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Opening the Door to Legal Health Discrimination

Has the infatuation with incentive-based employer wellness programs “inadvertently put a target on the backs of employees who are dealing with obesity?” That’s the concern expressed recently by OAC Vice President James Zervios. He’s not alone in sounding an alarm about health discrimination. A new commentary in The Hill warns that penalties in wellness programs will promote “legalized discrimination” against people with obesity. David Seres, a medical ethicist at Columbia University Medical Center, writes:

If we aren’t certain as to the cause of obesity, and we know it is not simply a matter of lacking motivation, and we have no reliable cure, how is it that we can justify penalizing the obese for a poorly treatable preexisting condition? Beyond the fact that obesity may not be as high a risk as previously thought, how do we justify this kind of institutionalized prejudice and the blaming of the victims?

Some employers are undeterred by these concerns. An increasing number of employers are tapping into aggregated data on employee behavior from wellness programs and consumer tracking databases (aka “big data”) to identify potential health issues. One vendor of such services, Harry Greenspun of Deloitte LLP’s Center for Health Solutions, recently told Dow Jones Business news:

I bet I could better predict your risk of a heart attack by where you shop and where you eat than by your genome.

The creepiness grows when you consider that employers are paying wellness firms to scan employee data to predict which ones might get pregnant. In a world where none of this is compulsory, it might not be such a big deal if someone decides she wants to opt in. But increasingly, employers are taking advantage of the opportunity to impose financial penalties on employees who don’t.

One of the major benefits of the Affordable Care Act has been the elimination of penalties for pre-existing health conditions. It’s ironic to think that penalties are returning through the back door of financial incentives targeted at people with obesity and other health risks.

Harriet Brown, writing in Quartz, summed up the growing concern, saying “your company’s obsession with ‘wellness’ may not be good for your career.”

Click here to read more from Dow Jones, here to read more from Quartz, here to read more from Business Insider, here and here to read about mixed results with wellness programs for employees at the Mayo Clinic, and here for the commentary by Seles in The Hill.

Come In, photograph © Johan Larsson / flickr

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February 25, 2016

4 Responses to “Opening the Door to Legal Health Discrimination”

  1. February 25, 2016 at 7:13 am, Al Lewis said:

    It is way worse than this. There is a multi-pronged effort to get companies to disclose the number of overweight and obese employees they have.

    Further, Aetna is collecting employee DNA and telling them whether they have an obesity gene. And then lying about it.

    • February 25, 2016 at 7:42 am, Ted said:

      Thanks Al, for sorting this out. There’s supreme irony here because this is embedded in the ACA, which was supposed to eliminate egregious discrimination.

  2. February 25, 2016 at 8:05 am, Joan Ifland said:

    The supreme irony is that workplaces encourage obesity by including addictive, processed foods in the cafeteria line, as well as providing free obesogenic foods in the break-room, and vending machines. They also typically allow employees to bring calorie-dense foods into the workplace and promote them through email blasts. When food is brought in for meetings, it’s likely to be harmful pizza and sandwiches. This is beyond unethical.

    • February 25, 2016 at 9:27 am, Ted said:

      Well said. Joan. Thanks!