The Wellness Game: The Employer As the New Parent

The Wellness Game: The Employer As the New Parent

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Eat your vegetables.  Turn off the TV.  Go outside and play.  Go to bed on time.  These four imperatives were once amongst the core messages delivered to children by their parents and neighbors, a setting of behavioral parameters that people intuitively expected would help to produce healthy, well-balanced kids.  We’re not so good at this anymore.  Like so many other behaviors that animate the phrase “personal responsibility”, in the face of economic and demographic tumult we have decided to pass the buck on them in our homes, neighborhoods, schools, and churches.  We now want employers to handle them, and health-contingent wellness is the final step in the ascendancy of the employer as the new parent.

Employers find themselves teaching employees how to read and write effectively, do math, be polite, how to eat in the presence of others, and even how to sleep better.  Why not throw at their feet the notion that employers should coerce workers into intrusive and dubious health-contingent workplace wellness strategies that are easy as pie for the healthiest, but far more difficult for the less fortunate who are, ostensibly, the ones who need the most help?  This is not why most people start businesses (unless, of course, you’re a wellness vendor).  It certainly is not why people devote themselves to work, which is supposed to be for securing (hopefully) individual and familial prosperity and experiencing the unique contribution to personal dignity that comes from purposeful endeavors.

US employers are not responsible for the chronic disease crisis; truth be told, their sufferance of the costs of many wellness-sensitive events is limited because the majority of the medical catastrophes that health-contingent wellness programs promise to prevent (such as heart attacks, strokes, and many cancers) happen predominantly in older people who have mostly left the work force. Employers have been caught up in the maelstrom of demographic, industrial, and technological changes just like the rest of us.  Yet,  not only do we actively seek their participation in fishing expeditions such as health-contingent workplace wellness programs, some of them jump in with both feet.  This should help to remind you that your CEO might just be the one who graduated at the bottom of his class.

Should employers want everyone to be hale and hearty?  Of course.  I want everyone to be hale and hearty and to live an absurdly long, healthy, prosperous life.  It’s just not clear that the path to health is paved with health risk appraisals, biometrics, and cost-shifting the burden of higher premiums on to the backs of people who, for whatever reason, could not master the four fundamental tasks written at the beginning of this piece.

Organizational cultures should be configured around health centric messaging and tools that help people voluntarily, and by following exemplary health leaders, elevate themselves and change the trajectory of their health lives.  But, the intrusive and coercive nature of health-contingent wellness programs is the most demeaning kind of paternalism.

If you are comfortable today with the notion that your employer should be your parent, consider this: another function of highly engaged parents is to punish when things don’t go as expected.

Vik Khanna is a St. Louis-based independent health consultant with extensive experience in managed care and wellness.  An iconoclast to the core, he is the author of the Khanna On Health Blog.  He is the new Wellness Editor-At-Large for THCB.

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52 Comments on "The Wellness Game: The Employer As the New Parent"


Guest
Dec 9, 2013

That’s a nice read. Overall, everything seems to be trending in the right direction for a change. Permissiveness and technology reigned for well over a decade but now you are seeing the basics make a comeback – the importance of getting outside and exercise, farm-to-table, etc. Definitely good to see.

Guest
Uwe Reinhardt
Sep 21, 2013

Good post, Mr. Khanna. I have deplored this Nurse Ratchet intrusion for a long time as well.

But hold on. The next frontier undoubtedly will be that employers pick our spouses for us. After all, a well working marriage is good for health and worker productivity. And who else would know better than employers whom we should marry, given all the data they have on us.

Anyone willing to put some VC money into perfect-mate consulting companies vending their expertise to employers?

Guest
Sep 24, 2013

Uwe: thank you for your comment. Your characterization of wellness as a Nurse Ratchet intrusion is brilliant, and I plan to borrow it frequently (with due credit, of course).

After employers have picked our spouses, perhaps they can move into selecting our cars, homes, pets, and even friends. Given the wellness industry’s most recent obsession with leveraging “social media” to help people do whatever it is wellness vendors want them to do, that seems only natural.

Maybe the real path to wellness is for people to just reside at their workplace, where the wellness-driven command and control function can finally reach its zenith.

Guest
Uwe Reinhardt
Sep 24, 2013

Living at the worksite would have its advantages. Using moder psychology — peer pressure — every employee’s health statistics (body mass, body mass changes past period, body mass change projected period, ditto for blood pressure and cholesterol, etc could be posted on line (just as the Chinese communes posted birth control data by name at the commuine gate).

Guest
Jun 27, 2013

My only “problem” with the article is the thought that Wellness vendors might be the only people in the world who want to “parent” their employees…I only think its false because my company (I own it) would be considered a “wellness vendor” and I have absolutely NO desire to parent my employees!!! In fact, I do even less wellness for my employees than my clients do for theirs! After all, the people I hire already know (or at a minimum have easy access to) what needs to be done to be healthy and they are grown ups….do it or don’t, but don’t expect me to bribe you or penalize you! Do it and health will be your reward, don’t and sickness will be your penalty. I control what snacks and beverages are available in my office. I take the steps and park out at the far end (lead by example), but beyond that I feel no obligation to do anything to influence my employees behavior…we are at work to do a job for which we are compensatedfairly and which has reasonably generous bbenefits.

Guest
Jun 28, 2013

Hi Deb, and great to hear from you. You are indeed my kind of parent: you lead by example and expect your people to be responsible adults. What a concept. GE could learn a lot from you.

Guest

I agree with everything pointed out here. obviously every employer would want his/her employee to be fit and sound.

Guest
Jun 13, 2013

A mind-opening article. Many employers overlook these important stuffs concerning their employees. Thank you Vik for posting this.

