Employers Worrying about Obesity, Not Discrimination
Health insurance and business observers are noticing a growing blind spot for some businesses. These businesses more concerned with health costs than they are about discriminating against employees with physical or medical limitations.
The Americans with Disabilities Act (ADA) bars employers from compelling employees to provide personal health information for the purpose of health screening. The EEOC has recently sued several employers for wellness programs that violate those provisions of the ADA. President Tom Parry of the Integrated Benefits Institute recently told Business Insurance:
The ADA issue has certainly created challenges for employers. There’s no doubt about it. At the same time, I don’t see employers giving up because of the challenges of the ADA. They recognize that this is a significant issue that they absolutely have to deal with.
Writing in Health Affairs, Al Lewis, Vik Khanna, and Shana Montrose present a frank assessment that these programs have no value for promoting wellness or saving money:
We conclude that these programs increase, rather than decrease employer spending on health care with no net health benefit. The programs also cause overutilization of screening and check-ups in generally healthy working age adult populations, put undue stress on employees, and incentivize unhealthy forms of weight-loss.
In the LA Times, Mike Hiltzek is even more blunt. Labeling them as costly scams that harm employees, he says the real goal is “to charge higher premiums for workers who don’t participate, or who fail to meet wellness milestones.”
The thought that people with obesity only need a little carrot or stick from their employer to get them to an ideal weight is a fantasy for people who have never lived with obesity. For people whose lives are profoundly affected, the real need is for more effective options and access to evidence-based care. Constantly prodding people with unrealistic “everybody-should-have-a-BMI-under-25” goals does great harm. For many people, a BMI of 30 or 35 is a hard-won victory.
A $4,000 cut in pay and benefits — which some wellness schemes impose — merely adds insult to injury for a low-wage employee with obesity. It is simply health-based discrimination, thinly disguised. We hope that EEOC will continue to enforce the law against such discrimination.
Against Social Discrimination, Image © Kostis Vassiliadis / flickr
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