Old 12-04-2014, 12:20 PM   #66
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I agree that individual responsibility/accountability is important, but I don't see this issue as a company looking over anyone (though it is in the company's best interest to retain good employees and they construct certain enticements to do so).

I see it more as a company controlling its healthcare costs by sharing good experience and passing on bad experience. Let's use smoking as an example, if an employee smokes then the company's health care costs will likely be higher and they pass that on to the employee causing it through a surcharge. Conversely, if an employee agrees to regular health screening, it is likely that the company's healthcare costs will be lower and it passes on some of those savings to the employees whose behavior contribute to the savings in the form of lower premiums or better benefits.
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Old 12-04-2014, 12:33 PM   #67
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I wouldn't care about anyone else's 'wellness activities' either if we didn't have a system that subsidizes bad (health) behavior, and costs of healthcare in the US weren't completely out of line with other countries.

While there are definitely health risks beyond anyone's control, the costs associated with preventable health issues are substantial, among the highest incidence/costs health issues. Making a non-smoker subsidize the healthcare expenses of a smoker is but one. And the causes and solutions have been well known for decades.

Heart disease
Threat level: High

Why care:
As the leading cause of death in the United States, diseases of the heart take the lives of over 300,000 American men on an annual basis — that’s almost one death every minute and a half. Now, although “heart disease” is somewhat of an umbrella term, most prevention tactics apply equally across the individual diseases of the heart.
Things to avoid

• Smoking
• Alcohol (no more than two drinks per day)
• Fatty foods, specifically foods high in trans fats (beef, cheese, milk) or saturated fats (deep-fried foods, bakery goods)
• The couch
• Beer belly
• Stress
Things not to avoid
• Physical activity (at least 30 to 60 minutes of moderate physical activity on most days of the week)
• Fruits and vegetables
• Omega-3 fatty acids (fish, flaxseed oil, walnut oil)
• Regular health checkups (blood pressure and cholesterol)

Lung cancer Threat level: High

Why care: Right behind heart disease on the male mortality charts is cancer, causing upward of 290,000 deaths a year in men. While not all cancers are preventable, lung cancer — the leading cause of death among the cancers in men — is certainly one of the most preventable.
Things to avoid
• Smoking (the sooner you stop the better)
• Secondhand smoke
• Alcohol (no more than two drinks per day)
• Workplace carcinogens
• Household asbestos and radon (both may be a problem in your home; if unsure, have your home inspected)
• Air pollution (ever consider moving?)
Things not to avoid
• Physical activity (at least 30 to 60 minutes of moderate physical activity on most days of the week)
• Fruits and vegetables

Type 2 diabetes
Threat level: Moderate
Why care:
Although not the biggest killer in men, diabetes is still one of the leading causes of morbidity (disability of morbidity). In fact, diabetes is being called an epidemic in the United States. Why? Well, there are an estimated 23.6 million people currently living with diabetes in the States — that’s 8% of the entire population. Yep, 1 in 13 people have diabetes — right now — 90% of whom have type 2 diabetes. Thankfully, type 2 diabetes can be prevented.
Things to avoid
• The couch
• Beer belly
Things not to avoid
• A well-balanced diet
• Fruits and vegetables
• Physical activity (at least 30 to 60 minutes of moderate physical activity on most days of the week)
• Testing for diabetes or pre-diabetes (particularly if there is a family history of diabetes)

