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12 April, 2013 Posted by John G. Self Posted in Healthcare, Stories
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The Elephant in the Room Is Fat

Posted April 12th, 2013 | Author: John G. Self

It has been a long, tough day, a good day but stressful nonetheless.  A delicious ice-cold martini sounds incredibly tempting. 

But as I lean back in my chair, I bump into the elephant in the room.

My waistline is greater than the insurance target of 40 inches – not much, but enough to drive up the cost of my health coverage.  One martini, as tempting as it may be, represents 388 calories.  If you want to add an olive, or four, that is another 12.5 calories per olive.  The gym in the lobby of my building, by comparison, helps to burn calories and represents lower health benefit costs and, ultimately, better health.

First, let me go on record and say that I think it is inherently unfair that gin, a clear spirit, should have any calories at all.  Scotch or bourbon should have a lot of calories based on their rich looking golds and browns.  But gin, or vodka? Well, that seems wrong.  But it isn’t and that brings me back to the elephant in the room.   

The room is really a metaphor for our country.  We have become a nation of overweight – fat – people whose eating and wellness habits are contributing mightily to the rising cost of healthcare. 

Something must be done, but people are not going to like it.  It will be painful because sacrifice – and exercise – will be involved.  If you don’t like this message, and you think that I am as full of sh*t as a Christmas Turkey – or in text/SMS shorthand, AFOSAACT – then pay attention to this:  your employer may insist you change.  

That’s right.  Increasingly, employers are telling their employees to lose weight and lower their blood pressure or face $1,000 or more in out-of-pocket costs for health coverage.  Companies have finally come to the conclusion that voluntary wellness programs rarely work on the majority of employees and so companies like Michelin North America, the premium tire maker, are requiring their employees to share personal health information such as body-mass index, weight and blood-sugar levels, or face higher premiums, according to a Wall Street Journal article earlier this week [paid article].  

No one argues that the connection between poor eating habits, obesity and high blood pressure, significantly increase the risk of stroke or heart disease, two very costly illnesses.  But, already, employees and worker rights advocates are using the silliest three words when it comes to personal accountability:  That’s not fair.

Employee rights advocates are saying the Michelin program, and others like it, amount to “legal discrimination,” the WSJ quoted Lew Maltby, a worker’s rights advocate in Princeton, NJ.  “While companies are calling them wellness incentives, the penalties are essentially salary cuts by a different name.”

“It means workers are getting their pay cut for no legitimate reason,” he said.

Good grief.  Don’t you love it?

OK, so it is apparently not fair to hold employees accountable for their personal health. 

Let’s shift to the other side of the healthcare cost equation, providers – doctors, hospitals and others.  They, too, are being criticized for contributing to increasing healthcare costs.  Consumer advocates – I wonder if Mr. Maltby is in that loosely defined group – are arguing for reimbursement recalibration.

What an innocuous sounding word, “recalibration,” until you understand that what it really means is that the federal government and private insurance companies are going to cut the money they pay to hospitals and doctors under healthcare reform and deficit reduction initiatives.  It is a cut in the pay for a group of workers who went to school for 10 years or more, who pay the earth for malpractice coverage, and who work long hours – for “no legitimate reason.”

Maybe I will have that martini after all.

 © 2013 John Gregory Self

© 2021 John Gregory Self

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