New Obesity Disincentives Raise Questions
Employers worldwide understand that obesity is a major problem, and many have been taking steps recently to incent employees to lose weight. After all, obesity is costing U.S. employers over $13 billion annually according to the National Business Group on Health, and the figures can be even more mind-boggling when expanded to a global scale. Several businesses have taken an active approach to address the epidemic through wellness programs and financial incentives. But recent government initiatives, particularly in Japan, to institute financial disincentives for employers with overweight workers are drawing attention and raising difficult questions.
Japan Measuring Waists
In one of the most ambitious campaigns by any country to manage obesity, Japan has passed a new law that requires companies and government offices to measure the body fat of employees between the ages of 40 and 74. If employees are found to be over the waistline limits of 33.5 inches for men or 35.4 inches for women, they would be required to receive dieting guidance for up to six months and, if necessary, further re-education if they do not show improvement after the six-month period.
Under the new law, Japanese companies face requirements to reduce the number of obese workers by 10% by 2012 and 25% by 2015. Employers will be fined if they cannot meet the new requirements, and they may have to pay more into the national healthcare system. But do these aggressive requirements go too far?
The law is intended to reduce the number of individuals with metabolic syndrome, a group of factors (obesity, high blood pressure, high cholesterol) that heighten the risk of developing vascular disease and diabetes. However, many critics think the law is too strict, causing more than half the male population to be labeled obese. Others think the law can have a negative effect by heightening anxiety, encouraging overmedication and, ultimately, raising healthcare costs.
Some Japanese think the law won’t have as much an effect as it would in other parts of the world – particularly the United States, where the waist measurements of Caucasian American males average 39 inches and those for females average 36.5 inches (according to the National Center for Health Statistics). But would American government entities even consider such a measure? Apparently, one state is taking a similar approach.
Alabama to Charge Overweight Workers
After ranking second in the national obesity rankings, Alabama is cracking down on overweight state employees. The State Employees’ Insurance Board recently approved a plan to charge state workers starting in January 2010 if they don’t have free health screenings. For any worker with a Body Mass Index (BMI) of 35 or higher who does not make any progress over the coming year, the state will charge them $25 a year for health insurance that is otherwise provided for free.
The measure is among the most aggressive employer weight-control programs in the U.S., but some experts are already questioning whether the requirement will have the impact the Board intended. The Board has not yet determined how much progress a person would have to show and is uncertain how many people would be affected since the charge can be avoided simply by showing an effort to lose weight.
Do Disincentives Go Too Far?
Disincentives for unhealthy behavior are not uncommon in this day and age. In fact, there are several employers who penalize smokers in their workforce by charging them additional fees for healthcare coverage. But the issue of obesity can be tricky for employers looking to install disincentives. First, there is the potential conflict with the American Disabilities Act (ADA). While being overweight is not considered a disability under the ADA, many accompanying conditions (sleep apnea or diabetes) may qualify for ADA protection. Then, there is the potential conflict with non-discrimination laws, which could turn into messy litigation.
While such disincentives are eye-catching, they are not likely to become popular trends because of the potential compliance headaches. Employers are more likely to reward employees for healthy behaviors rather than punish them for unhealthy behaviors. However, it will be interesting to see how far these disincentive programs go and the impact they bring to their respective healthcare systems.
For more information, please visit the following links:
New Japanese Law Requires Employers to Combat Obesity in the Workforce
Japan, Seeking Trim Waists, Measures Millions
Alabama Workers to Pay for Extra Pounds
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To learn more about obesity management, Dr. Will Yancy, Assistant Professor of Medicine at Duke University Medical Center, will be addressing this very topic at Hill, Chesson & Woody’s Fall 2008 Lunch & Learn on October 15 at the RTP Hilton. Further details will be available at www.hcwbenefits.com. We hope to see you there!
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September 12, 2008
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