Workplace wellness incentive programs are not a new phenomenon, but the Internet is in turmoil today over a recent announcement by the national drugstore chain CVS. Beginning in May, CVS will require employees on the company's insurance plan to undergo health testing—including body mass indexing and blood glucose testing—or face a $600 annual penalty.
The company's rationale? Coercing employees to submit to health testing will provide incentive for workers to get—and stay—in shape. Employees' health information will not be accessible to the company itself, but rather to a third party responsible for administering company insurance benefits. Reportedly, with the advent of Obamacare and rising healthcare costs, practices like this threaten to become more commonplace in the corporate environment.
Attention everyone, everywhere. If you've been struggling for years to get in shape, whatever that means to you, you can just quit whatever it is you're doing right now because CVS has got it all figured out. It turns out whatever silliness you were attempting, you just didn't have the proper incentive. Except, as it happens, this regimen already exists and it's called humiliation and fat-shaming. Have someone tell you you're overweight, or pay a major fine.
Then there's the next major issue. CVS, which really should by keyed in to the latest, or at the very least some, health news, ought to know Body Mass Index (BMI) is by no means an accurate indicator of health. As Keith Devlin over at NPR pointed out back in 2009, there are at least 10 good reasons BMI is entirely bogus, not the least of which is it hinges on the notion of the "average man."
According to the Centers for Disease Control and Prevention, BMI may have some minute health relevance, but correlation varies widely based on sex, race and age. For instance, at an equivalent BMI, women tend to have more body fat than men. Additionally, a BMI which shows up as within the ideal target range can actually be a smokescreen for serious underlying health factors. The complexity of BMI as an indicator of health presents something of a double-edged sword for these employee health profiles: the more in-depth and contextual the profiles are about their patients, the more accurate they are… but being in-depth requires being considerably more invasive.
Further, what happens if this incentivizing fails? There are laws against discriminatory hiring and firing practices, but our society is far from perfect. What's to say what goes through the mind of a CVS hiring manager, however unconsciously, who knows a fitter-looking workplace equates to better insurance benefits? What's to say companies like CVS won't subtly modify their hiring profile to lower their insurance costs and score better benefits? Perhaps most realistically and devastatingly, who's to say what goes through the mind of an overweight employee who worries his job security is threatened by his health status or appearance?
Obesity is more prevalent in low-income workers, due to a variety of factors, including workplace stress and purported diminished accessibility to healthy food. The economists will side with CVS and agree when it comes to incentives, money goes a long way. It's great to promote health and wellness initiatives in the workplace, but CVS, which is being blatantly reactive, and even "bullying" according to some sources, seems to be going about it all wrong.
Once the doctor hands an employee the "overweight" card, who's going to be there to counsel him on the best fitness, diet and mental health practices for his personal lifestyle? If this is not the company's responsibility, as many will argue, why make him pay emotionally to find out he's unhealthy in the first place?
Photo from NBC's coverage of CVS's program.