Lepers and wellness

Finally we are getting somewhere.

Smokers have gone from the most accepted folks to the most scorned lepers. Smoke has gone from "smells like smoke" to "what's that awful stench?". People have apparently gotten so feeble that even walking past a smoker standing outside in the elements makes their heart race and induces cancer and early death.

Anyway, we know that one's final illness is always expensive. Now things have progressed to the point that companies are choosing which final illness they will allow employees to have based on some price schedule.

Referring to some unfathomable cost information, some illnesses are OK, but some fall into the new leper category. There will be no end to it you know. Folks pushing and prodding with carrot and stick until everyone behaves and is indoctrinated.

Somehow the streets get cleaner, the air is less tainted by human activity, but the people are not as kind, or hospitable, or likable.

And let's not fool ourselves. Our drive for "wellness" is the same drive that sweeps away Downs infants, girls in India, and any other people or things that upset our clean, neat, pretty and antiseptic vision for the world. Lepers on the inside, sweet smelling on the outside.

Luckily we are all given the same general time on earth, whether we struggle against it or not. Soon enough we will all meet somewhere else, and get a glimpse of what things really smell like.

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First they tried nudging. Now companies are penalizing workers who have high health risks such as obesity and high blood pressure or cholesterol as insurance costs climb.

The businesses are deducting from employees' paychecks, adding insurance surcharges or offering insurance discounts or rebates only to low-risk workers.

"Employers know they have to do something," said Garry Mathiason, a senior partner at the national employment and labor law firm Littler Mendelson, based in Boston. "I believe that in just the next two years more employers will turn to penalties to change employee behavior."

A 2003-2004 National Health and Nutrition Examination Survey showed about two-thirds of adults in the United States were overweight and almost one-third were obese. A U.S. surgeon general's report said health care costs of obesity totaled more than $117 billion in 2000.

More employers have charged higher insurance premiums the past few years for tobacco-using employees. Otherwise, wellness programs had been primarily voluntary, offering in-house fitness centers and free health screenings, for instance.

But many employees of Indianapolis-based Clarian Health didn't use the programs, hospital spokesman James Wide said.

In 2009 the company will start reducing pay for employees in its health plan by $10 per paycheck if their BMI — a measurement of body fat through a height and weight ratio — is in the obese range of more than 29.9. The deduction will be $5 per check if they don't meet required cholesterol, blood pressure or blood glucose measurements. Workers will be required to complete an annual health risk assessment and can appeal to have their fees dropped if they show improvement.

Scott's Miracle-Gro Co., a lawn and garden company based in Marysville, Ohio, charges $40 more per month in health premiums for employees who don't complete annual risk assessments. The company charges $65 more for workers who don't try to reduce any high health risks that show up.

"We think that personal accountability is a big part of driving overall wellness, but we also provide our associates with the tools they need," spokesman Jim King said. "We think our program is a good balance of the carrot and the stick."

King said participation rose from 70 percent to 95 percent after the charge was added.
Scott's earlier stopped hiring tobacco users in states where that is allowed and reserves the right to fire employees who use tobacco.