Monday, February 1, 2010

More on Worksite Wellness Programs and Health Care Reform

While pundits and bloggers continue to speculate on just how the House and Senate are going to get two competing health care bills passed, the Disease Management Care Blog has continued to grapple with the issue of employer wellness programs. There's this 'snarky' (a quote taken from one of the 43 comments) piece over at The Health Care Blog as well as this posting over at the Health Affairs Blog. The latter prompted a well-written response by Alan Balch, which can be found here.

Basically, the reform bill passed by the Senate would permit employers to increase the value of any worksite incentives for wellness program participation from 20% to 30% of premium. Critics charge that a large financial incentive could be used to underwrite the premium costs of persons that have already attained wellness goals, effectively shutting the door on affordable insurance for persons with chronic illness.

There are a variety of legal, regulatory, policy and real world reasons why that cannot happen, many of which are addressed in the blog postings that are linked above. However, in thinking about this, it all comes down to a paraphrased quote from the opinion page of the Wall Street Journal several weeks back: it's up to society to not only struggle against being ensnared by its vices, but by its virtues also.

If we worship human life, how should we ask our young persons to go to war? If we treasure the rule of law, should it be applied all the time every time? Those off-topic and incendiary issues are best left for other bloggers, but it's an interesting concept when it comes to heath care. If there is a lack of scientific evidence that employee premium differentials are safe all the time every time and that employers could somehow camouflage cherry-picking underwriting as a wellness program, is that reason enough to forbid the practice altogether?

The DMCB doesn't think that's reasonable and that we have the ability to develop reasonable policies and other regulations to adequately address that improbability. It hopes that if a version of health reform passes, that the Senate provision on worksite wellness survives.

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