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Knock On Wood —

March 21, 2014

Fat HealthFat News

One year ago from yesterday, I sounded the alarm on a new “wellness program” at CVS Pharmacy, wherein employees must participate in a “voluntary” health screening where they must disclose their personal health information, including weight and sexual activity, or else face increased insurance premiums. Shortly thereafter, Michelin Tires announced a similar punitive, but “voluntary wellness program.”

CVS

I encouraged people to join a boycott, as well as call and write CVS executives, but that went nowhere. But today, there’s finally some action being taken that may put an end to the practice once and for all: a civil lawsuit.

CVS cashier Roberta Watterson claims the company made her disclose personal information, including her weight and level of sexual activity, threatening to charge her $600 a year if she refused… Though Watterson’s suit highlights the privacy concerns raised by employer health screenings, her more pressing claim in the suit is that CVS should compensate her for the cost of the health screening as well as the gas she used to travel to the doctor and the free time she spent getting tested. The suit is seeking class-action status.

I’m not entirely convinced that this lawsuit will be the death knell for coercive employee wellness programs, especially since our judicial system seems to favor the interests of corporations and wealthy Americans above individuals. Companies are given incredible latitude to practice business as they see fit and employee privacy is practically a joke any more. So the idea that employers can, and should, keep tabs on what was once deeply-personal health information between a patient and doctor, is not surprising at all. What’s bizarre, though, is the motivation.

CVS spokesman Michael DeAngelis wrote to Huffington Post and said, “Our employee health benefits plan complies with all applicable laws. By knowing their blood pressure, cholesterol and glucose numbers, as well as other potential health risks, our colleagues are empowered to work toward or maintain healthy behaviors that can lower their overall health care costs.”

The implication is that without CVS interfering, their employees wouldn’t know their blood pressure, cholesterol and glucose numbers, and therefore would not be empowered to engage in healthy behaviors. DeAngelis goes on to assure us that the records are kept private and that CVS management has no access to those records. Then what is the point of having them?

If the whole point of the program is to make employees aware of their health status, and not to micromanage their lifestyles, let alone discriminate against unhealthy employees, then why not simply provide free coverage for wellness checkups with the employee’s doctor? I mean, awareness of your blood pressure is great, but improving your health outcomes requires an ongoing relationship with your doctor, not a one-time visit to an corporate-sponsored physician, so that you can monitor those health indicators over time. Simply having a baseline set of information on current health status does neither the employee nor the examining physician any good.

It’s this kind of invasive corporate oversight, and the collective shrug society gives in response to it, that makes me skeptical of libertarianism. Conservative outrage over Obamacare revolves partially around privacy and the belief that the government will be all up in our business when it comes to our health choices. Of course, that same outrage dissipates when you ask libertarians if corporations should have similar oversight of our health.

The same goes for spying. There’s been a lot of hand-wringing and pearl-clutching over the National Security Agency’s surveillance program, but virtual silence on the ubiquitous practice of corporate surveillance because, as this Washington Post article tries to paint it, you can “opt out” of corporate spying by boycotting those who collect data about you, unlike government spying. Of course, this ignores the fact that much of the data collected on you by corporations is done by parties you aren’t even aware of and is sold to other companies without your awareness, let alone consent.

But in the case of corporate health oversight, there is the potential risk that unhealthy employees may be fired to save money on insurance. Employers should have ZERO say in our personal health choices. None. As I mentioned in my previous post, the skyrocketing costs of healthcare is due to healthcare companies gouging our for-profit system, not worse outcomes from fatter Americans.

By allowing CVS to pry into their employees’ health choices, we are essentially shifting responsibility for a dysfunctional healthcare system to consumers, rather than the corporate profiteering that drives higher prices. We’re abdicating our right to privacy by saying, “Obviously companies should monitor employee health because they’re providing health insurance.” I’m happy to say, though, that at least this kind of health oversight is still pretty rare among companies, I would imagine due to the animosity it builds in their employees.

My hope is that CVS will see just how misbegotten their intentions are and switch back to a reward-based system of encouraging healthy behaviors, rather than the coercive approach they’re forcing now. And perhaps this lawsuit is the first step in helping them see the error of their ways. I wish Ms. Watterson all the best on her lawsuit and I will be sure to update you all on any results that come from it.

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15 Comments leave one →
  1. March 21, 2014 12:19 pm

    omg. thank you. you help me stay sane in this depraved time. thank you so much. resistance is wonderful.

