The late Dr. C. Everett Koop was the most revered Surgeon General in history, perhaps even the most revered Cabinet member. His calling card—indeed, his claim to fame – was his integrity. A Reagan appointee, he acted as though he reported to no one other than the American people and his own conscience. His penchant for candor and scientific independence fueled the federal government’s groundbreaking steps to raise public awareness about HIV/AIDS at a time when the tendency was to demonize and diminish. He resisted incessant political pressure and refused to take positions or produce data that he knew to be false.
This drew strong support from both sides of the aisle, and even his detractors never questioned his honesty. (Exhibit A: The two authors of this posting, whose political views have little else in common other than respect for strong, independent-minded politicians.)
Dr. Koop’s legacy stands in sharp contrast to the eponymous award dispensed by The Health Project, whose committee members have turned their back on their founder. The last thing Dr. Koop would have expected is to see is *his* award bestowed upon people who know that they don’t deserve it. The 2012 award was given to three recipients for work done in Nebraska: a vendor that claims wellness programs don’t even have to exist to save money, an outfit that can’t even spell the name of its own founder, and a state employee benefits plan that is under investigation for sky-high administrative costs.
Among the extravagant statements that formed the basis for the award (like claiming more than $20,000 in savings for every person who reduced their risk factors for a year, even though per-person spending is only $6,000), they claimed to have made 514 “life-saving catches” on employees with otherwise undetected cancer. This data was obviously wrong to begin with — that cancer rate would have been at least 40 times greater than Love Canal’s. Nonetheless, it sure sounded good, and the Governor of Nebraska himself was all-in too, so an award was issued.
The problem was that even though the Project’s Koop Award Committee was willing to overlook the ”error”, the perpetrators ended up confessing. They admitted that the 514 people who they claimed had cancers on which they made “life-saving catches” did not in fact have cancer at all. Rather, they had mostly benign polyps that had small chances of someday turning into cancer. To say Nebraska’s program made “life-saving catches” would be only slightly more accurate than saying that preventing someone from boarding a plane saves their life because the plane might crash.
Even by the gauzy ethical standards of the wellness industry, where every single vendor claiming savings can easily be shown to be making them up, besmirching the name of history’s most revered Surgeon General for dishonest commercial purposes elevates malfeasance to a new plateau. Koop Committee members, allegedly the field’s leaders (and two of whom we know to be highly ethical), but also naturally including BP’s wellness muses, Mercer and Staywell, must have asked themselves the question: “How would America’s Family Doctor have reacted to having his award given to people who publicly acknowledged falsifying data?” and, shamefully, decided his reaction wouldn’t matter. So they let their friends in Nebraska keep their award.
For its part, Nebraska refuses to return the award voluntarily, recalling the immortal words of the great Senator S.I. Hayakawa during the debate about whether to return the Canal Zone to Panama: “We stole it, fair and square.”
The health services blogosphere was atwitter with outrage, and LinkedIn polls of the ethical wellness rank-and-file were unanimous in opposition, as this decision benefits Nebraska at the expense of the rest of the industry.
It also appears that the Committee is hoping the lay media won’t notice this desecration, because they’ve successfully gambled that most of the field’s other exaggerations (about phony life- and money-savings claims) would be unnoticed outside of the industry. However, those tales of fancy were too technical to interest a lay audience. Here’s a guess that they’ll lose the gamble this time both because these misrepresentations of a dread disease are so cavalier…and because unlike other wellness vendors, these perpetrators have now admitted them.
We can only imagine what Dr. Koop, who unflinchingly confronted ideologues of all stripes in pursuit of the public’s health, would say. We hope that the lay media will say it for him.
Al Lewis is the author of Why Nobody Believes the Numbers, co-author of Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care, and president of the Disease Management Purchasing Consortium.
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 also the Wellness Editor-At-Large for THCB.