By Donald B. Ardell, Submitted February 25, 2010
“Now and then there arises a man who on peril's edge draws
from the scabbard of despair the sword of victory.”
Robert G. Ingersoll (1833-1899)
A recent headline in a Wall
Street Journal article gave the impression that worksite wellness programs
are at a crisis point due to a federal law. This is a major development.
I'm surprised the problem has not received more attention. Other than the
WSJ piece, I have seen or heard nothing about this conflict. In fact, neither
WELCOA nor the National Wellness Institute has released an alert or other news
item about how worksite wellness has come to what Ingersoll might have seen as
peril's edge - a grave threat to the U.S. worksite wellness movement.
What is the grave threat? What is so pernicious as to
sound a death knell for programs that encourage workers to understand and
reform poor habits in order to suffer less illness? What is it about
worksite wellness that persuaded a WSJ writer to describe such programs as
being endangered?
Before reading the article, my thoughts went to all kinds of
scenarios, what Albert Ellis might have labelled instances of horriblizing,
such as the following:
* Perhaps it has been declared illegal for employers
to encourage workers to assume more responsibility for their own health
status. Maybe the thinking is something like this: The medical
system exists to deal with illness and diseases caused largely by hazardous
habit patterns. Therefore, circumventing poor habits by promoting health
undermines the nation's health system and imperils the financial interests of
insurance companies, doctors and the pharmaceutical industry. These
players are all major donors to Congressional campaigns and lobbying interests.
* Regular exercise and/or sound nutritional practices
are contrary to the ways in which most Americans prefer to live, and thus worksite
wellness information creates stress, thereby proving intrusive and inconsistent
with First Amendment safeguards.
* Teaching workers to think for themselves, to doubt,
to question and to demand objective evidence for claims of one kind or another,
could eventually lead many employees to start thinking for themselves about
certain off limits questions, such as who made us, why did he make us, what
does he want us to do and what happens to us after we die. Thus, such
programs are clearly sacrilegious, leading to possible blasphemies or even
doubts about the public interest merits of recent Supreme Court rulings.
* Jobs are designed for corporate profits; activities
unrelated to the production of goods and services damage the economy and
undermine homeland security.
However, I soon realized that these fears of mine were a bit
over the top. Something else led the Journal reporter to conclude that
worksite wellness programs were in immanent peril. I looked more closely
at the article and sensed from the title that the problem was none of the
concerns expressed above. The title of the WSJ piece, Wellness
Efforts Face Hurdle: Asking Workers About Family Health History Can Clash With
U.S. Genetics Law (February 1, 2010), hinted at a different problem.
Well, OK, a hurdle is still a hurdle which could, if set too high to pass over
or too wide to go around, put a halt to wellness programming at companies all
over the land. This was still a serious matter. So I resolved to
read on and assess the degree of danger of losing worksite wellness because of
something related to recent genetics legislation.
Here is what I discovered.
The law in question is designed to discourage workplace
discrimination based on risks of future illness conditions. OK, so how is
that a problem with regard to offering a wellness program?
Well,
the writer suggests that employers might lure trusting workers to reveal
information about their genetics, and that they might even use cash and other
worksite wellness incentives as bait for this purpose! Suspicions are
raised by the fact that companies offer the insurance premium reductions and
assorted other rewards if employees complete those nefarious health
surveys! Never mind that company management insists the sole purpose is
to discover who might benefit from health advice or specific wellness
activities or educational sessions targeted to future problem areas. We know
from the behavior of banks, investment firms and other machinations of the Wall
Street set that it is unwise to trust big companies.
For the record, be advised that the Genetic Information
Nondiscrimination Act, enacted in 2009, does indeed restrict employers' and
health insurers' ability to collect and disclose genetic information. The
restrictions apply not only to genetic-test results, but family medical
history, as well. The legislation expressly prohibits insurers and
employers from using genetic information for coverage and employment decisions,
such as hiring, firing and promotion.
So then, how much of a problem is this?
Some worksite wellness leaders claim that cash and other
incentives are essential for gaining participation of workers in the wellness
programs offered. They seem to believe that employees take positions
something like this: Pay me or I won't cooperate in learning how to boost my
prospects for not getting sick, run up medical insurance costs or better the
quality of my life. Unless, of course, you pay me to help myself.
A survey last year by PriceWaterhouseCoopers found that 70%
of employers offer wellness programs, and 64% of companies included financial
incentives to participants for completing health risk questionnaires.
Popular wellness programs include smoking-cessation, weight-loss and disease-prevention
efforts.
How consequential is this conflict between genetics law and
wellness program incentives and information gathering? More important,
how hard will it be for companies to surmount privacy barriers in the
provisions of the new law?
Some wellness managers cite cost savings from using these
incentives to gain cooperation and thus data, and now worry that the new rules
will prevent them from channeling at-risk employees to needed diabetes, cardiac
and respiratory programs. Others think they can work around the
restrictions. The American Medical Association and the American Heart
Association have come out against exempting wellness programs from restrictions
on collecting genetic information. Wellness programs need not collect and retain
private genetic information to be effective, said the AMA in a letter opposing
exemptions.
I
say, Good riddance to invasive questionnaires and incentives to reveal
sensitive family data. And, most important, good riddance to fake wellness
programs. This might be just the kick in the pants needed to leave the
history-taking and disease management, testing, prevention
and assorted health education efforts to the medical
managers. It might be the kick in the pants needed to begin organizing
and presenting REAL worksite wellness programming.
In short, it might be a turning point for the better, the
inspiration needed to draw from the scabbard of despair the sword of victory.
Instead of prevention and health education, both reliant on now inaccessible
family history taking, worksite managers can offer education in reason,
exuberance and liberty. They can introduce and render fascinating applied
philosophies via connections between great ideas and great thinkers with
current issues and eternal mysteries. They can teach critical thinking
and science appreciation, vital in a society wherein 44% of Americans believe
God created human beings in their present form within the past 10,000 years.
(Source: 2009 Gallup poll, as reported in the WSJ's
Health Journal, February 23, 2010, p. D1.) They can also focus on
positive, life enriching matters such as exploring varied paths to happiness,
joy, humor and meaning, while encouraging environmental awareness, global
consciousness and a dazzling variety of possibilities wherein workers might
choose to work at becoming better people capable of increasing their quality of
life and that of others, as well. All this and more may not have direct,
measurable links with corporate medical cost savings, but it may have indirect,
significant consequences for employee satisfaction and productivity, and thus
corporate success.
Besides, it is always a good idea to seek opportunity in any
crisis, real or imagined.
Be well, look after yourself and always look on the bright
side of worksite wellness hurdles and life itself.
February 25, 2010 An Opportunity for REAL Wellness