  2. Nof permalink
    March 21, 2014 1:35 pm

    I can’t recall where I saw it now, but there was yet another article detailing how wellness programs are ineffective at saving any money for individuals, companies, or insurance providers. The only thing they’re good at is making people who run wellness programs richer.

  3. March 22, 2014 4:16 pm

    Reblogged this on Sly Fawkes and commented:
    This sort of thing drives me batshit. My company does the same thing. We have to take this survey put out by Aetna every year to discern our “level of health risks.” Every year it puts me in the “high risk” category, and I can tell you, that’s about 100% because of my BMI. I bet if I put in numbers that put my BMI in the Socially Acceptable category but put all kinds of terrible stuff in the other categories, I’d be less likely to “red line.”
    I’m not going to divulge the name of my company, as I need my job and it’s a single-site entity. But this sort of thing disgusts the hell out of me.

  4. BBDee permalink
    March 22, 2014 11:14 pm

    My employer hasn’t started making this crap mandatory yet, but they have tons of “voluntary” programs and do their best to nag & guilt trip us into participating. My health insurance co. also has something like this, still voluntary but invasive and coercive just the same. Some nurse from my health insurer kept calling me to try to get me to sign up for a “health profile” and assistance in “health management.” I kept not answering or returning her calls so she sent me a letter saying that she was going to contact my physician to discuss with HER the importance of getting me to participate. So after that I finally took Nurse Ratchet’s call and asked her why they were so ardently pursuing me for a service I did not want. She said “We’re just trying to help you manage your chronic, catastrophic health conditions.” To which I replied WHAT??? I don’t have any ‘catastrophic’ conditions!!! She said, Oh, but your latest reports from your doctor’s office said you are diabetic and have COPD… I said I AM NOT DIABETIC!!! I had 2 high blood sugar readings, but my last 3-4 have been NORMAL… and as for the COPD… yes, I used to be a smoker, but I quit 3 years ago. I have never had any kind of test done on me to see if I actually have this condition, I was given an inhaler which had no effect on me and found that my occasional shortness of breath was actually relieved by taking ANTI-GAS PILLS, so I quit taking the inhaler and am no worse off for it! Therefore I do not believe the COP diagnosis is valid either. So please STOP STALKING ME! You are CREEPING ME OUT!!!

    “Well, remember, we will be here if you need our help…”

    YEAH, RIGHT!!

    • March 27, 2014 3:34 pm

      If they ever do it again, tell them that their practices are a violation of HIPAA.
      I personally do have chronic health conditions, but at this point none are catastrophic, and whether they are or not is none of anyone’s business unless I choose to discuss them.
      This sort of thing is horrifying.

  5. Dizzyd permalink
    March 23, 2014 6:02 pm

    Aw heck! Let’s just call a spade a spade and pull this thing out into the sunlight to show what it REALLY is – a blatant attempt to enforce conformity and a means to punish all those outside of the “acceptable” range. Another attempt to make money off the fatties.

  6. gingeroid permalink
    March 23, 2014 6:54 pm

    It’s a nudge, and a nudge that most people would support. The big argument for socialized medicine is that people will get all those diagnostic services. What is left unsaid is that people will get them whether they want them or not. How many times do you need to check out your fasting glucose before you’re convinced you’re not diabetic? For now, the coercion is not being applied by the government and that is why there is a libertarian shrug. If CVS employees hate this program and still want to work at a pharmacy, they can go work for a competing company. However, it’s disingenuous to blame it solely on libertarianism. There are plenty of statists who want this program rolled out on a national level because it’s in the best interest of the collective to know those metrics to further nudge behavioral changes. Next step? Mandatory treatment. And again, you’re not going to see a lot of opposition because who would be against treating diabetes?

    • March 23, 2014 9:53 pm

      The idea that if one company has toxic practices (say Hobby Lobby’s attempt to control employee birth control access), telling them “just work somewhere else” is contingent on a position actually being available in this employer’s economy. I’m not blaming libertarianism for the economic system we have right now, I’m blaming Ronald Reagen and Bill Clinton and the rest of the deregulation capitalists who ignore what capitalism was like prior to FDR putting an end to financial practices that nearly destroyed this country during the Great Depression.

