MolaKule
Staff member
quote:
Why wellness is making employees feel sick
Financial Times 02/17/05
author: Patti Waldmeir
(c) 2005 The Financial Times Limited. All rights reserved
Last week the head of General Motors predicted the decline and fall of the American economy, unless companies like his can spend less on healthcare for people like me.
Caring for the workforce in an era of double-digit healthcare inflation is one of the biggest factors hampering the global competitiveness of the US economy, according to Rick Wagoner, chairman and chief executive of GM. Small wonder that so many American companies are getting the "wellness" bug.
According to the latest survey by the Society for Human Resource Management, fully a third of American companies offer smoking cessation programmes for employees, over a quarter provide weight-loss programmes and 11 per cent offer "nutrition therapy". I guess I should be glad I work in an office where the departmental budget for sweets is still fully funded.
But even as I sneak yet another biscuit (or brownie or muffin or gooey treat) from the office manager's desk, it seems obvious that the days of mainlining goodies or indulging other forms of vice that boost the healthcare budget are probably numbered for most of us in the American workforce.
Recently a small Michigan company fired employees who refused to take a test to prove they were non-smokers. The only thing really shocking about that story was that it should have shocked anyone. In America, the freedom to fire is almost absolute: and when profits are threatened by vice, it is not hard to predict which will prevail.
So are there any limits to what US companies can do to their employees in the name of "wellness"? Does American law - so famous for penalising many forms of workplace bias - give free rein to "lifestyle discrimination"? In many ways, it does. America may be the land of the free, but in the workplace, that sometimes means the freedom to discriminate.
If you happen to be female, old, black, handicapped, pregnant, or just possibly a Muslim, you can fight that freedom with a lawsuit: American employment law protects against discrimination by race, sex, age, religion, pregnancy and disability, by all but the smallest employers.
But in most other areas, an employer's freedom of prejudice is very broad and that includes bias against what employees do in what used to be known quaintly as their private lives.
Smokers are protected against job discrimination in more than half the states but sunbathers and skydivers (and anyone else who risks boosting the healthcare budget) most likely are not protected even if they are indulging their vices off the job.
So long as a company cloaks its self-interest in the guise of morality it is probably free to charge higher health insurance premiums for smokers, fat people, or anybody else who could represent high medical bills. The key is to set up a wellness programme aimed at saving errant employees from the ****ation of ill health: if the employer can plausibly claim to be trying to rescue you from disease, the boss is free to use financial penalties to bludgeon you into a healthier lifestyle.
Helen Darling, president of the National Business Group on Health, a coalition of big companies looking for healthcare solutions, says she has no problem with companies charging higher healthcare premiums, at least for smokers. "The only thing that motivates people, unfortunately, is money," she says. "Why should everyone have to pay the price of somebody else's bad choices?"
Opponents counter that smoking is less a choice than an addiction, and that since that particular addiction is more prevalent among certain ethnic groups, penalising smokers could even run foul of civil rights laws that protect black Americans and other ethnic groups where smoking is more common.
But, so far, no such theory has survived in court. And efforts to challenge wellness policies under a whole raft of other federal laws including the Health Insurance Portability and Accountability Act, the Americans with Disabilities Act and federal benefits law are unlikely to succeed except in the most extreme cases, legal experts say.
But the American Civil Liberties Union, which defends civil liberties even in the workplace, says the real issue is not smoking or obesity or any other human failing - the issue is privacy. Why should employers be allowed to know, let alone care, what we do in our private life?
Ms Darling has an answer: something has to give. If healthcare costs keep going up, should companies tell their employees they cannot afford to provide the latest drug treatments for their ailments or should they try to recoup some of the health costs of smoking by surcharging those who light up at home? Put that way, the choice seems obvious.
But Mark Rothstein, director of the Institute for Bioethics, Health Policy and Law of the University of Louisville, says many of these wellness programmes - even the most seemingly innocuous - represent what amounts to a "privacy tax".
He describes the University of Louisville's own programme, which involves a financial incentive for employees who agree to a comprehensive health assessment - including working with a health coach who telephones periodically to check whether you are lifting weights or eating your greens. Professors, he says, can afford to refuse to participate: but what about the janitors? They probably cannot pay the "privacy tax" for refusing to reveal their detailed health profile to a coach who may or may not tattle to their employer.
Rebecca Hastings, of the Society for Human Resource Management, says there is a difference between encouraging wellness and penalising unwellness. "In general it is not a good idea to use punitive measures," she warns, especially in the case of smokers who are already in an "us versus them environment".
As the economy improves, employees are going to be scrutinising such policies carefully, she says. "Companies should look very carefully at the balance between the cost of replacing an employee and the cost of healthcare," she advises. Cutting healthcare costs is not a one-way street.