So now more employers are trying a different strategy - they're replacing the carrot with a stick and raising costs for workers who can't seem to lower their cholesterol or tackle obesity.
Overall, the use of penalties is expected to climb in 2012 to almost 40 percent of large and mid-sized companies. The penalties include higher premiums and deductibles for individuals who failed to participate in health management activities as well as those who engaged in risky health behaviors such as smoking.
"Nothing else has worked to control health trends," says LuAnn Heinen, vice president of the National Business Group on Health, which represents large employers on health and benefits issues.
So they blame the patients...
Their attitude is presumptive.
- They presume we don't care about our health. That we have to be “forced” to comply. That we want to be fat and miserable.
- And they also presume to know what's best for us. That non-compliance actually is the problem. Frankly, their track record isn't that great. And they still totally ignore the possibility that they might be flat out wrong.
Let me tell you how this manifests in my life:
Every six months a young lady from our insurance company calls my husband and asks him questions. He's a diabetic so this is pretty standard. The past couple years they have had this “incentive program” to lower costs. If you participate in “Health Awareness” activities you save money.
EVERY SINGLE health awareness activity involves eating more fruits and vegetables. Even if you run marathons, there is no way to get the incentive if you don't eat more fruits and vegetables.
So every six months this young lady asks my husband if he is going to eat more fruits and vegetables. And he says:
“Do you have the study on which that advice is based?”
And the young lady says “Huh?”
“You are recommending a diet which has never been shown to benefit diabetics, so please cite your source.”
“But sir Fruits and Vegetables are part of a healthy diet.”
Do you have a long term study you can send me?
“Well No.”
My husband has the absolute best blood sugar numbers any of his doctors have EVER seen. They tell him to “keep doing what he's doing”.
If he eats more carbs- his blood sugar with go up. Period.
But this administrative aide who doesn't even know the basics of carbohydrate or insulin chemistry can call our house and demand he eats more fruits and vegetables or lose his “incentive” to be healthy.
He is extremely healthy. And there is no accounting for that in their plan. He gets no compensation for his self motivation.
It's insulting. And patently unhelpful.
The other way this strategy backfires-
I do not participate. I am pretty sick and I refuse to even sign up for the program. When I find an ACTUAL DOCTOR who understands my illesses- and helps me recover- I might think about sharing the details with some anonymous insurance company employee and her ridiculous checklist.
Yes, I pay more, but I'm not healthier. And that's what they say their goal is. Ha.
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This is one of the most dangerous trends in health care.
- It takes medicine out of the hands of professionals. Hell, they barely know what they're doing. Cholesterol screening has shown absolutely zero benefit, for example...
- And puts it in the hands of insurance companies, employers, and the government.
- And it creates rigid rules. Which are difficult to change.
- Shifting the most drastic health and economic consequences directly to the most vulnerable.
And force those with chronic illness out of employment and insurance coverage.
Clever, that.
It's a little more subtle than just raising our rates and refusing cover to sick people, but accomplishes the same thing.
I really hope it backfires on them. Motivates some class action malpractice suits.
