Health insurance costs could be offset by wellness

January 23, 2012|Beth Kassab -- Local News Columnist, Local News Columnist

How happy are you on a scale of 1 to 10? How many days did you exercise last week? How many vegetables did you eat yesterday? How financially secure do you feel?

This isn't a questionnaire people are filling out in the doctor's office waiting room. It's information their health-insurance company wants, and I'd be lying to say it doesn't make me a little squeamish.

Employers are trying to lower their soaring health-care costs, and wellness is the industry's favorite new antidote. (All of those years of focusing on helping the chronically sick manage their diseases didn't work out so well considering that, as a population, we're still pretty unhealthy.)

The wellness craze means that many of us now do things like fill out surveys with such intimate details as how we feel about our relationship with our boss or how supportive our family and friends are. Talk to a health coach about how many biceps curls we did during our last workout. Calibrate our pedometers and report, literally, every step we take to our employers.

And if we don't do these things? Then many employers withhold financial incentives worth hundreds of dollars toward our deductibles and other insurance costs. Many people can't afford to pass that up.

It's all a bit too Big Brother for my taste. At least, it was until I started to consider the long-term consequences of not doing it.

The end game here is that more and more companies are laying the groundwork to eventually charge people who are fit and healthy less for health insurance than those who are obese or have unhealthy blood pressure or cholesterol levels.

And that really is a more equitable system. Why should a person who eats right, exercises, doesn't smoke and rarely visits the doctor pay as much as a person who has a two-pack-a-day habit, has Type 2 diabetes and is constantly seeing a doctor?

How well we take care of ourselves is largely a choice.

And more companies are seizing on that to help control costs.

"The goal of incentives is to motivate people to take control," said Beena Thomas, vice president of health and wellness at OptumHealth, which helps employers design wellness programs. "We know that it can drive behavior change."

"Now what we're starting to see is companies incentivizing outcomes," she said.

That means companies are starting to measure workers' body mass index, blood pressure and cholesterol, and charging less to those who hit the right numbers.

It's only a matter of time before we all start lining up for our annual visit to the premium doctor.

Despite the promise of lower costs and a healthier work force, I still have some reservations.

For example, where does the prying end? Will insurance companies eventually find out if we have gotten a speeding ticket? After all, speeding puts you at a higher risk of injury.

What about protections for genetic information? Right now the Genetic Information Nondiscrimination Act prohibits employers from firing us, or insurance companies from dumping us, because we are genetically predisposed to cancer. But we all know laws can be changed as easily as your doctor changes gloves.

And even experts in this area, like Thomas, concede there's no evidence to show whether these programs result in lasting lifestyle changes or go the way of the laundry-strewn treadmill.

"The jury is still out," she said. "There is very little research that has been done today that shows that incentivizing outcomes is the answer."

But incentives aren't going away. A survey by the Kaiser Family Foundation found that the number of large companies (more than 200 workers) participating in such programs is increasing. Twenty-seven percent of large companies already offer gift cards, cash or some other incentive to employees willing to chat with a health coach or fill out assessments.

We'd better get used to it. I am. or 407-420-5448

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