      As far as mandatory treatment by the government, this all depends on your definition of “mandatory.” A person with diabetes on Medicaid or Medicare is under no obligation to exercise or eat a diabetic diet. If your blood sugar continues to stay high, if your insulin levels get dangerous, they aren’t going to cut your healthcare. They can’t. The most they can do is goad you when you come into the office and when you finally need your foot amputated, the government will pay for it. There’s no such thing as mandatory treatment. Now, mandatory health insurance? Yeah, that makes sense, considering we require mandatory car insurance if we expect to drive. And prior to the ACA, if you expected to use the healthcare system, then you could theoretically go to the ER and leave the hospital with the hugely expensive bill. The ACA was the pro-business answer to universal, single-payer healthcare because the mandate would bring them a shitload of new business.

      So when you say that statists want “this program,” I don’t see that happening. The government will not financially penalize those with unhealthy behaviors because the minute you point to exercise or diet, others will point to smoking or drinking, and then you’ve got essentially most of the country up in arms about their unhealthy habit. So, you can either point to hypothetical oppression of the future or you can cite something that is happening right now under corporate direction, but only one of them actually exists.

      As far as being a “statist” goes, I’m not. I believe that for capitalism to work, you have to have private and public interests counter-balancing each other. If we deregulated everything and shrunk the government, the corporations will fill that void. Hell, they already are and we’re seeing the results from coal ash spills in North Carolina (by a governor who used to work with Duke Energy, the polluter) to the earthquakes caused by fracking pretty much everywhere. Regulation is what protects us from the greed and excess that is second nature to Wall Street. If wanting rigorous oversight for companies that can affect both the health of our economy and the health of our earth makes me a statist, then so be it. But I find anyone’s trust in the nobility of the free market as self-regulating in any way, shape and form to be naive, particularly after the last 30 years.

      Peace,
      Shannon

      • gingeroid permalink
        March 25, 2014 7:18 pm

        Yes, deregulation is terrible. I can’t wait to go back to air travel being a luxury and paying for long distance by minute and zone. What destroyed this country during the Depression was overregulation, right down to burning fields of food while citizens starved in order to maintain prices.

        I define mandatory in the traditional sense. Here’s one play out: every person will have their blood glucose checked every time they see a practitioner regardless of consent. Everyone found to be diabetic will be subjected to wellness counseling, regardless of whether it’s wanted or not. Failure to follow the prescribed measures, such as losing weight, will result in being barred from seeking any medical services because of non-compliance. The underlying assumption behind these wellness nudges is that the individual can’t take care of their own health. The only way to ensure the individual takes care of their own health in the manner deemed to be acceptable is through ever-increased control of that person. I object to any sort of mandatory commerce, including health insurance. People should be free to make their own decisions about their health and how to pay for it. Rush Limbaugh doesn’t have health insurance. Do you think he’s unable to pay? When my family was struggling, we bartered for care.

        Nobody in government is trying to regulate “unhealthy behaviors”? In food policy alone there have been attempts at sugar taxes, drink size restrictions, salt bans, trans fat bans, fast food restaurant bans, etc. The thing about targeting unhealthy habits are that they’re never done all at once and we have a for thee but not me mentality. How often are cigarette tax increases passed? For the most part, it’s only the smokers complaining. Lastly, I never said you were a statist.

        Way off topic, but even the National Academy’s studies show there is a very low risk of earthquakes caused by fracking.

      • BBDee permalink
        August 10, 2016 10:32 pm

        Nailed it!

        • BBDee permalink
          August 10, 2016 10:34 pm

          Shannon’s take on regulation nailed it, that is…

    • March 25, 2014 9:45 pm

      [restarting to avoid noodling]

      Wow. That is some amazing revisionist history on the Great Depression. And are you sure you want to defend an airline industry that has come to charging for carry-on just to squeeze every last penny? In fact, pretty much every business that becomes deregulated also becomes more monopolistic, less competitive and shittier all around. As far as your dystopian medical scenario, I’m not buying. We’ had over a decade of obesity panic and nobody has even come close to enacting anything so Draconian. The worst it’s gotten is Bloomberg’s soda ban and people went to the polar opposite of Bloomberg, from a raging capitalist to raging Marxist. And De Blasio openly supported Bloomberg’s ban.

