Should Employees Pay More if They’re Unhealthy?

There is a major change brewing in health care. Many people are realizing the benefit of shifting the focus from treatment of diseases to prevention. The reason is clear; it’s not only better to stay well than to get well – it’s cheaper.

As more and more American workers find themselves with high blood pressure, increasing blood sugar levels, and risky cholesterol numbers, insurance companies are becoming more reluctant to pay – especially since many of these conditions are reversible with a healthier lifestyle.

Companies are now starting to make employees pay more if they aren’t healthy enough.

Michelin North America, the tire company, used to offer incentive programs to improve employee health, such as extra money for completing health-assessment surveys or participating in a non-binding “action plan” to walk every day. But Michelin and other similar companies are realizing the incentive strategies aren’t working as well as companies hoped.

Businesses are now approaching the health problem with penalties. Starting next year, Michelin employees with certain health risk factors may have to pay as much as $1,000 more for health coverage. Michelin is not alone in this trend; CVS Caremark asked workers last month to report their body fat, blood sugar, blood pressure and cholesterol levels to the company’s insurer by May or be fined $600.

There is a reason companies are specifically asking for weight, blood sugar, blood pressure and cholesterol levels. If a person has three out of the following five criteria, they have what doctors call Metabolic syndrome (see Metabolic Syndrome music video on the next page):

  • Waist ≥ 35 inches for women; ≥ 40 inches for men
  • Blood pressure > 130/85
  • Blood sugar > 100 mg/dL
  • Triglycerides > 150 mg/dL
  • HDL < 40 mg/dL for men; < 50 mg/dL for women

Metabolic syndrome is a condition associated with a higher risk of stroke, heart disease, and diabetes. These are the very parameters some companies, such as Michelin and CVS, are requesting their employees divulge in order to determine whether the employee pay more for health insurance.

New York Mayor Bloomberg was unsuccessful in his recent attempt to ban super sized sodas from the city to eliminate a major source of empty calories. There is a lot of resistance to being told what to do, even if in theory it is good for us.

Health care costs are soaring (according to the WSJ, industry is expected to pay $12,136 per employee this year) and the majority of illnesses could be reduced or prevented just by eating less, eating healthier, exercising regularly, getting more sleep and having regular check ups.

If individuals choose not to take steps to stay well, companies that in turn have to pay higher premiums are going take a more aggressive role. A recent study by Aon Hewitt revealed that 60% of employers plan to penalize employees who don’t take action to improve their health. Businesses didn’t succeed with the carrot of incentive programs, so they are going to use the stick of financial penalties.

Individuals are going to have to develop healthier habits: eating less fast food and less restaurant food, getting 30 minutes of exercise daily, eliminating smoking and maintaining good sleep and good hygiene (as George Burns said on becoming 100, “If I’d known I was going to live this long, I would have taken better care of myself”).

But companies can also do more. Managers and human resources are going to have to be advocates for health and make health a priority in the workplace.

Sitting eight or more hours a day harms our health. We need to get rid of the cubicles and open the prairies. Have more walking meetings, stand when we talk on the telephone, have standing desks and more gyms and walking paths and yoga classes at work. We have to eliminate poor choices from the food options in the workplace – if people can’t live without a doughnut, they have to either bring it with them or go out and buy one.

Companies should consider having an in-house physician. In the old days, larger companies like Gillette and Polaroid had a physician in house. This made preventive measures and testing easy for employees. People didn’t have to take off an entire day to go to a 15-minute appointment.

Without question there is much to work out. Some employee-right advocates consider these penalties to be discrimination.

But at the current trajectory, by 2020 half the country will be either diabetic or prediabetic (blood sugar above normal but not quite diabetes) and that is not financially sustainable for the country. It’s also terrible for the affected individuals.

The good news is that the discussion of shifting the focus from treatment to prevention is now on the table. And that means future generations may live longer and have lower health care costs.

What do you think? Do these measures seem more like employee discrimination or wellness incentives? How do you want to see business culture change to help improve health?

See my video on Metabolic syndrome on the next page.

Click here for my Free three-video Health Accelerator Series and learn what tests are essential, how to prepare for your annual exam and five things you can do today to jump-start your health.


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Susan T.
Susan T4 years ago

Yes. as a person with a chronic illness you would think I would answer NO. But if a person uses more resources they should pay more. I go to the store and when I buy more I pay more. Why should it be different for health care?
A person should pay for what they use.

Chinmayee Jog
Chinmayee Jog5 years ago

I think this is an excellent idea - the government has tried numerous methods of making people achieve better health, but unfortunately you always have to hit the public where it hurts for them to pay attention to ANY major issue - in the wallet! So if this is what it needs to come to, then so be it. I'm guessing that any genetic issues will be taken into consideration?

Rebecca P.
Rebecca P5 years ago

Wow, it is this kind of thing that makes me very relieved that I don't live in America.

Because I don't live there my opinion isn't really important in this matter I guess, because there would be nothing I could do about this, but personally I see this as discrimination, & as Stephanie R. pointed out: "Discrimination is illegal and should remain that way!"
I completely agree.

Camilla Vaga
Camilla Vaga5 years ago

hmm not all people can help that they are fat, so it is unfair

Fred Hoekstra
Fred Hoekstra5 years ago

Thank you Dr. Mache Seibel, for Sharing this!

David Murray
David Murray5 years ago


Paul E.
Paul Elsass5 years ago

To the last comment, you wouldn't pay more. In fact, you would likely pay less than your peers. The way these programs normally work is that they typically look at the following measurements:
Does the person smoke?
Does the person's total cholesterol fall in a health range (less than 200 for example)
Does the person's blood pressure fall in a healthy range (120/80 or less for example)
Does the person have a healthy body composition or BMI (such as body fat of less than 18% for men and 28% for women)?

You would get a point for each goal that you meet. The more points you get, the less you pay. Again, keep in mind that if you cannot meet a goal for a medical reason, you would be given an alternative. This type of program is good for all parties involved.

Jacqueline S.
Jacqueline S5 years ago

Who will cast the first stone? I am 57 years old, 5'7 in, after 5 children 116 lbs. I exercise, my total cholesterol is 160, BP is 110 / 70. Don't drink, but i smoke. Haven't had a cold in over 25 years and only go to the doctor for my yearly check-up. So I am a drain on our healthcare? Charge me more? Prove I am sickly!

Paul E.
Paul Elsass5 years ago

Absolutely agree with the last comment. These programs are specifically designed to incentivize behavior change in making better health choices, which affect controllable illness. The government does not allow employers to do this in a way that discriminates on uncontrollable health problems. Again, if you cannot help it, you simply get a note from your doctor and you will not be penalized. I hear people voice concern on this all the time, but the fact of the matter is that when we look at chronic health conditions overall, more than 65% are caused by controllable lifestyle choices. Further, if we look at specific diseases, such as heart disease, stroke, PVD, diabetes and even some cancers, the percent caused by controllable lifestyle choices is MUCH higher. Did you know that in this country, more than 60% of people are overweight? The research is in, and the bottom line is that the vast majority of these overweight people CAN help it. They may not want to and it may not be easy, but they can. If they really can't, then no problem, just get a note from your doctor stating so.

Arwen Woods
Arwen Woods5 years ago

I think in the case of preventable illnesses, absolutely yes! However, if the illness the person has cannot be rectified by lifestyle changes, I do not think it is fair at all.