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A rebuttal from Goetzel? Of course not. The Wellness Ignorati deal in secret missives to the media, not open discussion. Or, in the case of the proposed Code of Conduct urging vendors not to harm employees or lie about outcomes, stonewalling it. What they never do is, engage with this blog. We’re good enough for Slate, STATNews, and the Chicago Tribune (and that’s in the last 3 months alone), but not the Wellness Ignorati.
However, we did manage to get a thoughtful response from a third party, Michael Prager. He raises some excellent points.
First, Ron says (and has said variations of this on many occasions) “most diseases are preventable” by wellness. That statement is flat-out wrong. Had Ron said — and this is Michael’s take on what he meant to say — “most people eventually die of chronic diseases that, had they made better choices in their life, might not have developed until later in life,” then he would have been right. Fact is, heart disease and diabetes are leading killers. Just as Michael says.
Ron got it totally wrong, though, with his most-diseases-are-preventable mantra. Only a few diseases are preventable through corporate “pry, poke and prod” programs. Just look at Ron’s own HERO guidebook. It lists diabetes and heart attacks and a few other ICD 9 codes as “potentially preventable hospitalizations.” Meanwhile, there are about 14,000 other ICD 9 codes (or 60,000+ ICD 10 codes) which are not preventable through workplace screenings, though one study tried to credit a wellness program with a decline in cat scratch fever.
Think of all the diseases or other expenses or health programs you yourself (assuming you are a non-smoker) have endured in your lifetimes. How many would have been prevented by one of Ron’s pry, poke and prod programs? Or, as Wellsteps’ Steve Aldana says, by eating one more bite of a banana? (He really did say that, but the STATNews website seems to be down this very minute.)
Now, if employees were covered for their entire lives by employers (they aren’t), and if employers could get them to reduce their risks (they can’t), then corporate wellness could work, and might possibly save money.
Second, Michael also points out that I distinguish disease-related “events” from the diseases themselves. These events are — and Ron’s HERO guidebook agrees with me on this — the only place an employer actually realizes savings from wellness, offset by many other costs. However, very few events caused by these conditions take place during our actual <65 working years. Like the annual odds of a heart attack for commercially insured people <65 are about 1-in-800. Using a few generous assumptions about program effectiveness, that already-low rate means it costs companies about a million dollars to prevent one through pry, poke and prod.
Finally, you should know a little about Michael’s back story. He did in fact turn his own health around through rigorous attention to diet and exercise, and I applaud and respect him for that. He encourages others to do the same, as do I. However, “encouragement” and intrinsic motivation are a lot different from, for instance, Michael O’Donnell’s recent diatribe that employee health insurance premiums should (at least in part) be assessed on a per-pound basis, sort of like when ordering lobster or mailing a package. That system, Mr. O’Donnell says, will get employees to lose weight.
Alas, if there is one thing wellness vendors can’t do, it’s get people to lose weight. The best example would be Ron’s buddies at the Vitality Group. They couldn’t even get their own employees to lose weight.
I am shortcutting Michael’s comments, so do go take a looksee on your own. It was a thoughtful response (two words you won’t see in succession in any other TSW posting) and is worthy of a careful read.
Usually a tease like that leads to exactly the opposite content, as in Wellness Corporation Solutions Gives Us A Dose of Much-Needed Criticism, which of course turned into the poster child for our observation that “in wellness you don’t have to challenge the data to invalidate it. You merely have to read the data. It will invalidate itself.”
This is not that situation.
Michael Prager points out on his blog that I overstated the wellness-programs-as-fat-shaming case. Note he doesn’t say I’m wrong, but he does say I overplayed my hand, which I did. Many wellness programs fit my thesis…but some don’t. If a company’s program is all about offers rather than threats, about creating an environment conducive to health improvement instead lecturing people on their weight, about doing wellness for employees instead of to them, and about leaving people alone who don’t want to or can’t lose the weight, then I’m all for it. I should have been clearer about that.
If anyone would like to nominate an employer who has such a program, I would be happy to write it up.
And as you can see, we are also open to criticism of our positions, as long as the person writing the critique has a good point. Naturally, this industry is overflowing with vendors and consultants who probably have never had a good point in their lives…and naturally Wellsteps is leading the way. When we observed that Wellsteps’ most recent outcomes report showed costs going up and down at the same time, here is their (Troy Adams) rebuttal: We are full of “hot air.”
Please visit Michael Prager’s blog. Ironically, I don’t think we would take issue at all with his main point which appears to be that wellness should be done for employees instead of to them. (He is in the business of doing wellness for employees, not to them.) And, in fact, if he were actually thinking clearly about his own business success, he’d be pointing that out and trying to figure out ways to work together.
Second, note that our math and facts are never, ever criticized, even by our most virulent critics. What he criticizes is that we “mock critics who say that calling people ignorant is bullying.” Well, we call them the “ignorati,” not ignorant. “Ignorati” means they ignore facts, which is a brilliant strategy.
Third, he is breaking ranks with the ignorati, by not ignoring us. This creates a problem because he doesn’t actually point out a single thing we say that is wrong. Indecorous, perhaps, but wrong, no.
Michael, have at it: find a mistake in our math or a lie that we told about your integrity-challenged colleagues and we’ll apologize to it and link people to it. Go ahead, make our day. Because right now the fact that you, having shown that you are willing to criticize us, can’t find anything to actually criticize us about (other than our “bullying” observations that people who can’t do arithmetic shouldn’t be doing arithmetic), makes our case much better than we ever could.
Addendum: his is actually a very interesting blog on its own merits. He does do wellness for employees instead of to them ∞