Enforced wellness programs to cut company costs

On 60 minutes they were talking about wellness programs and how some companies were making them involuntary instead of voluntary. Alright. I can see their argument (smoking, poor diet & lack of exercise lead to higher health costs) but I don’t really agree with that viewpoint. There are tons of things that are coorelated with poor health and/or lowered life expectancy.
Being old
having high stress
being single
being divorced
being athiest
being gay
not having close friends and having poor relationships in general with others
being pessimistic

Just to name a few. If you are going to avoid hiring people who smoke and don’t exercise to save healthcare costs you might as well not hire people who are gay, who don’t have friends and who aren’t religious believers for the same reason.

Another problem is that healthcare costs aren’t really that high for many people until they reach their 40-50s and they start to go up. Refusing to hire someone in their 30s because they have a habit like smoking that could cause problems in 20 years makes little sense because by that time they probably won’t work at the same company anymore.

Do you have cites for any of the things on that list? I wasn’t aware that, say, being gay was a health hazard.

First off that cite is only for one specific disease not for gay health in general.

Even if we stipulate that belonging to each of the categories in the OP increases on health risk that doesn’t necessarily mean that they are the causes of the health problems nor that they are to the same degree of obesity. Obesity is at the top of the list of preventable causes for disease along with smoking. Those two factors are head and shoulders above any other preventable factor. Companies can reduce their health care costs by hiring employees that are fit and do not smoke or mandating that current employees cease smoking and get into shape. That is their right and I do support that so long as there is help to get into shape and quit smoking.

Working in a cubicle, staring at a CRT, under flourescent lights for 60-80 hours per week.


I have a feeling that if you look at the life expectancy for straight 20-year-old men with HIV and compared it to straight 20-year-old men without HIV, you’d get the exact same results. Anyone can get HIV regardless of sexuality. Being gay is not a health hazard.

I wouldn’t enforce such schemes in my own company, but I think employers are perfectly entitled to mandate such things in their own companies if they want. Health insurance is now my second highest cost (after salaries), so it is certainly an obvious place in the budget to try make some savings.

Health insurance cost is just one angle - there is also the effect on productivity of workers who take more sick leave.

Again, I wouldn’t implement it myself but I have no objection to other employers doing so.

And while I agree with that, it’s one more sign that the current system of health-care provisioning in the US is coming to collapse.

NHS is coming. I’d bet almost anything on it. What form it will take is up for grabs. But some form of national health insurance is coming.

You really think so? I live in the UK and I’m actually quite happy with the system here, but my general impression is that Americans really don’t like the idea of socialis(z)ed medicine. How could such a system be implemented in the face of (what appears to be) almost universal public rejection?


“Americans” in general aren’t crazy about the idea. The bizarre thing is, it’s big business that now seems to favor the idea, because they don’t want to (and claim they can’t) pay for health care for their employees. They also think that they’re at a competitive disadvantage compared to foreign companies that don’t have to pay for their employees’ health care.

Here and now, it’s Big Business that’s pushing for socialism.

Except that’s probably a myth. From a recent Scientific American Article to that effect:

Also, even if the health risks weren’t mythical (or at best uncertain), obese workers would still be footing their own health costs through lower pay:

On the other hand, if we’re not talking about protected classes and exploitive labor practices, I know of no laws preventing employers from forcing their workers to do or be whatever they want.

Uh both of your cites agree with me, from the first:

and from the second:

The first article is just a bunch of hand waving about BMI and underweight being dangerous (duh!). That can’t change the fact that obese people are simply at a greater risk of disease than a person at a healthy weight.

This is just completely wrong, but I’ll take some responsibility for your misinterpreting the article, because I think you must have read just the one page I linked to. The Scientific American article is about how prior reports that overweight and obesity causes excessive disease and death are probably bad research and that there’s little good evidence that it does.
It’s a six page article starting here.

I’ll requote also, so you see they’re not talking about about underweight:

The article *does * acknowledge that people who are massively obese (BMI>40 or at least 100 lbs overweight) which is a very small fraction of the U.S. population have a higher risk of disease (though they’re unclear on death). But that’s not enough to support your statement that “Obesity is at the top of the list of preventable causes for disease along with tobacco”.

The other article based it’s assumption that there are higher healthcosts on the same bad outdated research. In fact the article that they cite for that data actually acknowledges that fact. Anyway the point of the article is that even if there were higher health costs associated with obesity, those are being paid by the obese in lower wages.

You are making a mistake by lumping people in the overweight category with people in the obese category in order to minimize the affects of obesity. Common tactic of obesity apologists. For example:

Overweight people are not obese people. This is exaggerated by the fact that the BMI scale is not particularly accurate. However, even when using this scale, truly obese (of every type) people are more unhealthy (as a group) in almost every way.

Either way, the mortality rates of each group alone are really of little utility to an employer. Healthcare costs are what matters. The mortality rate is also affected by drug advances, and life-saving technologies- but of which, cost money. A obese person taking 3 drugs to control his ailments may live as long as a man of more modest proportions, but the cost to the company isn’t the same.

Hit submit too soon.

If obese people truly do make less, it may not be a direct function of their obesity. Obese people are also more likely to be depressed, among other things. It may be these side-effects that lower wages.

Astorian is close but not quite where I was coming from (though he’s right, I believe).

I view NHS as a political issue. The current health care system in the US faces continuing rises in cost and continual cutbacks in what are now traditional means of obtaining health care (employers and such).

Put those two curves together and, slowly but surely, political pressure will grow from the electorate to have some sort of health care, however minimal at first, provided by the government. Once that door is opened it’s only a matter of time until some form of NHS (whether the British or Canadian models or something else) in its full-blown form occurs.

Watch for it. Medicare and medicaid will continue to expand service. Then expand some the persons covered. Then those not covered will be able to ‘buy in’. Then some enterprising politician will begin floating ‘NHS’ as a campaign issue as a means of ‘rationalizing’ the system.

I did read the entire article and I consider it a bunch of hand-waving to mask the truth that obese people have a much greater health risk. It conflates people that are just naturally bigger with those that are obese. It then tries to show that obese people are ok by showing that those that are just naturally bigger may be in shape. I don’t buy it for a second.

What you call a very small fraction of Americans is over 10 million according to your cite which constitutes 3-4% of the population. And, according to your cite, these 10 million people have a greatly increased risk of disease. Now, besides smoking, can you name me a preventable factor that greatly increases the risk of disease in such a large segment of the population?

I didn’t analyze the data, I’m just going by what they say in the Scientific American article on this. But IIRC that’s not what they did. They analyzed the four categories separately (not lumped) and couldn’t find a clear health risk for anything but massive obesity and for overweight and mild obesity found a possible health benefit. That’s pretty different from what people are being told.

It’s fine if you want to disbelieve it, this is clearly going to be debated until the end of time. But if the data is still questionable, it’s annoying for companies to dictate their employees’ health decisions. It’s annoying even for things that aren’t questionable.

Again, though legally nothing is stopping them from doing so. It’s a free country.

things that cause an increased risk of illness in 3-4% of the population? There’s alcohol use, drug use, untreated depression, unsafe sex, poor hygiene, bad driving, lack of seatbelts, lack of airbags, untreated high blood pressure, poor food handling and people who drive Camaros. I could go on all day.

People who drive unsafe cars *like * Camaros, rather.