HEALTH CARE/Joan Retsinas

The Art of the Scam: Wellness Programs

Forget the “art of the deal.” Look to the “art of the scam.” nnHere is an especially artful one, meriting praise from consummate deal-makers.

Consider “wellness.” We don’t need a Ponce de Leon elixir to bolster our health. We need to give thanks for the healthy genes we inherited. We need to obey the easy maxims: wear seat belts, don’t exceed the highway speed limits, get vaccinated against whatever is endemic, wash our hands. And the difficult maxims: cut the calories, up the exercise, axe the cigarettes (as well as the drugs). Limit alcohol; and, if we don’t, then stay out of the drivers’ seats. We should take medications to lower blood pressure and cholesterol (after we’ve lost weight and started exercising). If we have a chronic disease, like diabetes, we should follow the regimen. There is no arcane secret in these prescriptions.

Yet scamsters have made “wellness” into a marketable product – in the words of a noted deal-maker, “wellness” is a “fantastic” deal.

A deal, as well as a scam, needs two or more parties, who all expect to benefit.

On one side, employers want healthy employees. More specifically, they want to see less absenteeism, less days lost to illness, higher productivity — in short, lower workforce costs. Presumably, healthier employers will meet these goals.

As for employees, they may not care whether their employers’ costs fall. But presumably they would like to be “healthier;” that is, feel better. And they acknowledge all those maxims preached to us ad nauseam. (In spite of the advertising hype of soda companies and fast food restaurants, nobody over age 10 rates those products healthy, or considers “channel-surfing” as exercise.)

The genius of this scam lies in the packaging. Why not package “employee wellness” into a program, then peddle it? At first blush, the notion is perfect: employers will gain a “better” workforce, employees will gain enhanced wellbeing, and of course the “wellness” company will profit.

An $8 billion “wellness” industry has popped up. Typically a program employee, maybe a nurse, will assess health, monitor weight, cholesterol and blood pressure, urge exercise, and offer “incentives” to employees, encouraging them to meet “healthy” guidelines (generally, lose weight.) The program might offer on-site vaccinations, make referrals to substance-abuse programs, offer “smoking cessation” incentives. Seventy percent of large employers offer a program.

The “Koop” award, given annually to the best “wellness program,” signals the idiocy of these programs. This year the award is much like the person yelling ”he’s naked” at the Emperor: the Boise School District won for the “best” wellness program in the nation, among the seven entries; yet the health of the 3000 employees declined. Weight went up, as did blood pressure and cholesterol. Smoking declined, but not as much as it did outside the Boise workforce. In fact, some critics of “wellness” programs suggest that those programs may enhance employee stress – leading to worse “health” measurements. That scenario is not implausible. If an employee fears that a weight gain will lead to a pink slip, the monthly weigh-in would be dire.

The true genius of this scam, though, lies beneath the surface. This Emperor is not naked: he wears an employer’s garb. For employers, the “wellness” program constitutes a line-item; but, whether or not the total labor costs rise or fall, that cost is immaterial.

The programs deflect the possible role of employers in bolstering employees’ health. For healthier employees, employers could first of all discard the brutal boss, who bolsters employee stress, but does not increase productivity. Emma Seppala, from Stanford, has described the tangible benefits of kind, humane bosses. That costs nothing.

Next, employers could: 1) make the workplaces healthier by obeying OSHA regulations, instead of resisting them; 2) guarantee comprehensive affordable family health insurance coverage to all, even part-time workers; 3) provide paid family and medical leave, so workers could take care of themselves and relatives; 4) provide sufficient paid vacation time for employees to engage in recreation (as employers provide for executive staff); 5) provide sufficient lunch and breaks for employees to eat all that nutritious fruit; 6) pay lowest-level employees much more than the minimum wage. All these cost more than a “wellness” program. Yet all these could bolster their workers’ health.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, November 15, 2016

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