CVS/Pharmacy to mandate employees to undergo regular health screenings or pay a “surcharge”

English: Alternative Logo of the CVS Pharmacy

English: Alternative Logo of the CVS Pharmacy (Photo credit: Wikipedia)

CVS/Pharmacy will reportedly mandate its employees who participate in their healthcare plan to undergo regular health screenings or face a $600 annual “surcharge.”  Employees believe the mandate would infringe on their personal liberties.  Some don’t want their weight to become public knowledge amongst company management.

Company management states that they would not be privy to such information, yet are implementing this mandate so as to push employees to pursue a healthier lifestyle.  They believe that regular doctor visits are essential to living a long, hearty life. 

I was watching ABC World News tonight and they interviewed a man who sued his company for a similar policy.  He lost.  The judge said his company had every right to implement such a policy.  After all, he had the “choice” not to visit the doctor.

I am bit conflicted on the matter.  On the one hand I don’t like when government or in this case an employer mandates anyone to do anything outside of their workplace.  I see it as a personal infringement.  I certainly don’t believe that my weight would be confidential.  The cynic in me believes that somehow my weight would cause my insurance to go up anyway.  They would probably tell me that I need to pay more because I have a greater risk for health problems.  (Even though in reality I seldom need to go to the doctor for any ailments).weight scale

But I don’t know if I am thinking of this in an entirely objective manner.  Like every topic I debate on this platform, I try to be as fair as possible.  From an employer perspective I can see why they would want me to go to the doctor.  Reasoning would deduce that regular health screenings would probably reduce overall health care costs.  Regular screenings help discover ailments that would otherwise go untreated for months, if not years.  Additionally, maybe (and this is meant in the slimmest of chances) they actually care about their employees well-being.  Yes, I know.  Probably not the case, but I thought I should still provide it.

Overall, I am skeptical of this policy.  I certainly don’t like being told what do in my personal life.

What do you think?

Do you think this should even be legal?

Email: realtalkdebate2012@gmail.com

Twitter: @adrakontaidis & @talkrealdebate

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About adrakontaidis

A conservative who doesn't pander to the GOP.

13 responses to “CVS/Pharmacy to mandate employees to undergo regular health screenings or pay a “surcharge””

  1. JF Owen says :

    First a disclaimer – I’m one of those employees that has a few extra pounds to loose, so I’m one of the ones policies like this are focused on.

    Having said that, I think policies like this are useful, inevitable and, yes, legal. My company has a similar policy, although it’s packaged a bit differently. Our policy has a base rate for insurance coverage and employees who participate in the “wellness” program get bonus points that can be used to reduce their share of the monthly premium. It’s an involved program, but the upshot is that anyone who meets all of the target activities can realize a reduction of about 15%. The salient point is that neither the employer nor the insurance company tells me what I have to weigh or what my lifestyle habits can be. It’s still my choice.

    For example, if I’m overweight and I agree to participate in a structured exercise program, I get points. I don’t have to loose weight, I just have to try to lose weight. If I actually do lose a few pounds then I get maximum points. I don’t have to make it to the ideal weight; I get the maximum points just for making progress.

    The same rules apply to other health issues including smoking, high blood pressure, high cholesterol, etc.

    We spend more on health care in the United States than ANY other industrialized nation. Despite that we’re well down the list for life expectancy and, more importantly, quality of life as we age. How much fun is it for a man to live well into his seventies if his body is so tired and damaged that he can’t play catch with his grandson, walk a secluded path in the woods to his favorite fishing spot or paddle a canoe across a pond with his best girl?

    We have to do something to reduce health care costs and expenses without sacrificing care. Getting healthier is one way to do it. My sense of independence doesn’t mesh well with being told what to do any more than that of anyone else. But sometimes you need a push and a nudge in the pocket book is a reasonable way to do it.

    • realtalkrealdebate says :

      Thanks for the comment as usual 🙂

      Great point. I think my hesitation is that like you I don’t want to be mandated to do anything (a.k.a. Bloomberg soda ban; although that is different).

  2. Nancy says :

    More BIG BROTHER watching!

  3. Nancy says :

    It is a Catch 22. The United States pay the highest for health care. Because the Doctors malpractice insurance is so high especiall in Illinois, they have to charge high prices, plus people are so sue crazy. We pay the most for medications because we have to pay for the research & advertising were as other countries don’t. When I was growing up & still today, if you didn’t have health insurance, you went to the nearest county hospital. They have the best doctors there. That is why premiums are so high. Most people in their 20/30’s are pretty healthy, so to make them go to the doctor every year might be a waste. Yes, everyone should see their doctor at least once a year, but it shouldn’t be mandatory and it should be between the person & their doctor & no one else.

    • JF Owen says :

      Nancy – Doctor’s malpractice insurance is only a piece of the puzzle, and not the largest piece, when it comes to high health care costs. I also suspect that the folks in France and Germany, two countries that have pharmaceutical industries that easily rival our own, might dispute your contention that other countries don’t expend capital on pharmaceutical R&D.

