No 'Health' in Healthcare?

Molly Rowe, for HealthLeaders News , September 14, 2007

An article in this week's Boston Globe describes several companies' efforts to improve employee health and reduce insurance costs by docking pay from employees deemed "unhealthy." It's part of a growing trend across all industries to encourage employee health through reward and, as the case may be, punishment. Not surprisingly, employee advocacy groups like The National Workrights Institute are against the practice, saying employers are trying to control personal behavior and inappropriately collecting private health information.

I think it's a great idea--albeit rife with potential problems. Kinder, gentler efforts haven't worked. Healthcare spending in the United States is expected to nearly double by 2015, according to the National Coalition on Health Care. Voluntary wellness programs haven't made the difference on employee health--or insurance costs--that companies hoped. Subsidized gym memberships are only as good as the people who use them, and in-house weight loss programs only work if employees stick to them. Even hospitals, where the effects of unhealthy living are seen firsthand, struggle to improve employee wellness.

Take for example the Institute for Healthcare Improvement's annual forum in Florida last December. I was astounded by the popularity of the conference's designated smoking area. I know 21 percent of Americans smoke cigarettes, but it still surprised me at conference themed around saving lives. I couldn't help thinking that if smoking cessation isn't important in healthcare, where is it important?

Don't get me wrong: I talk to numerous senior leaders who are healthy and fit: marathoners, iron men (and women), power walkers. But, in general, the healthcare industry is not much better than other industries in terms of overall worker health. If employee wellness doesn't matter in a profession where there are constant reminders of the risks of having a few extra pounds, high cholesterol, or a pack-a-day habit, where will it matter? On some level, healthcare workers may be held to a higher standard--as examples of healthy living--and unhealthy caregivers weaken healthcare's ability to deliver the message with any credibility.

Experts predict that companies across all industries, including healthcare, will adopt more stringent employee wellness policies in the next few years. How about you and your hospital? How do you encourage--or enforce--employee health and well-being? Do you penalize or reward employees based on health? I'd love to hear what you think.

Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at

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