Personal Responsibility

Joe,

Lately, as like most of my corporate HR peers, I've been spending a lot of time working on the problem of rising healthcare costs and the resulting impact on the cost to insure our workforce. As we look for solutions that would help us in this effort, it seems that the best approach is an agressive wellness (health management) strategy. Most of the research suggests the a vast majority of healthcare costs flow from medical conditions that are behavior related (i.e. they are caused by choices the individual is making) and are largely preventable.

If that's the case, then the best way to control healthcare costs for comapaies (and our country) apprears to be to incent and mandate healthier coices on the part of each individual. This could mean higher health insurance premium costs for smokers or the overweight. It could mean mandated health behavior interventions programs.

The things that strike me about this entire issue is 1) how quickly and fervently many people reject that an employer (or anyone else) should be able to tell them how to make lifestyle choices and 2) how little responsibility people will accept for their own health. On the one hand, most people will agree that smoking is a choice made by the individual that can or should be penalized. However, when you start talking about weight or physical activity, the excuses start to fly. It seems that we can somehow rationalize that we shouldn't be penalized for eating fast food for lunch every day.

If someone drinks too much and makes the choice to get in their car and drive, most everyone I know would agree that the person should be held responsible for their actions and punished for that decision. If another person makes a choice (like leaving their child in a car on a hot day) that endangers a child, we'd want them held accountable and punished as well. So, why aren't we willing to be responsible for decisions that are affecting our health (particularly considering how high the stakes and the costs are)? Why don't we feel that the over-eater should be held accountable?

I have some theories, but I was interested to get your opion on a couple of topics:

• How do you feel about employers mandating healthy behavior (i.e. the has been at least one company that will not employ smokers)?
• What do you think is going on as it relates to personal responsibility and the behaviors impacting our health?

I look forward to your thoughts.

Jason