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MN2020 Journal: Which Side Are You On? Wellness Data and Dark Motives

October 09, 2009 By John R. Van Hecke, Executive Director & Fellow
Living healthy is a no-brainer. We should eat well, consume modestly, and engage in regular, moderate exercise. It's hard to argue with that. So when the company announces its wellness initiative, lots of people sign up, seeking a healthier life.

Typically, some sort of participant bottom line is established. Weight, body mass index, smoking, diet, blood pressure, general fitness and, occasionally, long-term health issues like family health history or genetic predisposition to disease vulnerability are recorded. Then, goals are set, matched with educational and motivational tools.

Most of us had a food consumer/diet/nutrition unit during a health or Home Economics class during our secondary educations. Precious few of us remember how to translate food packaging label nutritional information into calories. Everyone understands that mindlessly consuming a half-bag of nachos in front of the TV is not good for the waistline but the cold calorie conversion math teaches a different, lifestyle lesson.

The National Academy of Sciences observes that physically active men should consume 2700 calories a day. If one ounce of flavored nacho chips, approximately 11 chips, equals 160 calories and is purchased in a 24 oz. bag, eating a half-bag means snarfing 1920 calories. That's roughly two thirds of an active man's total daily caloric requirements, chowed during Monday's Vikings-Packers game, after dinner.

It's important to learn, embrace and apply the nutritional science. Every wellness professional will lead with that assertion. Simultaneously, even without nutrition labels, everyone understands that a nacho chip-based diet is unhealthy and should be stopped or altered ASAP.

As I understand it, behavioral research suggests that true, long-term lifestyle change is difficult and requires building a supportive community around healthy living choices. Addiction treatment, for example, is built on this premise. Many wellness programs offer support groups and weekly weigh-ins, all working towards reinforcing the desired change.

Data lay at the center of the wellness program initiatives. Without it, change or even initial education is impossible. But, what happens to that diligently recorded and reported data? There's the rub.

Unless specifically stated otherwise, workers should expect that employer-offered wellness program data belongs to the company. Don't be shocked. This isn't new. Courts have repeatedly ruled that workers have rather limited expectations of privacy on the job. Your internet use on company time, for example, is a function of company productivity, not your free speech rights exercise. We must assume the same with wellness program generated health data.

Do wellness programs serve participants or another, darker master? That's the troubling question emerging in health insurance consumer protection circles.

If an organization's goal is health insurance cost minimization, wellness data provides great insight into lifestyle and long-term health costs. For employers looking to reduce its health insurance premium payments, forcing high risk/unhealthy individuals into higher co-pay brackets or off the group plan altogether bears cost-reduction rewards.

Since insuring lower risk, healthier individuals is more profitable than insuring a group containing demonstrably greater percentages of unhealthy people, insurance companies will use wellness data to further drive higher risk people from its policy rolls.

In either case, wellness program gathered data drive the cost containment effort.

Many organizations legitimately seek wellness' workplace benefits: a healthy, happy, stable work force. Fewer absences and less turn-over reduce costs and contribute value to a company's productivity and bottom line. But never forget, every silver lining requires a dark cloud. Whatever wellness benefits are achieved can easily be compromised by a hidden cost reduction agenda.

Responsible business and organizational leaders, including state public policymakers, will smartly establish a firm firewall between wellness program data and their information exchange with insurance providers.

Every Minnesotan must climb the healthcare personal responsibility mountain; we don't need health insurers pushing us off the cliff on the way up.

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