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eridani's Journal
eridani's Journal
June 25, 2016

Employer Wellness Programs Are a Great IdeaŚRight?


Actuarially driven discrimination can be as technologically sophisticated as it is socially regressive. Some programs rely on arbitrary formulas like the Body Mass Index (BMI)—a metric derived from height and weight used to bluntly assess obesity—instead of more holistic health examinations.

Insurers can’t be blamed for using BMI as a rough indicator of obesity-related risks within an insurance pool. But for an individual worker, such as the diabetic retiree with asthma who might exceed her target BMI but is not in a position to crash diet to achieve a “wellness” benchmark, how would making her doctor’s visits more costly make her healthier?

The very concept of “incentives” raises questions of medical efficacy. How would insurers even measure the long-term “success” of linking premium rates to a weight-loss program? As NPWF’s testimony pointed out, “There is scant—if any—empirical evidence that monetary rewards can result in sustained weight loss. Crucially, there is no independently evaluated research demonstrating that linking the cost of employer-sponsored insurance to certain biometrics has an impact on health outcomes.”

A possible side effect of biometric surveillance, the group argues, is anxiety: Arbitrary health assessments could lead to “more people refusing testing and treatments they need for fear employers and insurers will use the information against them,” and, while premium rates continue to inflate in general (worker contributions to insurance plans have jumped over 80 percent since 2005), the wellness gap could impose “higher health insurance costs for the consumers who can least afford to pay.”
June 25, 2016

INTERSECTIONS: US has longest health care waiting times


It is a common mistake to associate universal or near-universal coverage with long waiting times for specialized care. ( Read the previous sentence again-- a mistake to associate universal coverage with long waits.) The UK has short waiting times for basic medical care and non-emergency access to services after hours. The UK also has improved waiting times to see a specialist and now ranks fourth on this dimension with the US ranking third. Patients in the Netherlands, Germany, France and Switzerland have rapid access to elective or non-emergency surgery compared with patients in the US.

Again, it is a mistake to associate universal care for all with delays in care, seeing a specialist or elective surgeries. If this goes against the propaganda one commonly hears in the US, such propaganda being paid for by US health insurers and Big Pharma, then read the above paragraph again. Now, it is true that Canada is having some wait times for specialized elective care--this is NOT a reflection of universal care (read the above paragraph again), it is a reflection of some issues unique to Canada that Canadians are addressing--just as the UK addressed waiting times to see a specialist and now ranks just behind the US.

If universal coverage was the cause of waits, then US Medicare patients would be looking at serious delays. US Medicare patients are not suffering, for many they are safe from predatory health insurers for the first time in their lives (except for privatized Medicare Advantage plan patients, who face restricted, choice, narrow networks while costing taxpayers more). What is often cited is Canadians wait for elective knee or hip replacements--in fact US patients wait also, often voluntarily putting off joint replacements for years on end--and remember that for 37% of US patients without good insurance the wait is infinite.

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Gender: Female
Hometown: Washington state
Home country: USA
Current location: Directly above the center of the earth
Member since: Sat Aug 16, 2003, 02:52 AM
Number of posts: 51,907

About eridani

Major policy wonk interests: health care, Social Security/Medicare/Medicaid, election integrity
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