Wellness programs: Well-intentioned, but too intrusive for some

Wellness programs have been popular with companies looking to lower their health care costs for years, but some observers are starting to question just how far these programs should go.

As health care costs continue spiraling every year, some companies are taking a more assertive role in their quest for employee wellness. Rather than a friendly, we're-all-in-this-together attitude, some employers are starting to penalize employees with unhealthy lifestyles.

Clarian Health, a major employer in Indiana, had considered charging employees with high cholesterol, blood pressure, and blood glucose $5 per paycheck for extra insurance copayments. Obese employees would have been charged $10 extra, the Terre Haute Tribune-Star reported. After discussions with employees, however, Clarian revised the plan to provide its workers with incentives, not penalties.

Lawyers and groups that follow insurance and employment trends say punitive measures are gaining a foothold. Jim Hertel, publisher of the Colorado Managed Care Newsletter, told the Denver Post that employers and benefit consultants are showing more interest over the last few years in basically slapping a "surcharge" on less healthy employees based on blood test screenings, body mass index, or other measurements.

All this attention on weight in the workplace is making some obese employees feel singled out and demoralized.

"Most people do not choose to be fat," said Peggy Howell of the National Association to Advance Fat Acceptance, a civil rights organization that fights discrimination against fat people. "But once people are fat, it is next to impossible to change that," she told the Boston Globe. "It's far healthier to accept who you are and get on with your life than to be obsessed with what goes into your mouth."

It might be difficult NOT to be obsessed in some workplaces, where companies are offering cash prizes for weight loss, complimentary gym memberships, or free consultations with nutritionists and dietitians.

The programs in many cases are not only voluntary, but also popular with employees. Some of them are quite generous. Blue Cross and Blue Shield of North Carolina, for example, offers $600 to employees simply to take a half-hour health assessment. But some of the wellness programs may have the unintended down side of focusing negative attitudes on the obese.

In a recent Yale University survey of about 2,000 overweight women, 53 percent of those polled said co-workers stigmatized them, and 43 percent said their employers stigmatized them. According to Yale's Rudd Center for Food Policy and Obesity, overweight individuals are paid less for the same jobs, are more likely to have lower paying jobs, and are less likely to get promoted than thin people with the same qualifications.

While no federal laws exist to prohibit discrimination against obese individuals, in Connecticut, the federal Americans with Disabilities Act is supplemented with a ban on discrimination based on a "chronic condition."

Labor and employment attorney Bernie Jacques of Hartford advised employers in the Connecticut Business Journal to be sensitive to bias issues and to ensure privacy of all employees in wellness programs. Avoid mandatory or punitive programs, "unless you have a large budget for litigation."


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