CVS Caremark was in the news a couple weeks ago after they launched a
new element to their health insurance program. As part of their standard coverage,
all employees have been asked to take a health screening or face a $50 per
month penalty through their premiums. As part of this screening, employees must
disclose some sensitive information, such as weight or BMI, which would be
collected and tracked by a third party.
This new policy created a firestorm.
The first objection was that it was mandatory, forcing employees to
disclose information they may not be comfortable sharing. On top of that, by including weight and BMI,
some observers saw this as a first step towards a “fat tax”, where employers could
raise premiums or deny coverage for poor health.
While I can't speak to how this info might be used in the future (although
use of medical data by employers is illegal right now), I am bewildered by the
criticism. That criticism isn't difficult
to respond to:
- Understanding your key health metrics is
an important part of maintaining, and ultimately improving, your
health. Although there is little hard
data around the quantified self movement, there is plenty of anecdotal
evidence that having this data leads to better decisions
- Whether you interpret the $600 as a
penalty or an incentive to do your health screening, employers should have
some tool to encourage employees to collect this data. Let’s be honest, most people will not do
this on their own
- CVS Caremark isn't the only company doing
this – according to the National Business Group on Health, 62% of large
employers offered biometric screenings in 2011 and 52% of those had
incentives to complete them. And as
one of the largest healthcare companies in the US, it’s important for CVS to
be a leader and set the tone for other companies to follow
What I’m more fascinated by is the root causes of this fear. Given the state of our healthcare system, you
would think everyone would be open to new, innovative approaches to reducing costs. Instead, this is a reflection of larger themes
in our national dialogue:
- Backlash against any policy that is perceived to reduce individual choice, even when the decision is made with positive intent
- Mistrust of large corporations and government, with a believe they are nefarious and any data they collect will be used negatively
- A media that recognizes these fears and stirs up controversy by highlighting stories that play into them
As a country, are we so stubborn that we’re unwilling to try new approaches,
even if it reduces some of our choice for our own benefit? CVS Caremark is a Fortune 20 public company and
I can guarantee if this program doesn't show results (monetarily or
health-related), it will get shut down.
But that doesn’t mean we shouldn't try it, even for just one year. I agree, there are some policies that may go
too far (i.e., NYC’s soda ban – while I applaud the intent, it’s too capricious
and difficult to enforce), but shutting down innovation under the pretense of
individual choice sets a dangerous precedent.
On top of that, whether we want to acknowledge it or not, large
corporations and government drive the economy and agenda of this nation, but
also help us live better lives. Without
large business, we wouldn't have Walmart, Apple, or Google. Without government, we wouldn't have roads,
public education, or scientific advances.
And, for better or worse, in order for them to continue serving us and
improving our collective lives, they need to be smart about their money, which often
times means using data to make better decisions.
The controversy seems to have died down for now, but I believe this is
only the start of a larger conversation about the employee-employer relationship
around healthcare.
