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Health and Wellness
Nanny Employers Are Here

Kaiser Health News has an interesting report out on the rise of ‘voluntary’ wellness programs across the country—programs which fine or reward employees based on whether they participate in regimens designed to make them healthier (and thus cheaper to insure). Employers have started to institute these penalties and the Equal Employment Opportunity Commission has responded by floating a rule to govern these programs:

Under the proposal, wellness programs would be considered voluntary so long as the employer rewards or penalizes an employee no more than 30 percent of the cost of health insurance for a single worker. Since the average cost for such coverage is $6,025 a year, the 30 percent limit would be about $1,800.

Employers cannot fire workers for declining to participate nor can they deny them coverage, the proposal says.  They also must give workers a notice explaining what medical information will be obtained by the wellness administrator — often a private contractor — and how that might be used.

Some people, however, are already raising warning flags:

The equation tilts too far against workerswhen … employers can charge you a couple thousand dollars more for refusing to give private medical information, [that] doesn’t sound very voluntary to me,” said Samuel Bagenstos, a University of Michigan Law School professor.

It makes sense for insurers to manage their risk pools by incentivizing healthier behaviors directly. Charging people who present health risks and don’t take steps to lower those risks—by quitting smoking or losing weight or what have you—is part and parcel of what insurance is all about: matching premiums to risk factors.

But doing it through the employer-employee relationship adds a further, more insidious level of coercion into the process. Employers already have a good deal of control and leverage over the lives of their employees; giving them more power to dictate behavior (as Bagenstos points out, a penalty complicates any claim to this being ‘voluntary’) is not sound policy. No matter how caveated it all is in the statutes—workers can’t be fired, denied coverage—this is precisely the kind of arrangement that could lead to all sorts of unintended consequences.

And indeed, we should be trying to move the whole system in the opposite direction. Employer-provided health care benefits are one of those zombie artifacts of an era where lifetime employment with a single company was very much the norm—an era which is quickly receding into the past. It’s time to make a serious effort to delink health care and other benefits from employment. The sooner, the better.

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  • FriendlyGoat

    Sure, delink health care from employment with national health care for all. But if you REALLY think that millions and millions and millions of employees want off of their group plans for the opportunity to buy individual insurance, you have completely lost touch with reality.

    As for the wellness programs, the sooner the government puts limits on this game, the better. Many employers have discovered that they spend more on wellness plans than they gain in savings from any employees participating in them. So what they really want now is a green light to impose big penalties on those who refuse to join, because the penalties can be more significant savings than any from so-called wellness.

    • qet

      FG, I believe you are being totally unrealistic. As payment for health care moves completely onto the government, which it is and which I believe from your prior posts you wholeheartedly support, more and more mandatory requirements as to “wellness” maintenance will be imposed top-down, by HHS or whatever agency is in charge of writing the regulations. The argument will be that your failure to be able to run at least 2 miles in under X minutes, or your weight of Y, or your penchant for cookie-dough ice cream, increase everyone’s health care costs, therefore, since the public is paying for your health care, you owe it to the public to change your habits. The concept of “none of the boss’s (i.e., the government’s) business” will simply disappear. So it will keep happening with employers, too, and far from limiting it, the government will encourage it, now that GovCare has been completely upheld and thus the insurance companies are now de facto departments of the government.

      • FriendlyGoat

        I can’t really see the Dems enacting your scenario of mandatory wellness requirements as a condition of participating in health plans. I CAN see the Dems being a bit like a nanny with respect to our habits, nagging us here and there—which is actually a fine idea,

        • qet

          When you say “Dems,” I presume you mean Congresspersons and POTI. And I agree. Such things are what they expect bureaucrats to take care of. But if you are saying that you can’t see bureaucrats enacting mandatory requirements, then you’re not the goat I take you for.

      • CapitalHawk

        qet, you don’t seem to understand FG’s view of the world. Businesses making its employees do things is double plus ungood. Government making everyone in the whole country do things is super fantastic. Simple.

  • fastrackn1

    “Employer-provided health care benefits are one of those zombie artifacts of an era where lifetime employment with a single company was very much the norm—an era which is quickly receding into the past. It’s time to make a serious effort to delink health care and other benefits from employment. The sooner, the better.”

    I couldn’t have said it better myself….

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