Where’s the Line Between an Owner’s Right to Run Her Business, and an Employee’s Right to Personal Liberty?

Allow me to tell you the exact same story, but from two different (and equally valid) points of view.

woman business owner

The Business Owner: “During the last 10 years, I’ve seen my company’s healthcare costs increase 160% in total, now over $12,000 per year per employee. During that same time, I did everything the benefits consultants told me to do: (1) first increase the copays for doctor visits and drugs, then when that didn’t lower total costs, (2) change the employees’ financial obligation from copays ($15 per visit) to coinsurance (15% of the cost of the visit), then when that didn’t work, (3) change the plan design to place more of the financial obligation of healthcare expense onto the employee, which chased away my top 10 employees, lowering our sales productivity.  Now those same consultants are telling me the only way to lower next year’s costs is to insist my employees make themselves healthier this year.  So I’m financially mandating wellness from each employee.”

american workersThe Business Employee: “During the last 10 years, I’ve seen my payroll deduction for healthcare coverage rise 220% in total.  At the same time, my pay has increased only 30%, barely keeping pace with inflation, with fewer colleagues to share the workload.  The owner keeps changing our healthcare coverage every year or two, saying she can no longer afford the older, richer package, so my out of pocket expenses for healthcare have also increased.   Now she’s telling me I have to lose 50 lbs (get my BMI < 35) by the end of the year, or I’ll pay $1000 more than my slim and fit colleagues next year, for the same coverage.  There goes Christmas.  What’s next – fire me for having diabetes and bad knees from my weight?”

It’s a true story playing out all over America.   The Wall Street Journal recently reported that up to 60% of companies surveyed plan to implement penalties (rather than incentives) upon workers who don’t get healthier (Leslie Kwoh, “Shape Up or Pay Up: firms put in new health penalties”, A1 and A6).   This leads to at least two questions, “Are such penalties legal?” (Yes, within limits), and “Where do an employer’s rights end and an employee’s rights begin?” (Harder to answer)

Most would agree the employer has no obligation to build and run an onsite gym or cater lunch every day from Whole Foods (although high-tech, high-profit companies often do something similar).  All would agree that the employee has the right to quit if she/he finds the corporate rules, salary or benefits unacceptable (but that’s very hard to do in the new global economy).  Let’s seek the middle ground.

weight of the nation

Given the facts that obesity is now directly or indirectly responsible for (1) ~ 50% of the deaths in the US (CDC, Weight of the Nation), (2) ~ 30% of healthcare costs (several sources), and (3) 450 million missed days of work annually in the US (2011 Gallup), business owners feel financially obligated to structure benefits to attract and retain fit employees.  The question is, “how will the US workforce respond?”  Will we argue the financial reality of the business owner, or redirect those energies against the real enemy – overweight and obesity.

What is in an employee’s control?  Certainly not whether they get leukemia (Act of God if you will), but diabetes, hypertension and hyperlipidemia might be (diet and exercise balanced against our genetic inheretance).

What is an employer’s obligation?  Certainly not gym memberships and delivered veggie-humus wraps, but civil workloads and facilitating an exercise-at-desk-program might be.

At KP Georgia, we have the highest HEDIS ratings in the state for Adult BMI assessment, as well as, Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents.  We join our members and corporate partners in the fight against obesity, and its sequelae.

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