One of the many curious features of Obamacare was an incentive to get employees to participate in corporate wellness programs. The incentives could be enormous, amounting to 50 percent of monthly premiums, according to an article by Sharon Begley. Some workers could pay half of what other workers paid just for filling out health questionnaires, participating in medical screening, weight loss programs, and the like.
But now the U.S. Equal Employment Opportunity Commission is suing several employers for violating the Americans with Disabilities Act. Begley quotes an employment law attorney as saying, “You can’t make medical inquiries unless it’s consistent with job-necessity, or part of a voluntary wellness program.” The “incentives” in Obamacare are so punitive that participating in these programs is no longer “voluntary” but coerced, he argues.
The Business Roundtable is, of course, furious. They supported Obamacare and now are threatened with damages simply for complying with the law they supported.
Corporate Wellness Programs Are Bunk
I’m tempted to say something about chickens coming home to roost, but that ain’t the half of it. The really funny part is, the evidence is mounting that corporate wellness programs don’t work. They don’t save money and they don’t improve health. A study recently published in Health Affairs concludes, “there is no clinical evidence to support the conclusion that three pillars of workplace wellness—annual workplace screenings and/or annual checkups for all employees (and sometimes spouses), and incentivized weight loss—are cost-effective.” The study by Al Lewis, Vik Khanna, and Shana Montrose says the information that got the wellness incentive included in Obamacare has since been discredited and that more reliable studies actually show a negative return on investment.
Another article by Michelle Andrews in Kaiser Health News cites another researcher: “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.”
Even so, corporate CEOs remain blindly enthusiastic about wellness programs. I don’t know what it is about health care that seems to turn smart people dumb. The notion that these programs were a waste of money has been obvious for a very long time.
The Universal Desire to Control Other People
It might also be just the universal desire to control other people. I once had a meeting with the medical director of a Fortune 100 company. He was bemoaning that he couldn’t follow employees home to make sure they used their weed whackers properly on the weekend. I pointed out to him that he isn’t running a plantation. He doesn’t own his employees, and that the cost of replacing exasperated workers would be higher than anything saved by his meddling in their lives.
Wellness, like prevention, can work well when targeted at a high-risk population, but the cost of applying such provisions to the general public outweighs any possible savings. By definition, people who are active at work are healthier than the general population. The people who are most likely to participate in these programs are the very people who are already healthy and health-conscious. They don’t cost much to insure because they don’t file many claims, and they are unlikely to improve their health status because they are already healthy. Plus, reward programs can be easily manipulated: crash diet right before a weight loss weigh-in, and pig out the rest of the time.
I’m afraid “wellness” is nothing but a shibboleth human resources directors offer when the CFO demands to know what they are doing to reduce health care expenses.