Companies Demanding you get healthy: Where will this lead to?

Parent Cafe
221

<p>I can only recall one time where we had to deal with a claim issue and one time where I had to argue about getting a procedure done where lower-level management wouldn’t authorize it (I just went up the management chain). Both of those issues were in the 1990s; one when we had an HMO. We don’t really use much in the way of medical services but generally haven’t had coverage or payment issues for medical services.</p>

<p>I’ve worked with databases for almost 30 years. I’ve had entire HMO databases in my possession and I’ve looked at some of the data (I was diagnosing a software problem and naturally had to look at some of the data flowing through) and was pretty amazed at the level of detail of the information and thought that I wouldn’t want others seeing this kind of information about me.</p>

<p>I assume that I’m being watched - by automated systems and maybe a person if something comes my why that might catch attention. If you hang out on SlashDot (geek place for people in computing, communications, tech stuff), you’ll read about discussions about risks, problems, hacks, breakins, new products, conflicts, lawsuits, about tech, privacy and a bunch of other issues. Most of the people there, though, are technically sophisticated about computers, security, communications networks, databases, etc.</p>

222

<p>My company partners with a place that gives free check ups each year. The results aren’t shared with the company (or so they say). You get a 150 dollar discount with your insurance for the year if you go do it. If you don’t do it, you can fill out a health assessment and speak with a health adviser about your results and get the same discount. The assessment is just like how often do you exercise, how often do you drink, etc. When you speak to the adviser they suggest you eat more fruit and exercise more. ;)</p>

<p>Beyond that, you get different discounts for participating in different programs. Smoking cessation, receiving exercise tips, etc. The max you can save a year is 600. I figure it can only help lower costs of insurance if people are being more careful. Of course I’m sure people take the things and forget everything that was just learned to get the savings.</p>

223

<p>I am completely in favor of wellness programs that are voluntary. I don’t respond we’ll to threats.</p>

224

<p>

</p>

<p>Using the waist < 0.5 * height measure would likely be more accurate in terms to determining who is at greater risk of obesity-related health problems.</p>

225

<p>

</p>

<p>Just like there are those that have a much deeper distrust of “corporations” or the so called 1% about every issue and want to blame them for society’s ills or assert that their successes are only due to the exploitation of others.</p>

226

<p>My employer has been doing this type of screening for about 4 years, though they only ‘penalize’ those who are morbidly obese (BMI >40). Since I work for a very large hospital system and we self-fund our insurance plan, I assume that they have figured out there is some correlation between being morbidly obese and cost. They tried the coaching thing a while back (having an outside company call you to give you coaching for various things like weight, high blood pressure and cholesterol, etc) but most people weren’t interested in taking those calls, so they dropped it. </p>

<p>I think it’s important to point out that many, many people have chronic health issues and are * not * overweight. In my family, there are people very overweight with few problems and those who are thin and look to be in good shape with many problems. When you are analyzing health care cost data, the obese population does indeed stand out as a group with higher health care cost (as do senior citizens) but there are others. For example, women who wait until their later years to get pregnant often end up costing a lot more because they are more likely to run into fertility issues (and end up with multiples, who often need intensive care at birth), pregnancy complications, etc. Our VP of Human Resources told me that the most expensive cases we end up paying for are cancer, major trauma and babies who end up in the neonatal intensive care unit. But when you think about it, there’s really no way to screen for those types of risks, whereas, weight and some other bio-markers are basically low hanging fruit for employers and/or insurance companies.</p>

<p>I think we all need to be cognizant of what is probably coming up in the future because this is indeed a slippery slope. </p>

<p>For example, a lot of providers are transmitting rx’s electronically directly to your pharmacy through their electronic medical records. What does this mean to us, the patient? Well, your doctor at some point might get feedback that you didn’t fill your prescription. The office might call and ask why not? Perhaps, your employer or insurance company might decide that they aren’t going to pay for your heart attack treatment because you chose not to take your statin or high blood pressure medication. It’s not only going to be about the overweight.</p>

<p>There is a amazing amount of cutting-edge technology coming down the pipe. For example, you will be about to swallow a pill and it will monitor your health. </p>

<p>[‘Digital</a> pill’ with chip inside gets FDA green light - Aug. 3, 2012](<a href=“http://money.cnn.com/2012/08/03/technology/startups/ingestible-sensor-proteus/index.htm]'Digital”>'Digital pill' with chip inside gets FDA green light - Aug. 3, 2012)</p>

