Employers: Rewarding the Healthy

It is well-understood:  being healthy is cheap.  Healthier employees are cheaper employees--less costs fo chronic diseases (e.g. diabetes, obesity, cardiovascular health) and less productivity lost.

Employers really do not have any incentives to provide prevention plans for employees, as the majority of employees don't spend their lifetime at one company and leave for new jobs before employers could reap the financial benefits of investing in preventive behaviors of employees.  Tax benefits for employers could help.  Policymakers are trying to get a larger number of employers to grasp this notion.  A recent survey by Hewitt Associates says that 1/3 of employrs are planning to put more of an emphasis on wellness plans.  Some large corporations already do, such as General Mills, Dell, and Safeway.  More will like

ly follow suit, especially with the proposed policy changes.  

Sen Baucus (D-MT) and Sen Harkin (D-IA) are propsing tax incentives for employers that offer wellness programs to employees.  This is consistent with Obama's goals for health reform ("invest in prevention and wellness").  A victory for public health--a shift in focus from treating more expensive and downstream diseases, rather than a focus in less-expensive upstream acts of preventing diseases from beginning.  But who loses?

A recent Health Affairs article, "Financial Penalties for the Unhealthy? Ethical Guidelines for Holding Employees Responsible for Their Health," looks at the other side of this issue.  According to federal Health Insurance Portability and Accountability Act (HIPAA) regulations, employers can give rewards/penalties for up to 20% of the total cost of covering an employee.  However, unions and those concerned with personal freedoms are arguing about the blurry ethical line of holding employees responsible and protecting their individual liberties.  Considerations about paternalism, personal choice, privacy protection, access to health promotion, and the complexities of developing obesity are brought up on the opposing side.

Where do you stand?