Rumor has it that within the next couple of days Health Affairs is going to release a paper in which Ron Goetzel admits that — even with his finger on the scale as it always is (along with the other nine and all his toes) — wellness loses money. This is total vindication for the years in which he has preferred to simply fabricate large savings, based on trivial risk impact, and then accuse me of “outrageous inaccuracies” and other such fanciful tales for observing — accurately, as it turns out — that all his savings are made up.
Yes, I know I’ve said he has admitted wellness loses money several times before, like in his HERO Guidebook, or in STATNews, or in the Chicago Tribune. But those were all gaffes. (A gaffe is defined as “accidentally telling the truth.”) The difference is, this time it’s deliberate.
And, no, he hasn’t sworn off lying. Lying is a thing these days. He was way ahead of the curve on that. Mind you, I have not seen the article, and I wasn’t allowed to peer review it. (Health Affairs allows authors to rule out certain peer reviewers, so he ruled me out — despite admitting not too long ago that I am the best peer reviewer in the field.) However, I anticipated that, given his level of integrity, he would use the completely invalid participants-vs-non-participants methodology, and so I invalidated it for him ahead of time, not that he didn’t already know.
Despite admitting losses, he still holds to the fiction that somehow risk factors decline, a claim which I intend to examine once I see the article. I suspect he didn’t plausibility-test the outcomes (even though his HERO guidebook says to do that) and/or he didn’t count dropouts and non-participants. But we’ll know soon enough.
However, by admitting wellness loses money even if risk factors improve, he just invalidated every single Koop Award he has ever bestowed on any of his buddies. The reason is that in those award-winning situations, risk factors either only improve a trifle (Staywell, 2014 and Nebraska, 2012), don’t decline at all (McKesson, 2015), or increase (Wellsteps and Boise, 2016). None of these non-improvements acknowledges dropouts, of course.
PS Remember my $2-million reward for showing wellness saves money? Let’s make it $3-million.
A rising chorus of people (the usual suspects — Goetzel, O’Donnell etc.) say you don’t need an ROI from wellness, but here is an essay in Employee Benefit News pointing out why you do, citing three distinct reasons, each sufficient on its own.
By contrast to these three strong arguments in favor of demanding an ROI, the best argument against demanding an ROI from wellness is that you can’t get one, which explains the opposition from those usual suspects. They were all about ROIs before it was proven that you can’t get one, but that was then and this is now.
Here is one thing that doesn’t need an ROI: screening according to US Preventive Services Task Force guidelines. Ironically, that’s also the one thing that those very same usual suspects are opposed to. For them, it’s overscreening today, overscreening tomorrow, overscreening forever.