The bright young minds at U.S. and Canadian business colleges have some advice for employers devising wellness programs for their health plans: Concentrate on your employees’ well-being and watch the bottom line improve over time.
All of the 32 teams competing in an ethics competition Friday at the University of Arizona’s Eller College of Management recommended a non-coercive approach in dealing with the big causes of premium inflation in employer health-care programs — tobacco use, bad nutrition, obesity and alcohol addiction.
Use carrots, not sticks, and devise programs that set achievable goals and lure employees into participation voluntarily, the students said.
“The problem with a stick is that a stick is most likely to fall on those most vulnerable,” said Matthew Hurt, of the University of Idaho.
The Idaho team, which also included Benjamin Fujii, recommended a 5 percent reduction in premiums for simply participating in an employee wellness program. An additional 20 percent reduction should be available, they said, to those who participate fully in a plan that includes preventive care, nutrition services and exercise.
Most of the teams, which participated over the course of a long day Friday before a panel of judges from Arizona’s business community, rejected outcome-based measures in favor of participation.
Asked specifically about a program chronicled in the Wall Street Journal that dinged employees with a $1,000 extra premium for, among other things, having a waistline above 40 inches, the students universally rejected the approach as arbitrary, unethical and possibly illegal.
The Equal Employment Opportunity Commission requires that such programs be “reasonably designed to meet individual needs and must provide alternatives” when goals are not reachable, said Cliff Luber, of the U.S. Naval Academy, who presented with fellow midshipman Tim Waterman.
Paul Melendez, director of Eller’s Center for Leadership Ethics, said companies run a risk in devising punitive programs. “The people that have the greatest barriers to health are most likely to have a racial and ethnic component,” he said.
Melendez, a professor and associate dean at the college, crafted the exercise for the competition, now in its 11th year.
Voluntary programs with widespread participation also improve morale in the workplace, leading to gains in productivity and decreased absenteeism, said a team from Concordia University of Montreal.
Penalties, which require employees with unhealthy habits to pay higher premiums, might save some money in the short run, but they also create resentment, which could lead to losses in productivity.
“There is an unmeasured effect when the scale is tipped toward the penalty side,” said Franco Perugini, who presented with Melanie Chabot.
“The deal breakers are employee response and ethical considerations,” he said.
Perugini and Chabot had to do extra research for their presentation. Few Canadian companies have wellness programs, with health care being run as a national program.
“It was tough,” said Chabot, noting that Canadians also have much lower levels of smoking and obesity-related disease than their U.S. neighbors.
The Canadians are apparently quick learners. Two Canadian teams — from Simon Fraser University in Vancouver and Queens University in Kingston, Ontario — made the Final Four, or the “Ethical Four,” as Melendez called them.
They were joined by teams from Boston College and the University of Texas, Austin.
The Boston College team of Joshua Coyne and Alexander Tingle told the audience gathered for the Final Four competition in Eller’s Berger Auditorium that companies should regard their wellness programs as ethical exercises.
Improving the health of employees, the community and the country is “a company’s ethical duty,” said Tingle.
Tingle said companies need to keep that duty in mind and devise programs that “transcend laws and contribute to the welfare of the general public.”
The winning team, Qaid Jivan and Adrian Guemili of Simon Fraser University in Vancouver, urged employers to avoid “off-the-shelf” wellness programs and enlist employees to craft a plan suited to their needs.
Companies should “reward participation and not discriminate on the basis of current health habits,” said Guemili.