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Health in the Workplace: Bribes and Blackmail
By Rita Rubin | USAToday
July 21, 2008
Does your employer or insurance company offer bribes or threaten blackmail if you don’t lose weight, stop smoking or take other steps to improve your health?
An article (sorry, but unless you’re a subscriber, you have to pay to read beyond the first 150 words of the piece) in today’s New England Journal of Medicine examines how far employers and insurers can go before their efforts violate state and federal laws against discrimination.
I believe smokers at USA TODAY, as at many companies, have to pay a surcharge for health insurance. Other examples cited by the article, written by Michelle Mello and Meredith Rosenthal from the Harvard School of Public Health:
•FedEx pays $50 to employees with diabetes who participate in its disease management program and get a particular blood test and eye exam.
•Scotts Miracle-Gro fired an employee whose drug test detected tobacco use.
•Blue Cross/Blue Shield of Michigan created an HMO and a preferred provider organization, or PPO, that give employees discounts of up to 20% on copayments and employers and employees discounts on premiums if employees agree to “adopt a healthy lifestyle,” complete a health-risk appraisal questionnaire and have their doctor verify every year that they’re sticking with their healthy lifestyle plan.
In 2007, nearly 40% of employers said they’d start paying employees for “health-enhancing behaviors” in the next two or three years, and 40% said they supported higher premiums for obese people who wouldn’t participate in weight-management programs.
How far can they go? Health plans that sponsor wellness programs can only pay you to participate, not to achieve a particular goal, the authors write. In other words, they can pay you to join a weight-loss program at work, but they can’t penalize you if you don’t lose a certain amount of weight.
Do these incentives work over the long haul? Do they save employers and employees money? No one yet knows for sure, the authors write. There is some evidence that penalities are bigger incentives than rewards, though. Instead of offering co-pay and premium discounts to employees who get with the program, companies should add surcharges for employees who don’t, according to the authors.
What do you think? Does your employer pay or penalize you for getting and staying healthy? What kind of incentives have you encountered? Do you find them helpful?
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