Guest
Jun 14, 2013

Thank you very much for your kind words.

Guest
Botetourt
Jun 12, 2013

Vik–not seeking an argument, and I am not a wellness vendor. My point was to say that encouraging people (employees, too!) to understand their health status and act if they desire, is a good thing. HR depts don’t prescribe PSAs–but it may be worthwhile for many to see a doctor every decade or so. The wellness industry has been created out of frustration with a pathetic healthcare system–I think we agree on that. Employers are vulnerable to something that might make intuitive sense, but does not hold up to the evidence. But getting everyone interested in his/her own health status is not a bad thing.

Guest
Jun 14, 2013

Actually, the wellness industry is a creation of that pathetic healthcare system. Consider. for example, that some of the most vociferous proponents of health-contingent wellness program are medical care providers who see them as a feeder system to help create a new stream of patients (many of whom actually benefit from the care provided). Further, if you dig into the background of many of the larger wellness industry players, you will find very strong connections to that same pathetic healthcare system. The healthcare system’s rapacious maw has to be fed. There is a reason that health-contingent wellness is so centrally placed in the Affordable Care Act, which was strongly supported by hospitals, health plans, and wellness vendors.

Guest
Jun 14, 2013

Sorry…meant to say will NOT benefit from the care provided.

Guest
Peter1
Jun 12, 2013

“The wellness industry has been created out of frustration with a pathetic healthcare system–I think we agree on that.”

No I can’t agree with that. The “wellness industry” has been created out of a pathetic industrial food supply system that has created a culture of illness and treatment.

Guest
Peter1
Jun 12, 2013

If corporations really wanted to improve the “wellness” of their employees they’d tell them – DON’T USE OUR PRODUCT!

And if societal change is what they’re after then they’d stop selling their products all together.

Guest
Melissa Tobler
Jun 12, 2013

Vic, We don’t always agree…but bravo! This was well written and spot on. Key to your last paragraph is the comment on health-centric messaging. So many employers overlook this simple, often times cheap, initiative as a way to create a culture of expectation of personal responsibility.

Guest
Jun 12, 2013

Great to hear from you, Melissa, and thanks!

Guest
Dr. Rick Lippin
Jun 12, 2013

Best Wishes Vik Khanna on your new appointment at THCB

Rick Lippin

Guest
Jun 12, 2013

Vik,

So you’re the new Wellness Editor at THCB? That seems akin to putting a vegan in charge of reviewing new steak house restaurants. :)

V

Guest
Jun 12, 2013

Actually, I am an equal opportunity critic, as I love both vegetables and red meat.

Guest

I think that an employer should be an employer and just that, but workplace wellness programs are helpful for those who do need the motivation and a little push to get them to a healthier state. The problem seems that parents and teachers in school aren’t teaching the fundamentals.

Guest
Jun 12, 2013

Exactly the point of the piece. Thanks.

Guest
Dr. Rick Lippin
Jun 12, 2013

“SOCIAL INJUSTICE IS IMPACTING HUMAN HEALTH OUTCOMES ON A GRAND SCALE”

http://www.youtube.com/watch?v=QDI9gPdIpcw

Dr. Rick Lippin
Southampton,Pa

Guest
Rajiv Mehta
Jun 12, 2013

Bruce — I think pointing out bad ideas, even without suggestions of what would be better, is worthwhile in itself. We should at least stop doing the things that are counter-productive or ineffective. This seems difficult when there’s a culture of “do something, anything”. In Nasim Taleb’s book “Black Swan” he relates a story when he pointed out the fundamental flaws in certain economic models to a group of prominent Fed officials. Their response was, essentially, “Yes, but it’s the only models we have!”. The same attitude seems to be true in employee wellness. But, even if we don’t have better solutions, let’s at least stop doing things that are harmful.

And of course there are better ideas. But they’re not mainstream today, they’re outside of what is considered best-practices today, they’re different than what is considered to “innovative”. Those people would benefit from more support.

My own non-mainstream efforts have been focused on *helping* people take care of their well-being in whatever way they themselves feel is best. Not on motivating, gamify-ing, engaging them to do what someone else thinks they should do, but simply helping them to do what they want to do. Unfortunately this approach does not fit into the make-employees-do-the-right-thing world of employee wellness plans. You can read about the thinking in a paper from a few years ago (http://bit.ly/US8DNK) and a recent talk (http://slidesha.re/11g308K).

Guest
BobbyG
Jun 12, 2013

Median U.S. job tenure as of 2012 (BLS) was less than 5 years (4.6). So, you’re likely to coerce people into “improved health” at significant cost, and their next employer will benefit. Maybe that’s still a worthy goal from a national public health perspective, but there’s some “first mover disadvantage” here, no?

Where’s JD Kleinke when I need him?

Guest
Jun 12, 2013

Great point. This is exactly the reason that it historically proved so difficult to get health plans and self-insured companies to cover preventive clinical services…the downstream financial and health benefit would likely not be theirs and they knew it.

Guest
BobbyG
Jun 12, 2013

Added you to my REC blog blogroll, btw.

Guest
Jun 12, 2013

Thanks, BobbyG. I appreciate it. You can also sign up to follow my blog.

Guest
Dr. Rick Lippin
Jun 12, 2013

I’m with Rajiv Mehta’s comments-

I’ve studied the impact of job loss and the threat of job loss on health outcomes. Also 1 in 5 American workers are now part-time.

Would you trust your employer with your health verses your parents? Usually parents don’t fire you!

Dr. Rick Lippin
Southampton,Pa

Guest
Jun 12, 2013

Good point, Rick. At the end of the day, your parents probably are the people who are most invested in your happiness and success. If you expect your employer to take on that role, you are likely in for a very disappointing surprise.