The road to socialism is paved with good intentions

Now that health reform 2009-style is effectively dead we better hope like crazy that employers are successful in controlling health care costs. Wellness programs are an important weapon in the employer arsenal. By encouraging employees to eat right, lose weight, stop smoking and so on they can improve productivity, reduce health care costs and help employees feel better. There are limits, however, to how far employers can be expected to go in these efforts. For example, are employers really willing to get deeply enough into the off-hours lives of their employees to make a big enough difference in health care costs?

My working assumption has been that we still have quite a way to go before the limits of employer willingness and employee tolerance are reached. But after reading Wellness Efforts Face Hurdle in today’s Wall Street Journal, I’m starting to think that day may come sooner than I originally expected.

According to the Journal, the Genetic Information Nondiscrimination Act, which went into effect in 2009,

…restricts employers’ and health insurers’ ability to collect and disclose genetic information. That includes not only genetic-test results, but family medical history, too.

Some employers say the law is stymieing their efforts to promote employee wellness because it bars them from offering workers financial incentives to complete health surveys that ask about family history.

That’s a problem. Employees with a family history for certain ailments (e.g., heart disease, cancer) should undergo different wellness regimens than those without. Incentives are needed to drive the uptake of health risk assessments, so it’s a real issue if they can’t be offered.

I do understand the rationale for the restrictions, but it reduces the effectiveness of wellness programs, increases health care costs and makes health insurance that much more unaffordable. Over time, it reduces the number of employers who can offer health insurance. If businesses can’t find ways around the restrictions or alternative pathways for cost control, eventually they are just going to give up and ask the government to take over.

February 1, 2010

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