Charges of the watchful eye of Big Brother have not surprisingly greeted a Cleveland Clinic plan in which the hospital will raise insurance premiums by 21 percent on employees who don’t participate in a wellness program.
Critics will no doubt argue that the wellness program requirement, like the Clinic’s ban on hiring smokers, is another example of the U.S. sliding toward a nanny state in which people are essentially forced to change their behaviors to suit someone else’s priorities.
But the guess here is that the Clinic eventually will be regardeda trailblazer of sorts for offering us a preview of the future, in which employers routinely offer tiered health insurance premiums based on employees’ compliance with established wellness and fitness programs.
If employers like the Clinic are denied the right to essentially discriminate (before you object to the use of that word in this context, read its definition) against unhealthy employees, the U.S. tradition of employee-based health coverage may fade away, which wouldn’t necessarily be a bad thing.
Here’s how the Clinic’s system works, according to The Plain Dealer: Based on compliance with wellness goals, employees are placed in one of three groups — gold, silver and bronze. Each group will pay a different amount for health insurance premiums.
Gold employees are those who’ve reached the wellness goals set out for them by their doctors and will enjoy a 4 percent decrease in the cost of their insurance premiums compared to the prior year. Silver employees have enrolled in the wellness program and are working toward their wellness goals, but haven’t achieved them. Their premiums will rise 9 percent. Finally, there are the bronze employees — those who aren’t participating in the wellness program and will see premiums jump 21 percent.
To understand why health improvement initiatives have a much better chance at success if they’re led by employers, think back to the ridiculous furor over “death panels.” Preying on the seemingly widespread fear of government dominance over peoples’ lives, critics of federal health reform convinced a gullible portion of the population that the federal government would be setting up committees to decide whether sick patients were worthy of being kept alive.
The utter inanity of those claims (thank you, Sarah Palin) – coupled with the fact that numerous people willingly took what should’ve been obvious lies for fact – illustrates a simple truth: Government will virtually always face stiff opposition when making changes to healthcare in America.
Thatbrings us back to Cleveland Clinic’s “get healthy or pay up” wellness program, which is already generating results and making people healthier and saving money. Advocated by the federal government, such a program would likely be a nonstarter for a large portion of the population.
And that means future programsthat holdpeople accountable with dollars and cents for the health decisions they make can only come from employers. More and more employers are likely to reach the same conclusion the Clinic has: If workers don’t take steps to improve their own health, they’re going to start feeling it where it hurts most — in their paychecks.
[Photo from flickr user U.S. Navy]