The other morning on the Curtis & Kuby show there was a discussion about new rules and health-related restrictions that were being imposed on employees or would-be employees. Today I found a link to a Chicago Tribune article which concerns this very subject, and may have been the reason for their discussion.
According to the article,
"Indianapolis-based Clarian Health has told its 13,000 employees that, starting in 2009, it will charge them $5 per pay period if they use tobacco or exceed specified levels of cholesterol, blood pressure and other measurements. Penalties could reach $30 per paycheck.
The Cleveland Clinic, on Sept. 1, started nicotine testing in pre-employment physicals. If nicotine is found, applicants will not be hired.
And Weyco Inc., the suburban Lansing [Michigan]-based firm that drew national attention in 2005 when it fired four employees who used tobacco, has expanded the health-insurance requirement, penalizing employees whose spouses smoke or chew tobacco. Penalties are $50 per employee paycheck."
In the past, employers tried the carrot approach to improving employees' health: they would put incentives in place to get the workers to live healthier lifestyles, such as discounts on health club memberships, on-site gyms, or smoking cessation assistance. Now they're bringing in the stick instead.
Weyco, which is a health-benefits administration company, performs random testing for tobacco use every three months. If an employee tests positive for tobacco twice they will be dismissed.
The Clarian policy of charging employees $5 per condition per pay period could be the beginning of a nasty slide down the slippery slope. It's not a big step from charging an employee up to $30 a paycheck for their poor health scores, to actually firing the person. After all, companies are doing it for tobacco use, why not high cholesterol? Where do they draw the line?
I find this kind of information very chilling, especially since I am a cancer survivor and probably would not be top on any list of desirable candidates for a health care provider.
Many of the health conditions being monitored are not necessarily the result of the person's lifestyle habits to begin with: many are genetic in nature. For instance, high blood pressure can occur in people who are in shape and slender. Cholesterol levels are controlled by the liver; often diet does not help.
Rules such as these undermine the very idea of health insurance, which is that risk is spread out over a large group to mitigate the costs incurred by any single person. If those people at higher risk of illnesses are not able to be insured, and can't find employment in more and more companies, what are they supposed to do?
And what about people whose health conditions ARE caused by their own behavior? Will we no longer be allowed to eat at MacDonalds? Will they start searching our cars for Twinkie wrappers? Knocking on our doors at night to see if we're having a cocktail before dinner? How much privacy do we have to give up to our companies or our health insurance providers in order to get basic health care? Why should our personal habits affect our employment unless they impinge on our work performance?
Where do we draw the line and say "enough"?
The last paragraph of the article is a quote by Candace Gorman, a Chicago attorney specializing in labor law:
" 'They will cut as many people for whatever reasons they can get away with. Until Congress steps to the plate and joins the rest of the Western world in mandating universal coverage, the employers and insurance companies will whittle away the coverage, hoping that only the healthy will be covered.' "
I couldn't have said it better myself.