National Press Club

Union official debunks workplace wellness programs

December 18, 2013 | By Joe Sparks |

There is no evidence that wellness programs work, yet they may increase health care costs for people who need it the most, according to John Borsos, secretary-treasurer of the National Union of Healthcare Workers.

Borsos told an audience at a Dec. 17 National Press Club Newsmaker that wellness programs should be eliminated.

“You can take people who are generally considered to be fairly fit, fairly healthy, and put them in a category of being overweight that requires some kind of address” based on arbitrary standards, Borsos said.

He cited several studies that found no evidence that wellness programs improved health outcomes or saved money.

Washington Redskins quarterback Robert Griffin III’s body mass index would place him in the overweight category based on standards set by the wellness program at Kaiser Permanente, a company that has many employees represented by the NUHW, according to Borsos.

The Affordable Care Act implements new wellness-program regulations on Jan. 1 that will have a “profound effect” on more than 140 million employees, according to Borsos.

A better solution to reducing health care costs than wellness programs is to improve working conditions, take the profit motive out of health care and implement a Medicare-for-all health care system that would cover everybody at less cost, Borsos said.

He identified several problems with wellness programs.

First, there is no standard definition for them. They can range from “healthier food in vending machines to comprehensive programs that include risk assessments with measurements of an employee’s body mass index with a target goal of reduction. The [health care reform law] defines a wellness programs as a program offered by an employer that is designed to promote health or prevent disease.“

Although wellness programs are supposed to provide incentives for good behavior and can penalize bad behavior, most of the time the only incentives are negative, Borsos said.

The penalties can be substantial under the health reform law -- up to 30 percent for most programs and up to 50 percent for smoking cessation. This allows employers to shift health care costs to employees and often forces the employees who can least afford it to pay more for health care, Borsos said.

Borsos also criticized wellness programs for requiring employees to answer invasive questions about their health. One company survey asked employees whether health problems affected their work productivity, whether they ever had a total hysterectomy and whether they felt nervous or stressed in the last month. If the employees did not answer the survey, they faced a $100 fine. Some companies also require spouses to fill out these surveys.

Wellness programs persist, according to Borsos, because companies do a great job of pushing the product, and employers like the programs because they shift the cost of health care to employees and save the companies money.