Keep your wellness off my waist

By Denis Storey


There are certain maxims in the benefits business, such as:
  • Payroll deduction increases enrollment;
  • Emergency rooms are expensive—and bad;
  • Trade shows have open bars (or should);
  • And wellness programs save everyone money.
Well, it looks like we might have to strike that last one. The latest issue of Health Affairs dropped this week with what appears to be the results of one of the most exhaustive studies of workplace wellness programs we have on record. It was even big enough news to make the Associated Press.

Anyway, researchers followed the employees at a St. Louis hospital for two years, and while hospitalizations overall for those covered fell pretty dramatically—a little more than 40 percent over a range of conditions—higher outpatient costs wiped those savings out.

This runs contrary to not only popular belief, but a number of other studies, as well. Wellness programs on the whole, we’ve always been told, cut utilization, the very heart of what drives premiums. Everyone is jumping on board these plans, which attack things we know for a fact lead to higher health insurance costs, such as smoking, lack of exercise and bad diets.

Wellness plans are even included in the Patient Protection and Affordable Care Act.

But maybe that’s part of the backlash we’re seeing against these so-called “nanny provisions.” Few people would argue that soft drinks don’t contribute to poorer health. But look at the blowback Mayor Michael Bloomberg’s received from his drink ban in New York City. Granted, his particular proposal misses the mark, but I think he’s got the right idea. (I just would have made it a tax.) But on the flip side, does anyone still complain about how hard it is to find a place to smoke in the Big Apple?

(Now that I mention it, maybe this particular pushback is simply about obesity, which has become as American as the apple pie that got us here. Somehow it’s a protected social status. Alcoholism might be a disease—for which we punish the offenders, but obesity isn’t just a choice. It’s our God-given right.)

I don’t know. The contradiction bugs me. As a society we hate to be told what to do. But we don’t want to pay for someone else’s mistakes—or reckless lifestyle—either. So just what the hell are we supposed to do?

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