Obviously, "wellness" - however imprecise that word might be - is a Good Thing. The real question is if these plans actually improve health and cut costs. The answer appears to be no. There are just way too many conventional wisdoms that are wrong. In a nutshell, all of the so-called indicators don't show so much that you are "well", they show that you're "young and healthy". There is simply not enough hard evidence that taking a random group of adults, all of them products of an almost infinite set of life choices and genetics, and forcing behavioral changes on them will result in different health outcomes. It's important to add that prevention, in general, drives up costs, it doesn't cut them. This is pretty well known among those who study statisticsIf you read Karl Denninger at Market Ticker, you know he regularly talks (well, alright, almost preaches) that low carb diets are the answer to most of our current health problems and that the conventional wisdom is flat out wrong. Example 1. Example 2. Example 3 (all within 2 days). Newsflash: Karl's right. The fact that lots of doctors are coming around to this is more evidence. I could fill a post with links, but that's not the point. Furthermore, there's simply not good quality science to match our obsession with making everyone in the country look like concentration camp survivors. How many times do they need to find that higher BMI patients have better outlook and survival than thinner counterparts before they stop calling it paradoxical? (also) I recently lost a close friend to complications of liver cancer. He had lost 80 pounds due to the complications - he wasn't large to start with - and I think he would have had a better chance if he hadn't lost that 80 pounds and was more robust. It wasn't the cancer that got him.
According to Jonathon Adler writing in the Volokh Conspiracy, the premises of these corporate wellness programs are being questioned at all levels. A conference is coming (on tax day) to get some collaboration going on between more folks.
On April 15, the Law-Medicine Center at the Case Western Reserve University School of Law is hosting a full-day conference “Corporate Wellness Programs: Are They Hazardous to Well-Being?” Speakers include Dr. Soeren Mattke of the Rand Corporation, Dr. Michael Roizen, chief wellness officer of the Cleveland Clinic Foundation, Prof. Dennis Scanlon of Penn State, Prof. Sam Bagenstos of Michigan, Christopher Kucynski of the EEOC, Prof. Jessica Roberts of the University of Houston, Prof. Harald Schmidt of Penn and Elizabeth Click of CWRU.Adler, in turn, quotes from NY Times piece by Austin Frakt and Aaron E. Carroll in September 2014.
Wellness programs are popular among employers. An analysis by the RAND Corporation found that half of all organizations with 50 or more employees have them. The new survey by the Kaiser Family Foundation found that 36 percent of firms with more than 200 workers, and 18 percent of firms over all, use financial incentives tied to health objectives like weight loss and smoking cessation. Even more large firms — 51 percent of those with 200 workers or more — offer incentives for employees to complete health risk assessments, intended to identify health issues. . . .Again, the company I just retired from had a wellness program for years. It started out gradually: they want you to see a doctor and get tested for various risk factors. Two years later, goals were set for those risk factors. The year after that, you got penalized for not meeting their goals. In the early days, you got a price cut in your insurance costs if you got tested and by the time I left you paid extra if you didn't meet the goals. Around the annual screenings was a virtually continuous three-ring circus of activities to get employees to participate in group diets, or running clubs (never acknowledging that your cardio may be killing you) or other nonsense. Treating employees differently by charging them more or less for insurance because of blood test scores or other physical aspects is breaking the Americans with Disabilities Act. I have no doubt that if companies get actual data that shows they're not getting their sufficient return on their wellness investments, those programs will go away. Companies are always efficient about maximizing profits, right? I'm less optimistic that any wellness nonsense encoded into Obamacare will ever go away.
The Kaiser survey found that 71 percent of all firms think such programs are “very” or “somewhat” effective, compared with only 47 percent for greater employee cost sharing or 33 percent for tighter networks. . . .
What research exists on wellness programs does not support this optimism. This is, in part, because most studies of wellness programs are of poor quality, using weak methods that suggest that wellness programs are associated with lower savings, but don’t prove causation. Or they consider only short-term effects that aren’t likely to be sustained. Many such studies are written by the wellness industry itself. More rigorous studies tend to find that wellness programs don’t save money and, with few exceptions, do not appreciably improve health. This is often because additional health screenings built into the programs encourage overuse of unnecessary care, pushing spending higher without improving health.