Chronic liver disease (including cirrhosis) Threat level: Low
Why care: Chronic liver diseases and cirrhosis cause upward of 27,000 deaths in the United States, with the majority of these deaths being in men. Although this number has steadily decreased over the past few decades, there is still room for improvement considering that many causes of liver disease — alcoholism and infection with Hepatitis A or B — are preventable.
Things to avoid
• Alcohol (no more than two drinks per day)
• Binge drinking
• Unsafe alcohols (home-brewed or unlabeled)
• Beer belly
• Unprotected sex (Hep B)
• Needle sharing (Hep B)
• Sharing of other personal items such as razors or nail clippers with an infected person (Hep B)
• Raw or uncooked shellfish (Hep A)
• Excessive medication including combining certain meds (be aware of drug interactions)
Things not to avoid
• Immunizations for Hep A, particularly when traveling abroad
• Immunizations for Hep B
• Safe sex
• Proper food preparation (Hep A)
• Proper sanitation, particularly of infant diaper-changing tables and food preparation areas (Hep A)
• Hand washing before eating (Hep A)
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Old 12-04-2014, 12:38 PM   #68
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I agree that individual responsibility/accountability is important, but I don't see this issue as a company looking over anyone (though it is in the company's best interest to retain good employees and they construct certain enticements to do so).

I see it more as a company controlling its healthcare costs by sharing good experience and passing on bad experience. Let's use smoking as an example, if an employee smokes then the company's health care costs will likely be higher and they pass that on to the employee causing it through a surcharge. Conversely, if an employee agrees to regular health screening, it is likely that the company's healthcare costs will be lower and it passes on some of those savings to the employees whose behavior contribute to the savings in the form of lower premiums or better benefits.
I think your whole argument would go out the window if companies and the government would get out of the health care business. I'm quite sure the price of health care would also plummet. I have no issue with the government providing health care for those that cannot afford it, but providing it to everyone and then saying they have to make everyone stay in the best health to keep the costs down sure sounds like a nanny state to me.
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Old 12-04-2014, 12:52 PM   #69
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I see more and more potential for erosion of privacy and more 'control' put into entities that have no altruistic motive for a person's well being - just the bottom line.


No sir, I don't like it at all.
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Old 12-04-2014, 01:41 PM   #70
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I see it more as a company controlling
The End
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Old 12-04-2014, 01:44 PM   #71
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I think your whole argument would go out the window if companies and the government would get out of the health care business. I'm quite sure the price of health care would also plummet. I have no issue with the government providing health care for those that cannot afford it, but providing it to everyone and then saying they have to make everyone stay in the best health to keep the costs down sure sounds like a nanny state to me.
I agree with you that I would like to see health insurance divorced from employment. It was a bad idea to begin with that was the unintended consequence of governmental interference in wages and now that people change employers more it is worse.

I don't believe that anyone is saying that everyone has to stay in the best health, but what they are saying is that those who practice good health habits will get discounts and have lower healthcare costs and that those who neglect their health or just don't give a care will not get discounts so their costs will be higher. It isn't nanny state at all... it is simply a mechanism to assign personal responsibility... if someone practices bad health habits then their costs will be higher and it they have good health practices their costs will be lower because they will be given discounts to reflect the lower cost of providing insurance for healthy people. I see nothing wrong with that and those who believe in personal responsibility shouldn't either.
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Old 12-04-2014, 01:51 PM   #72
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I see more and more potential for erosion of privacy and more 'control' put into entities that have no altruistic motive for a person's well being - just the bottom line.


No sir, I don't like it at all.
Their interest in employee well being is self serving, not altruistic and they would admit to that. Employee illnesses result in less productivity, higher costs and lower profits.

Do/did you manage people? And if you did. you didn't give a rat's a$$ about their health? I managed people and cared about their health not only because of our personal relationships but also because of the disruption caused by their being out of work.
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Old 12-04-2014, 02:27 PM   #73
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I see a dangerous slope here because it won't be about rewarding 'healthy choices' it will be about penalizing lifestyle choices which are 'deemed by the powers that be' (aka the health care ins cos) to be poor choices compared to others.


What next? Genetic testing? Cost impacts on who you have relationships with or marry?


Implants to monitor your activities and diet with points deducted or rewarded for bad/good behavior?


No sir, I don't like the future of health care given these precedents.
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Old 12-04-2014, 04:01 PM   #74
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Make sure not to forget to wear your tin foil hat.

