An increasing number of U.S. companies are ratcheting up their employee wellness programs in order to reduce their cost of health care coverage and payout in employee sick days (thus, of course, increasing their profit for shareholders and executive salaries). They call these wellness programs by all sorts of cute names like Healthy Journey, Move It Program, and Health Counts. They entice employees with rewards programs including cash ‘refunds’ and free membership to health clubs, weight-loss, and smoking cessation classes. Their advertising materials are sprinkled with fairy dust photographs of smiling, fit people munching apples and carrots and bowls of granola. What’s not to love? Wellness is a good thing that everyone wants, right?
This week I received a welcome letter from my medical insurance company, thanking me for continuing with them in 2014, and encouraging me to participate in their wellness program. The letter included a two page ‘notice of privacy’ about how they supposedly protect (and can use under all sorts of ‘exceptions’) my medical information. It has a reading level of post-graduate school, but at least it does have a clearly marked section ‘For questions or complaints’ with a (non-toll-free) phone number to call.
On the wellness program informational brochure they sent me there’s a chart ‘how to earn points and rewards’ that resembles those annoying frequent flyer ‘miles’ offers. They list eight of their top point-earning activities, including diabetes prevention and smoking cessation classes. At the top of their list is an online ‘General Health Assessment’ which they say takes 15 minutes, completion of which qualifies me for a $30 gift card. Beside the chart is a photograph of a bearded, smiling, white coat and black stethoscope wearing Marcus Welby, MD look-alike, inviting me to sit down and tell him all about my health problems. Who can resist?
OK, yes, those pesky ‘accurate, reliable, error-free’ things are too much to ask of a medical insurance company, right? Their GHA begins with the profound question, “Are you living your life to the fullest?” The correct answer happens to be ‘No, not if you are bothering to take this silly test.”
To begin with, their ‘gender-specific health’ questions are woefully out-of-date, sticking with the annual pap smear no matter what your HPV status or age, as well as the out-of-date annual mammogram ‘requirement.’ But then I got to the nutrition section and my (normally low) blood pressure really went up. Here is their first nutrition question: “How often do you eat at least six servings of bread, cereal, rice, or pasta?” Choices are: “1) Daily, 2) Several times a week, 3) Few times a month, 4) rarely.” Their fitness and well-being (as in anxiety and depression) questions, were equally imbecilic. I made it through the silly questionnaire, scored a 100/100, but was told I needed to stop eating a high fat diet (I don’t–I was munching on kale at the time) and I need to follow current guidelines on preventive health screens like for mammograms.
Shouldn’t employee wellness programs be required to at least follow accurate, up-to-date medical information and guidelines? Otherwise it seems they do more harm than good. The federal government, as a part of ACA/Obamacare, stepped in this year to issue guidelines for “Incentives for Nondisciminatory Wellness Programs.” (Because besides being inaccurate, many wellness programs are also discriminatory, coercive, etc. See my previous blog post Corporate Employee Wellness Wants You from 10-29-13, as well as links to resources below). Their new guidelines go into effect January 1, 2014.
Reading through the Federal Register on these guidelines I see that people did raise the same questions I have about following national guidelines for screening and prevention. But they decided to stick with the vague ‘reasonable design’ clause and only: “…require that health-contingent wellness programs be reasonably designed to promote health or prevent disease…” The successful argument against requiring evidence-based clinical guidelines and national standards is the oh so American excuse that it would “inhibit innovation.” Inhibit innovation of poorly constructed, out-of-date, misleading, inaccurate, thoroughly frustrating ‘wellness’ screenings and interventions? I will be avoiding all wellness programs in the New Year.
- “Your Company Wants to Make You Healthy” by Jen Wieczner, Wall Street Journal, April 8, 2013.
- “Union Official Debunks Workplace Wellness Programs” by Joe Sparks, The National Press Club, December 18, 2013.
- “Workplace Wellness Program Study Final Report” by Soeren Mattke, et al., RAND Corporation, August 2013.
- “Rules Sought for Workplace Wellness Questionnaires” by Natasha Singer, NYT, Sept 24, 2013.