Wellnessless Initiatives
I love me some Minnesota Public Radio, and Kerri Miller is by far one of my favorite hosts (such an amazing voice!). She hosts Midmorning on MPR and she never fails to feature guests and topics that create great conversation. Driving in to work this morning, I caught a preview of her upcoming segment:
Are wellness incentives fair?
An amendment in the Senate finance committee’s health care reform bill would allow companies to increase discounts on insurance premiums for employees that meet certain health goals. Advocates say that financial incentives play an important role in encouraging healthy lifestyles, but opponents worry that lowering premiums for some will raise them for others.Guests
Michael O’Donnell: Founder and editor-in-chief of the American Journal of Health Promotion.
Kenneth Thorpe: Chair of the Department of Health Policy and Management at the Rollins School of Public Health, Emory University.
Dick Woodruff: Senior director of federal government relations with the American Cancer Society Cancer Action Network.
AAARRRRGGGGHHHHH! I am sick to death of Wellness Initiatives in their current form, and the initiatives being proposed as part of Obama’s health care reform legislation.
Don’t get me wrong. I l.o.v.e the idea of a wellness initiative: implementing health programs that promote healthy behaviors. My previous employer offered programs like brown bag lunches with guests speakers that talked about nutrition, blood pressure and cholesterol check-ups, on-site yoga classes, and 10,000 steps competitions. Participating in these programs came with financial incentives on insurance premiums. I am so down with that because we KNOW that healthy activity, good food, and stable blood pressure/cholesterol do good things for our bodies.
Too bad that the vast majority of the current incarnations of wellness initiatives foster more insidious motives. Yeah, the rhetoric looks good on the surface: promoting preventative care (such as smoking cessation) that pays us back down the road in terms of lower health care costs. But under the surface, there is a system for evaluating the health of employees - often based on inaccurate measuring tools - that penalizes people for what the system dictates is unhealthy behavior. Yes, you totally know what I’m talking about: Body Mass Index.
Why won’t this thing just DIE? A number on a scale is going to be used to determine what I pay for insurance? Conventional assumptions about my body size - you know, OBVIOUSLY I must be stuffing my face with high fat foods on the couch all day long - are going to gauge my “health”? They want to dictate weight loss for my “health” and reward me for dieting? Penalize me for not?
Unsurprisingly, plenty of callers have phoned in on Keri’s show to tout the fairness of penalizing people with higher premiums, citing that “it’s not fair that we should be burdened for other people’s bad choices.” Apparently, smoking, BMI, cholesterol, and blood pressure, are characteristics wholly dependent upon individual choice. Smoking? Yeah, that definitely is a choice. But blood pressure? It’s a little more complicated than simply a matter of personal choice. I don’t wake up in the morning and think, “Hmmm, I think I’ll go for a slightly elevated blood pressure today. Goes great with these shoes!” I guess all I want to say to those folks is: Fuck you. I haven’t asked you to bear any kind of burden for me. This just makes me so angry! I’m still not particularly fond of my body size, but I take care of myself, and I resent the implication that I’m some sort of walking time bomb and I should pay more now for the inevitable catastrophic costs I’m going to burden the system with later.
People NEED healthcare. Some folks will need a little less over their lifetime, and some will need more. I am so tired of the greed that permeates the current health care system; the need to classify risk assessment and wring as much money from people as possible and then refuse to pay that money out when people need it most. I have been without health insurance for a year now, and it’s scary. There’s something really wrong with this country when the value of a dollar is placed so far above the value of a person.
Filed under Fat(Riot)Grrl |7 Responses to “Wellnessless Initiatives”
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I could not agree more! Well said!
This topic gets me, too! I’m sorry I missed the Keri Miller show - I love MPR (but have to disagree with you on Keri’s voice, it grates on me a little).
I think part of this debate has to do with an American idea of not helping out people less fortunate. I am totally willing to pay more in health insurance to know my neighbors are covered, that my co-worker with cancer doesn’t have to worry about crazy insurance rules, and so people don’t end up being singled out for something like weight. Penalizing fat people is not going to change anything. I like the idea of incentivizing people. Why not give people discounts for exercising and other healthy behaviours?
Can’t tell you how many times I’ve gotten in arguments with my boss about universal healthcare. He just keeps railing at me that the U.S. has the best health care in the world.
My response: “Yeah, we totally do. But only for those who can AFFORD it.”
I think good health care is a human right, and I don’t think any system in which profit is a component is going to work. Health cannot be about profit.
In theory I agree; however, I think that in practice research must be funded by something. Many people would not strive so ardently to resolve research issues if they were not making as much money or anticipating making a lot of money. I think we must acknowlege that a large reason that the US has made the medical advances that we have, is because of the financial motivations behind them. Eliminating profit from the system would likely eliminate some of the competition that can so effectively drive many researchers.
That said, I totally think health care costs have gotten out of hand. I also do not have health insurance and it totally sucks. I have actually quit horseback riding at my parents farm and I totally hate that, but I can’t afford to get hurt and it is a potentially hazardous activity. One would hope some sort of compromise could be made.
Oh yeah, and incentives for positive behaviors versus postive numbers is a much better idea. I hate the fact that although my boyfriend eats lots of meat and very few veggies, he has lower cholesterol than I do. I do know that part of my issue is that high cholesterol runs in my family and particularly through my mother, grandmother, and great-grandmother. Why couldn’t I get Grandpa’s genes there? He ate bacon sandwiches almost everyday and stayed slim with low cholesterol!
I think an important thing to note is the broad shift we are seeing from university-based research to private corporation-based research.
One kind receives state funding and funding from foundations for research, and the other uses profits to fund studies that give them the results they want so they can….wait for it….make more profit. I’m totally looking at you, Pfizer!
I think there is something to be said about university-based research, a kind of trust factor, that I don’t have for a moment when it comes to for-profit companies that manufacture, for instance, medication. I wish we could put the research back in the hands of academics who aren’t out to make a buck all the time; who actually might give a damn about treatment effectiveness.
I’m just a socialist, er, I mean, Canadian ;) but I agree with you about healthcare being a human right. I go stir crazy hearing Americans slight the Canadian system-yes, it isn”t perfect, but it’s a whole lot more fair. As part of my professional organization, we had a great presentation by a health policy researcher. She shared that approximately 20% of people use 80% of health care dollars-in a profit-based system, you make more profit by cutting out the 20% who are going to need a lot. You just cannot make healthcare a money making venture, it doesn’t work. In America, it seems like people in the 80% group don’t want to help pay for that 20%, it’s somehow “unAmerican” to help each other out. Okay Sarah…stop ranting now… breathe in…breathe out…
I also second your comments about university-based research-having been in the land of academics for years, most of these people aren’t in it for the money-they are excited to find out real results that can help people. They build their reputations on quality methodology and objective interpretations of data. You can’t say the same for the profit-based counterparts.
I’m totally on your wavelength, PsychSarah!