<p>Who’s to say that your employer won’t make this a requirement in order to participate in their health care plan. And maybe it’s not a bad thing. I don’t know…</p>

227

<p>MomLive, that is a great post and a great link.</p>

<p>Thanks.</p>

228

<p>CJaneRead, really? Corporations are in the business of returning value to shareholders, not striving for the public good. It has nothing to do with distrust–it is a simple fact. And many of us would like to get the profit out of healthcare for that reason.</p>

229

<p>Corporations are comprised of people; government bureaucracies are compromised of people. Taking the profit out of healthcare can take the choices out as well. When people have less choices, that increases the power of those that are the remaining choice. This will often create a class of bureaucrats that wield power, that believe or not, does not always act in the “public good”, or more often, justifies the mistreatment of individuals in the name of the “public good.” I am no great fan of the current health care system in this country, pre- or post-Obamacare etc., but I will say, after having experience with a close family member as a health care provider and patient in a quasi-socialized medicine system — be very careful what you wish for.</p>

230

<p>Well, what we have is not working either. And millions of people in countries with universal, government-sponsored healthcare (including half of my family) are happy with what they have.</p>

<p>But you still miss my point about the differing motivations of corporations versus government or non-profit agencies. (Not to mention, your comments are eerily reminiscent of a public figure who famously said “Corporations are people, my friend.”) Corporations exist to serve and create financial return only for the people who are their investors–they are not in the business of altruism for the public at large.</p>

231

<p>

</p>

<p>Actually, our choices are limited precisely because of Big Insurance’s profit motive. Why do you think insurance companies spend billions of dollars a year on underwriting applicants? It’s so that they can determine if it’s profitable to insure the person. If it’s not, then the person’s choices are severely limited.</p>

<p>As for the rest, I think that’s a very good description of the insurance industry. A class of bureaucrats that wield power, check. Does not always act in the public good, check. The only difference is the reason for their justification of mistreatment of individuals. For Big Insurance, that justification is money.</p>

<p>You’re not a big fan of our system, and you think “quasi-socialized medicine” (which, BTW, Obamacare is not) is even worse. How would you have solved the problem of 50 million uninsured Americans?</p>

232

<p>MODS…shouldn’t this be in the non existent political forum?</p>

233

<p>I thought this was economics. The US citizens are paying<br>
800 billion dollars more a year for health care than any other country. This is after adjusting for the size of the population. That 800 billion is paid by people of various political persuasions, economic ideas, religious views, etc. it doesn’t matter.</p>

<p>Cvs is a private company asking for highly personal information from their employees. I don’t think CVS cares which political party their employees are members of but the company wants 600 bucks from each employee who doesn’t want to turn over his or her health records.</p>

234

<p>

</p>

<p>Actually, cancer risk is screenable to some extent and is targeted by medical underwriting. The biggest factor is previous cancer history.</p>

235

<p>

</p>

<p>On the other hand…CVS is taking on the financial risk of insuring their employees, so perhaps they do have an inherent right to some information. Do we lose our right to privacy when we allow someone else to pay for our healthcare?</p>

<p>I don’t think employers want to be in the business of monitoring their employees health but they feel like there is no other choice at the moment. They are just trying to be proactive.</p>

236

<p>If the government takes over healthcare, do they have the same right to do so? I think that they do but it will be a real mess getting there. BMI is a good example of the problems with healthcare metrics.</p>

237

<p>So momlive, should companies be allowed to hire based on health tests of applicants? CVS could lower its health costs if the company can screen potential employees?</p>

238

<p>I think that companies have been pushing on screening employees for a while. We’ve had drug tests and I’ve sure that you’ve seen the research on bias towards taller employees. We can obviously look at physical characteristics.</p>

<p>When we do interviews, we look for aspects of experience, character, what people do for hobbies, what their strengths and weaknesses are, are they team players, can they work independently, do they speak foreign languages, how good are they at puzzles and what they know related to what we do. And we’ll check references too. If someone was out sick a lot at a previous job, do you think that will factor into the hiring decision?</p>

239

<p>If a person’s health history is known, I think missing work because of illness is a factor in hiring. I wouldn’t blame an employer for trying to hire a healthier applicant. </p>

<p>I think giving an employer your blood work results is creepy.</p>

240

<br>

<br>

<p>I had to do that for a life insurance policy many years ago (not from my employer). I guess that it had an impact on premium rates. If life insurance companies can do that, can companies or their insurance companies?</p>