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Michelin, like many employers, is implementing a “wellness” program in which employees lose $1,000 of pay if they fail to achieve baseline requirements in three or more categories -- BMI, blood pressure, glucose levels, triglycerides and waist size. Those who surpass the cut-off can register for a health-coaching program and lose less pay. Employees who refuse to “voluntarily” turn over their medical information lose the full $1,000.
When we punish people for their poor health, we ignore the complexities of it -- genetics, individual circumstances, accessibility -- and create an environment of shame and punishment that is the precise opposite of the goals of public health.
In many cases these metrics aren’t entirely within the control of the employee, and some are entirely out of their control. Some are side effects of other life-saving medications, some can only be controlled with medicine that has side effects more dangerous than the initial health issue and some, like weight loss, don’t have a treatment protocol (before you shout “just eat less and exercise more,” look at the research on how often that fails. Hint: Almost all the time.)
Then there is the issue of being required to turn over private health information to your employer so they can fine you. How far does this go? What happens when they start requiring sleep tests and fining insomniacs? How about at-home alcohol tests and fines for employees who drink too much? Or maybe monitors on employees’ personal vehicles and fine them for speeding or poor driving.
Is this even legal? According to Justine Lisser, Senior Attorney-Advisor for the Employment Equal Opportunity Commission, “While normally the ADA [Americans with Disabilities Act] would prohibit an employer with 15 or more employees from asking questions about disabilities or requiring a medical exam (like a blood test to measure cholesterol), an exception is made for voluntary wellness programs…[But] if an employee fell outside some of the metrics imposed by the employer due to an underlying disability -- for example, if a person needed to take medication for a psychiatric disability that caused weight gain -- it might violate the ADA for the employer to penalize that individual for not meeting certain benchmarks.”
While Michelin is busy suggesting that you can tell how healthy someone is by weighing and measuring them -- despite a mountain of evidence to the contrary -- you know what has been shown to be seriously detrimental to health? Poverty. Of course these fines will hit employees with the lowest salaries the hardest. And they will have to figure out how to "get healthier" with $1,000 less in their grocery budget.
According to Ms. Lisser, “It's a confusing topic and one for which there are not, as yet, very clear cut answers.” Or maybe it is clear cut: If your company is actively focusing their time, energy and resources on providing you with access to healthy food options, safe movement options and affordable health care, then you can safely assume that they care about your health. If your company is using the threat of taking your income to cause you to (in)voluntarily turn over your private health information so that they can fine you if you don’t measure up, then you might assume that it’s about something else entirely.