January 25th, 2016

Wellness Programs at Work

NYT has a sum-up of a few of the ongoing and recent legal cases between the EEOC and companies implementing wellness programs for employees.


The Flambeau case is mentioned (a man missed a mandatory screening test and the employer, Flambeau, termed his health insurance). The employer won, the employee got his health insurance back after he got to the screening, and apparently the employer no longer has this policy anyway (unclear what they will do now that the case went their way). Other cases are pending.

Honeywell is fining employees up to $4K for not participating in screening; EEOC tried to get an injunction and failed. The case is proceeding.

The argument for screening is that the employer is hoping to get into a better, cheaper risk pool. The rationale is that screening and maybe moving some employees into some sort of medical or behavioral intervention will improve outcomes thus saving money (and, hopefully, lives) all around. If only we had evidence that this actually works. I guess we're currently engaging in a gigantic experiment to find out if this actually works.

"Dr. Gordon K. Norman, a consultant with Willis Towers Watson, which advises employers. He says companies are already being careful about how much they penalize someone for not participating. “Frankly, they realize there is a tipping point,” he said, at which a company’s practices make workers resentful or less engaged."

This is an interesting point, actually. We are at a point in the business cycle where we think we've cleared out a lot of the problems and are poised for the economy to really improve. However, in order for the economy to really improve, we need to see wages increase. And we don't _generally_ see wages increase because companies are feeling all good-hearted towards their employees (yeah, I know about that guy in Seattle -- there was a big expose on that guy, so, you know, the exception def tests the rule! And in this case, the rule survived). We _generally_ see wages increase because companies are experiencing retention and hiring problems -- that is, we hit a point where fairly ordinary people feel like they can sing Take This Job and Shove It as they walk out the door (<-- young people: youtube it. Then ask your grandparents to explain what a flat top is. Maybe we'll start a trend), because they know someone down the street will hire them to do the same thing, probably for slightly more.

If the NYT piece is correct:

"Jennifer Mathis, a former E.E.O.C lawyer who is now with the Bazelon Center for Mental Health Law [argues] If the higher courts go along with the idea that companies can demand this information as a condition of enrolling in their health plans, the debate over what is voluntary will be moot, because workers will not be able to afford to say no. “The whole conversation is over,” she said. “You can do anything you want.”""

Then there is no fucking chance in hell of any wage pressure whatsoever. If the people who _have_ good health insurance are feeling so uncertain in their job that they are forced to comply with all kinds of testing and being coerced into weight loss programs and so forth in order to avoid the financial penalties of refusing, then wage pressure is non-existent, and we are poised on the brink of a deflationary spiral that will make worrying about being forced to have your blood pressure taken, along with your BMI, glycolated hemoglobin and goddess knows what else -- well, those worries will seem trivial, because we'll be about to step off the edge into the abyss.

I've got my doubts about all that. I question whether insurance companies will continue to offer the price breaks that lure companies into these strategies, because usually insurance companies are kind of sensitive to the numbers and I don't really think a lot of these more forceful interventions are going to actually produce any useful savings for the insurance companies. I question whether a company large enough to benefit from instituting this kind of program can survive the bad PR associated with ludicrous program enforcement. I also kind of wonder about this scenario: Company A hires Company B to provide food in the corporate cafeteria. Picking the low cost bidder. And then Company A institutes some kind of intervention to get a break from the insurance people, and as a result of that, someone points out that it is actually impossible to comply with the nutrition guidelines from the insurance mandated nutritionist visits when eating food supplied by Company B. I feel like, at a minimum, the kafka-esque results will be mined for sitcoms, stand up comedy, and the Outrage O' the Week on FB and other social media, not to mention becoming a criteria for job hunters researching prospects on GlassDoor.

In any event, operations like CSPI and similar should have plenty of low hanging fruit to go after, pointing out that large corporations are punishing people for failing to adhere to a certain nutritional and physical activity standard that the same large corporations make, basically, impossible.


Oh, here's a little something to chew on:


It quotes this:


That is _really_ funny, in a very dark way.

ETAYA: Just to be clear. I'm not endorsing any of this stuff I'm linking to. And some of the writers at the latter link are nutters. But they are very funny nutters.