      Going to the hospital emergency room for non-emergency care, whether you have health insurance or not, is an incredibly poor use of medical dollars and prevents true emergency patients from getting the care they need. That one thing increases medical care costs in the US much more than malpractice insurance. Who do you think pays for the people who just drop in to the emergency room for care without real need or insurance coverage when a simple trip to the family doctor would suffice? The rest of us do both in higher medical prices and higher insurance premiums.

      Saying that people in their 20/30s in the US are healthy is like saying a car heading for a brick wall doesn’t have a sheet metal problem. Not yet, but it will after it hits. Our youth, and older people too, are over-weight, have high cholesterol, high blood pressure and don’t exercise enough. The young just haven’t had the problems long enough for the symptoms to become evident. Better to see the doctor when you’re young enough to reverse the problems than wait until your heart locks up or your knees give out.

      I’d be fine with people taking full responsibility for deciding when they were going to start taking care of themselves if they also took full responsibility for paying the costs of their health care when it came time to pay the piper. Unfortunately, it doesn’t work that way. I, and society as a whole, end up paying for the bad health decisions that individuals make.

      Millennial right?

  4. JF Owen says :

    Well, while I love a good debate, I sometimes get carried away. That last post is an example. While I don’t back away from most of it, that last sentence was me making assumptions and being a bully.

    The thing is that my back gets arched when folks appear to focus on personal freedom without recognizing that personal freedom is joined at the hip with personal responsibility.

    Everything each of us does affects others for the better or worse. We’re pack animals living in a complicated environment. How could it be any other way?

    Having said that, I still can’t excuse being a bully. See, my personal freedom to be an ass just impacted Nancy’s blood pressure.

  5. mariampera says :

    The CPS has enacted the same sort of “Wellness” program for its employees. I helped my mom fill out her form online–she was terrified of the $600 fine–and it’s really a dumb form that I think most people, kind of unfortunately, won’t take advantage of. “Are you happy?” “How satisfied with your life are you?” Rather than encourage honesty, I think all these programs do is try to shame people into making better health decisions. But when you’re asking questions about their health, especially mental health, people have a tendency to… how do I say this eloquently… blow smoke up your you know what. People have a hard enough time being honest with their doctors and caregivers; you expect them to honestly share this sort of information with their employers? And is there a danger of a slippery slope where this information begins to be used against employees?

    If we had a death in the family and I received mental health treatment to help me cope, is that later going to be something used to deem me unfit for work since my employer has access to some of my health records?

    I like the idea of encouraging wellness, but charging people for the insurance companies’ growing “costs”–which they are the ones creating in the first place–doesn’t make sense to me.

    • JF Owen says :

      Mariam – Your point on privacy is well taken and surely right next to fear about losing personal freedom when the concerns that people have about health care are discussed. I can’t speak to all “carrot and stick” health care incentive programs, but I will say that the one my company uses precludes transferring any employee specific heath information directly to the employer. The wellness plan is administered by the insurance company, which already knows what kind of treatments we are receiving anyway. The only information that is passed back to the employer is whether the employee is participating in the program and what level of premium discount they qualify for.

      We’ve had this program in place for 4 years. In that time our medical insurance costs have risen at a rate that is about half of the national average. This year our rates went up three percent, which is the lowest increase we’ve seen in fifteen years. We employ ninety-four people at this location and only one has refused to participate in the wellness program.

      As part of the management team of a small employer, I’m involved with the HR team that sources health care insurance for our company. It’s a daunting task that eats up hours upon hours of our time every fall. We’re committed to providing our employees and their families with a quality program that we and they can afford. Achieving that goal has gotten more difficult over the years. Currently, our family coverage costs over $13,000 per year. The company pays 85% of that cost.

      Honestly, I was skeptical when the AHCA was passed. I, we, have been burned too many times over the years with government programs that didn’t work as advertised. So far, and surely the jury is still out, we are cautiously optimistic about the AHCA. This year was the second in a row that we didn’t have to switch providers in order to keep premium costs down to a manageable level.

      In addition to the discounts our employees get for participating in the wellness program, there was an across the board discount offered by the insurance company for offering the program. It wasn’t much, but it does help and it shows that everyone has a stake in keeping health care expenditures down.

      We’re in a new era. When I was your age health care was relatively inexpensive and a small part of the cost of hiring an employee. Co-pays didn’t exist, deductibles were low and prescription coverage typically paid the entire cost for medication. Slowly things have changed and we’re almost to a pivotal breaking point.

      There are many reasons for that. Medical care itself is more complicated and advanced. We can treat things now that were a death sentence forty years ago. Complicated and advance equates to expensive.

      Medical administration has grown unwieldy and the bureaucracy surrounding it more convoluted. It’s almost impossible to be a wise consumer and comparison shop for services.

      Our demographics have changed. My generation, a large part of the population, is getting old and to the point where we require more care. That’s happening at a time when those “advanced” and expensive options are available, which ramps up the costs faster.

      Finally, as a nation we’ve become less healthy. Lifestyle is part of that and the wellness programs are one way to counter that trend.

