Today, at work, we received what can only be described as the first sign that health care benefits would further be negatively impacted next year. It came in the form of a survey asking us such ominous questions as “What would you choose between higher co-payments and higher deductibles” and “Would it be OK if we restricted you to a smaller network of doctors”.

The last question, though, was in a free format, asking us our opinion of how the company could improve health care and provide meaningful benefits to every employee. I took the opportunity to vent some of my feelings regarding the level of health and fitness in the organization and I am sharing with you the exact text of my response (nothing has been changed except for names). It took me only 5 minutes to type this and hit SEND, maybe because I feel so strongly about this:

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I strongly believe that there is a certain degree of responsibility regarding health and fitness that lies with every employee.
If there is an annual increase in the cost of health care it is almost solely because of the increasing lack of health and fitness in the participants (employees). The smokers, the obese, the non-exercisers … these people bring up the cost of health-care and literally “ruin it” for the rest of us.
Would these same people drive rashly or commit a theft? Not likely because the consequences are direct and immediate. An increase in insurance premiums or a criminal record both have immediate repercussions. But the same people have no qualms in reaching for the 5th pizza slice or for that second pack of cigarettes. “Hey, I have free health insurance from my company”, is the attitude.
A Wellness Exam with a direct consequence on the individual deductible and copay would be an excellent motivator to improve the individual fitness and make him/her more responsible employees. Smokers should have to pay higher premiums (if it comes to that) than those who abstain. One would only think that is fair since car- and life-insurance companies work like that. Why should those who are sincere in their health and fitness regimen, who exercise regularly and who show restraint in their eating habits have to pay the consequences for the irresponsible employees around them?
I use the office gym everyday and this is the number of people I see from our company: 2. That would be funny if it was not such a serious issue. Granted, some are members of programs like Weight Watchers while some might use a home gym or exercise elsewhere, but the bottom line is that bottom-lines and waist-lines are on the increase and hitting people where it hurts (the wallet) is probably the only way this problem can be solved.
A few of the obesity cases could be genuine health-related problems and nicotine addiction is also a genuine phenomenon. This is where more company-sponsored initiatives and incentives to lose weight or quit smoking could go a long way in motivating employees. Currently I see not a single such program.
There are numerous side-benefits to having fitter and healthier employees too:
1. Number of sick-leaves will reduce.
2. Employees will be more alert and focussed at work.
3. They will be more confident and this will boost their morale.
4. And of course the most important consequence: with a company-wide Wellness profile that is way above the national average, our company can command lower premiums and increase benefits to its employees.
I hope the company would seriously consider a “fitness-related or wellness-related benefits scheme” because that is the only way a fair system of premiums and benefits can be established. The car-insurance and life-insurance companies work that way - why shouldn’t the health-insurance folks?

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What do you feel about this? Should health care costs depend on the wellness level of the recipient?

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