      As far as the sugar tax goes, look at what legislation has actually passed: there’s been a lot of tax bills proposed (among the orange states), but most have been rejected; while most of the bills that have passed are restricting sugar sweetened beverages from schools, which I have no problem with. But the Rudd Center is still trying to persuade states to adopt sugar taxes and it’s gone nowhere (PDF). The vague future libertarian threat of mandatory diets is so far removed from what is actually happening that I have a hard time taking it seriously. Badgering doctors? Yeah. That’s what they do. Blocking access to healthcare until you lose 50 pounds? Never going to happen.

      If you object to mandatory commerce, do you object to car insurance? Do you think people should be allowed to operate cars without any way to cover the damage they might do to your car? Because mandatory health insurance is doing essentially the same thing, but for unpaid ER medical bills, which affects the cost of medical services that people with insurance are paying for.

      Finally, fracking… are you seriously saying that it’s just a coincidence that earthquakes in places where there have never been earthquakes before, like Ohio, started when the state started fracking? Because the USGS has confirmed happened in Oklahoma. Are you saying the people Azle, Texas should just stop trying to end fracking because the earthquakes that started suddenly with the practice? By the way, 90% of that National Academy study was paid for by the petroleum industry. And that’s why Rex Tillerson, the CEO of Exxon, sued to keep a fracking site away from his mansion.

      You can put your faith in corporations to self-regulate if you want, but I don’t trust them to do the work that the government was doing just fine until Reagan decided to start dismantling Roosevelt’s legacy. We may just have to agree to disagree on this one because there isn’t much you can say that will make me think we’re better off without robust regulatory to counterbalance Wall Street. To weaken the government now would be disastrous for millions of Americans who have been exploited by the excess of capitalism.

      Peace,
      Shannon

  7. vesta44 permalink
    March 24, 2014 12:00 am

    What I see happening with these “voluntary” wellness programs that corporations are starting to force on their employees is that once they’ve decided certain people (the fat ones) are going to have certain diseases because of their fatness, they’re going to try and force fat people into losing weight to “cure” those diseases. When that doesn’t work, they’re not going to mandate physicians visits and procedures to “cure” the diseases, they’re going to take away your health care altogether. In other words, if you can’t, or won’t, conform to their idea of “healthy”, no health care for you unless you have enough money to pay for it out of pocket (or qualify for Medicaid or Medicare). Because they could give a shit if fat people survive. In fact, they’d probably love it if we all died so they don’t have to look at our fat/disgusting/ugly (to them) bodies.
    And yes, this may sound cynical to the max to people, but after 60 years of life, I’m not convinced that it’s cynicism on my part to think this way. I’ve seen society go downhill in the last 60 years, I’ve seen people become less trusting of and less caring about their fellow man, and I’ve seen people coming to rely more and more on the government to make decisions for them – what’s “healthy”, what’s “safe”, what’s “ideal”, etc, instead of thinking for themselves and deciding what works for them. It’s not really a world I like much anymore.

    • March 27, 2014 3:38 pm

      It’s scary. Someone like me would surely be on the chopping block. I have the endocrine system from hell. I have both a zombie thyroid and a zombie pancreas. Neither of these things stop me from performing my job, but I’m sure they’d rather oust me just in case if it came to that. Mostly because I’m fat, but they’ll never admit that. Of course they’d never bother to examine the fact that both hypothyroidism and the insulin resistance caused by type 2 diabetes work to CAUSE obesity, they’d frame it as being all my fault for being such a horrible fat fatty. I really hate our society sometimes. Okay, most of the time.

  8. Len permalink
    March 25, 2014 4:07 pm

    Ugh, something similar to this has started happening in my (non-US) workplace. We were all asked to fill in a ‘health and wellness’ survey that asked incredibly detailed and intimate questions: our weight (not height, hmm), our eating habits, our exercise, our drug and alcohol intake, whether we had specific health issues such as diabetes or heart conditions … funnily enough, no gathering information about health issues not generally associated with weight, nor asking about disabilities, injuries and the like.

    It was fairly clear where the survey was heading, and although I’m no statistician, even I could see how badly designed and skewed it was. Not a well-designed survey at all.

    We were given the ‘anonymous’ survey by the health officer who then handed us a pen and sat down to watch us fill them in! Er, no. When myself and a few colleagues refused on privacy grounds, this officer blustered for a while about ‘100% compliance’ and eventually, when we pushed back hard, admitted that it was in fact a voluntary survey.

    At this stage, I think we were only saved by privacy legislation. Heaven help us if they find a way around it.

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