Don’t Blame CVS For Mandatory Health Screening
This past week, Rhode Island based CVS announced its 200,000 employees will be required to participate in a health screening or pay $600 more in annual health insurance premiums. The health screening will be paid by CVS and will assess employee weight, height, BMI (body mass index), cholesterol, blood pressure and glucose levels. This information will be submitted to a third-party administrator (not CVS affiliated) who will review the data and assess healthcare risks.
What is not being discussed is what the third-party administrator will actually do with the data and how employees with identifiable risks will be handled. Will they receive a phone call at the office (Hey Anne, the food nazi is on the phone for you), an e-mail (Hi Anne..it’s come to our attention that your BMI is alarmingly high…), a consultation (Anne..we’re here today to discuss how we can work together to bring your BMI down to acceptable levels..), an invitation to join an exercise program (Hi Anne..have you thought about joining the company sponsored Zumba class after work?), or be charged higher health insurance premiums?
CVS wants a healthier workforce because healthier employees translates to lower healthcare costs for CVS who pays for a large portion of the premiums. With 200,000 employees, an estimated* 35% are overweight and another 30% are obese which translates to two out of three employees or 130,000 who are more susceptible to cardiovascular disease, diabetes, musculoskeletal disorders (i.e. osteoarthritis), and some cancers. Is it any wonder that CVS is taking what critics consider desperate measures (but what private health insurance providers already do) to reduce healthcare costs?
America is fat and we all know why..we eat too much fatty processed and sugar laced food and we don’t exercise enough. Dieting is hard and often doesn’t work because sustainable weight loss requires a permanent lifestyle change and most people are not willing to change. A diet rich in healthy fresh foods is nutritious but also expensive and time-consuming. Our grocery stores have more aisles devoted to sugary drinks and processed foods than fresh foods and the preponderance of fast food chains lure people with the quick cheap fix. The only way grocery stores and fast food chains will stop selling junk food is if people stop buying the products that are making them fat and sick.
The obesity problem in the US is a cultural problem in which we pass the buck to employers to address when, in fact, the issue should be between our citizens, health care providers, and insurers. No other industrialized country in the world ties health insurance to employment the way the US does. We think our system is normal but it’s not. The system as we know it came about nearly 70 years ago when Congress acted to create “fringe benefits” in response to wage control mandates during World War II.
Our tax code does not recognize employer paid healthcare costs as taxable compensation which is unfair to those who purchase health insurance on the open market with after tax dollars. But the bigger problem is when employers are forced into the role of big brother. It’s not that medical screening is wrong; it’s that health insurers should be requiring the screening (as they already do with those who seek health insurance outside of employment) instead of employers.
None of our corporations or employers should be directly involved in our healthcare. The citizens of our country should be buying health insurance in a market where the field is open and the rules apply to all. People can’t be turned away for pre-existing conditions and those who choose to participate in high risk behaviors that increase healthcare costs should be subject to higher premiums. None of us is perfect and we all engage in bad behaviors from time to time and that’s part of life but those who continually engage in these behaviors will show the effects by becoming obese and/or developing cardiovascular disease, diabetes, kidney disease, osteoarthritis, and more.
Just as life insurers charge more to people who engage in high risk behaviors (i.e. motorcycle riding, parachuting, scuba diving, smoking) and car insurers charge more to drivers who are ticketed for speeding or accidents, health insurers should be able to charge higher premiums to those with a BMI above 25 and those who engage in lifestyle choices that statistically show will cost more in healthcare dollars.
So don’t blame CVS…blame people who won’t take responsibility for their health or blame Congress for they are the ones that put CVS and employers in the precarious position of telling employees in this country the truth and the realities of costs and benefits.Change is hard and no one with an employee based health insurance plan will want to give it up, but if those same persons balk at what private insurers are already doing to the privately insured, there won’t be much sympathy as these employees are asking their employer and their healthy co-workers to essentially subsidize their healthcare costs. The healthy already subsidize the sick; they shouldn’t also be required to subsidize those who are making themselves sick.
*Estimates based on Pfizer Facts “The Health Status of the United States Workforce,” page 40.