      There aren’t any easy solutions to the problem. Given that, I don’t think that we can afford to pass a reasonable one up even if it does intrude on our sense of personal freedom. The option is to let the costs spiral out of control to the point that only the wealthy can afford anything more than rudimentary care. That’s not the legacy I want to leave for my children and grandchildren. It’s not the legacy I want to leave for you.

      • mariampera says :

        I really like your explanation of this real life example of your company. There’s just one thing I’d like to point out: every doctor I’ve spoken with about Obamacare (which I generally support) has said that it really doesn’t do anything to address the people who are at the most risk. In some cases, if a doctor prescribes a brand medication the insurance will say, “No, we’ll pay for the generic; they’re the same.” I can attest that generics are not always the same as the brand name product; I’ve had horrible reactions to generic medication and not the brand name product, and vice versa of course. My point is, this sort of thinking allows the insurance company to be EVEN MORE INVOLVED in deciding the kind/level of treatment that patients get.

        Now, this doesn’t really seem all that bad. But my fear is that it will begin to look more like dental insurances. I have had good dental insurance at both companies I’ve worked–PPOs that let me go anywhere. However, they “cap” procedures to be worth a maximum amount, so if I choose to go to a dentist that charges more, I’m responsible. They have a dollar cap on how much they’ll pay for my treatment in a year. They also will pay for “two cleanings a year” that must be 6 months apart, even if my dentist thinks I should come in every 4 months to maintain my oral health. I have a tooth that is ready to break off any day that has had a root canal treatment done and is essentially filled with a lot of porcelain. I can’t get a crown put on it for another 8 years because they won’t cover another restoration until a decade has passed. I pay out of pocket for oral cancer screenings and for fluoride application as preventive services. Those aren’t covered at all, even though they actually save the insurance money in the long run. Most people won’t pay for those expenses if they are out of pocket.

        Maybe none of this will ever happen in medical insurance, but it definitely happens in the dental world so I don’t see it as impossible. I just think the kind of treatment you get and the frequency with which you receive it should be determined by your doctor, not by your insurance. Sure, people can choose to pay for things their insurance doesn’t cover–but most people won’t get treatment their insurance doesn’t cover because it’s expensive.

        This turned into a tirade about dental insurance, but my larger point is that insurance companies should not be dictating care, and right now they do. Wellness programs are good and they’re well-intentioned, but I really don’t know how effective it will be when all you’re doing is threatening people with a fee.

  6. JF Owen says :

    The primary goal of Obamacare wasn’t necessarily to improve healthcare itself, although aspects of the program do address that in many ways. It was to improve access to health care for those in our society that don’t have it and to lower the overall cost. We’ll see how well that works in the long run.

    You’re correct about dental care being handled differently by insurance companies. That’s not a new phenomenon. The first dental insurance that my family had almost forty years ago was set up the same way with the same restrictions. The dollar amounts were lower, but the system was the same. I’m not sure how it evolved that way, but I suspect that it has something to do with the lower perceived importance that dental hygiene had years ago.

    The first health insurance that covered my family had a lifetime maximum benefit of $100,000. That number is burned in my mind because we blew through that in just over a year with my son. He was born with five separate heart defects and was one of the first children in the US to have open heart surgery to correct that many problems. After the heath insurance maxed out, we had to bear the cost ourselves. It took years to retire that debt. One of the benefits of Obamacare is the elimination of those limits and that’s a good thing.

    As to whether the insurance companies will be able to dictate types of care and medications, they’ve been doing that for decades. Every plan has a formulary for medications and every plan has limitations on types and quantities of care. I don’t see that changing; in fact I suspect as time passes it’ll increase.

    Decades ago doctors services were limited to splinting a broken bone, sewing up a cut, controlling pain and infection, and simple surgeries. As science and technologies have advanced, both diagnostic techniques and treatments have improved to the point that what used to be a death sentence is now a bump in the road. Unfortunately, those treatments are costly and the challenge is trying to find a way so that the CEO of a company and the guy who changes your oil at Speedy Change can both get the care they need.

    A few years ago I had a blog and wrote a post about health care. This was before Obama was elected and before the AHCA so in some ways it’s dated, but the thoughts are still valid. We all have to care about whether the folks around us have access to reasonable health care. That may involve some changes in the system that we don’t like, but in the long run, the alternative is worse. http://tigerdad.wordpress.com/2008/05/page/3/

    As to whether carrots and sticks can work to cultivate participation in wellness programs and achieve the anticipated health improvements, I would suggest yes. When my kids were small, threatening to take away their allowance tended to yield an immediate improvement in the cleanliness of their room. The offer of a reward or the threat of a fine, while sometimes unpalatable, are usually effective with most people.

    I enjoy discussing things with you Mariam. You make the conversations lively and interesting.

    • realtalkrealdebate says :

      Glad your son is well 🙂

      Loving the debate you both are having. Although I have to admit I’m a bit jealous that I’m not as affluent in health care knowledge so as to join in. But glad everyone is getting along 🙂

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