The Surgeon, Ferdinand Sauerbruch

Doctors Get the Final Say on Wellness

Under regulations for employer wellness programs, doctors get the final say on wellness. This key point floats to the top of a lengthy point-counterpoint discussion just published in the Journal of Policy Analysis and Management.

Both Morgan Downey and John Cawley seem to agree that the provisions for employer wellness programs under the Affordable Care Act need a lot of work. Downey concludes that these programs will not work to promote wellness, they will only serve to shift costs onto people with obesity and other chronic diseases. Cawley seems to believe that they could work theoretically, but he acknowledges that they have many problems and a mixed record to date.

Perhaps because everyone recognizes that employer wellness programs have a shaky track record, regulations are in place to protect employees from discriminatory programs. The bottom line, as Downey put it, is that “the ACA puts the employee’s physician in charge of the wellness program.”

When it comes to weight management, one size does not fit all. So the regulations say employers “must provide a reasonable alternative that accommodates the recommendations of the individual’s personal physician with regard to medical appropriateness.”

In other words, your doctor gets the final say.

Click here, here, here, here, and here for all five parts of this very detailed debate.

The Surgeon, Ferdinand Sauerbruch. Painting by Max Liebermann, from WikiArt

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