I think they will focus on incentives and disincentives for things that people can control and are likely to change healthcare costs. If you marry a smoker, then yes, you will pay more.
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Old 12-04-2014, 04:30 PM   #75
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Again, I can assure you 'companies' would LOVE to stay out of employee health care, they can't. And if it was simply profit/greed, why would they knowingly bother with the self-inflicted controversy of wellness programs and incentives? If profit was the only motive, it would be a heckuva lot easier to just pass costs and/or reduce benefits to all employees.

I watched HC expenses go up way more than CPI for decades when I was working. And many employees complained bitterly when they're health care contributions increased some years (their contributions never exceeded 17% of total health care costs. We were self-insured and insured during my years in management so I've seen both cases. And it wasn't unusual for the contribution complainers to be among the first to complain about any wellness or other initiatives no matter how benign. You can't have it both ways.

If you don't want company wellness or a nanny state, knowing we already pay double the average for all other developed countries - what would you suggest, the very costly status quo?
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Old 12-04-2014, 11:20 PM   #76
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Their interest in employee well being is self serving, not altruistic and they would admit to that. Employee illnesses result in less productivity, higher costs and lower profits.
Yup-It makes for good talking points, good PR, and nice slogans for the posters on the walls. Yet, survey after survey, the largest employee dissatisfaction at MegaCorp dealt with work/family life balance. We could have re-written the manual to say:

'the company is willing to spend $300 extra in incentives if you complete the survey and talk to the the phone nurse (last week selling timeshares, this week promoting exercise and flu shots...). Oh, and by the way, we're going to need you to be in here Saturday. And the flights are scheduled for Sunday to run out to BF Egypt for a couple weeks. I know it's stressful, but we should be over this hump in a couple months...'

For the most part, I had good bosses. But the production date was set, and we did what it took to make the schedule. And we were paid well to make it happen.

I suspect that the corporate support of wellness programs is similar to individuals commitment to living a more healthy lifestyle. Easy to say, not too difficult to pay the membership fee to a fitness center, very difficult to actually go there and exercise on a routine basis.
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Old 12-04-2014, 11:24 PM   #77
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Stop wining and welcome to the real world grasshopper. If you don't like it then don't let the door hit you in the a_ _ on your way out.
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Old 12-05-2014, 08:42 AM   #78
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What accommodation is made, if any, or what price increase is imposed for people with disabilities that cannot participate in wellness programs and, through no fault of their own, cannot control certain aspects of their health profiles? Don't let the door hit ya? Do children with asthma have to prove worthiness? I think it is nuts. Just like crowding the most needy of healthcare out of the insurance pool doesn't make sense.
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Old 12-05-2014, 08:52 AM   #79
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What accommodation is made, if any, or what price increase is imposed for people with disabilities that cannot participate in wellness programs and, through no fault of their own, cannot control certain aspects of their health profiles? Don't let the door hit ya? Do children with asthma have to prove worthiness? I think it is nuts. Just like crowding the most needy of healthcare out of the insurance pool doesn't make sense.
Do you have an example of any company that has implemented a wellness program based on health metrics that are clearly beyond the control of employees, you mention disabilities for example? The ones I've seen or read about focused on well known lifestyle choices (smoking, excessive alcohol, illegal drugs, poor diet, inactivity, unprotected sex, etc.) that influence preventable diseases, all thoroughly documented relationships.

It's interesting how debates form using exceptions, extremes and hypotheticals as central factors are given credibility, not only in healthcare but so many other realms.
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Old 12-05-2014, 09:04 AM   #80
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Do you have an example of any company that has implemented a wellness program based on health metrics that are clearly beyond the control of employees. The ones I've seen or read about focused on well known lifestyle choices that influenced preventable diseases, all thoroughly documented relationships.
I was asking a question. How could I supply my own answer? Actually two questions - how disabilities are accommodated (think can't exercise, type I diabetes, genetic disorders that affect blood chemistries, or, for family plans try prader willi).

How are disability related health potential costs handled?
How are children monitored to assure compliance in family plans where costs are shifted from one family to another?

If this doesn't happen, then that is the answer to the question.
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