CYPRESS, Calif. -- At age 45, Rick Graham was 5-foot-8 and 235 pounds. His blood pressure was soaring, and he didn't have as much energy as he did when he was younger. The business analyst tried every diet in the book, but the weight kept coming back. Finally his employer decided to do something about it.
If Graham would try to eat better and exercise, PacifiCare Health Systems Inc. offered a novel reward: cash.
So now, once every 24 hours or so, Graham logs on to a computer system managed by his company and types in everything he has eaten: packet of instant oatmeal (104 calories), can of V-8 juice (35 calories), mini box of raisins (42 calories), Mandarin chicken (280 calories), wedge of banana cream pie (300 calories), pepperoni pizza (560 calories), eight cups of water (0 calories) and so forth. He then inputs any exercise he has done, which on this particular day happened to be nothing but is usually 25 minutes on a treadmill and 20 minutes on a stationary bike.
For keeping track of his food intake and his fitness routine, PacifiCare pays him about $15 every other week, or $390 a year.
The monetary incentives are part of unconventional new programs being rolled out by PacifiCare and other corporations around the country to try to coax, push -- or even force -- workers to become healthier.
The move is driven, the companies say, by soaring health insurance costs. They say that the fitter their workers are, the fewer claims they are likely to file. But some workers rights groups worry that these programs, while well intentioned, set a precedent for allowing employers to get involved in private aspects of people's lives.
"Do we really want employers conducting an extensive survey of employees' every unhealthy lifestyle choice? Do you really want your boss asking you what you eat and what you do for recreation?" said Lewis Maltby, president of the National Workrights Institute, a spinoff of the American Civil Liberties Union.
PacifiCare is among the more ambitious in its incentives. In addition to cash, the health management company offers its 9,100 employees rewards for participating in classes to stop smoking or to manage their diabetes or asthma. Workers can also earn credit for non-health-related activities, such as trying to manage their personal finances better, learning about art or music, washing their car or teaching their children not to play so many video games. The credits can be converted into iPods, spa certificates, water noodle toys for the pool and other goodies.
A number of other companies are trying similar approaches on a smaller scale. Many efforts focus on smokers, and some are not voluntary.
A Florida sheriff's office is requiring some applicants to take a polygraph test with questions about their smoking habits. Omaha-based Union Pacific Corp. last fall stopped hiring smokers in seven states. And Navistar International Corp., a Warrenville, Ill., truck manufacturer, is introducing an extra charge of $50 per month for health care coverage for those who smoke.
So now, once every 24 hours or so, Graham logs on to a computer system managed by his company and types in everything he has eaten: packet of instant oatmeal (104 calories), can of V-8 juice (35 calories), mini box of raisins (42 calories), Mandarin chicken (280 calories), wedge of banana cream pie (300 calories), pepperoni pizza (560 calories), eight cups of water (0 calories) and so forth. He then inputs any exercise he has done, which on this particular day happened to be nothing but is usually 25 minutes on a treadmill and 20 minutes on a stationary bike.
For keeping track of his food intake and his fitness routine, PacifiCare pays him about $15 every other week, or $390 a year.
The monetary incentives are part of unconventional new programs being rolled out by PacifiCare and other corporations around the country to try to coax, push -- or even force -- workers to become healthier.
The move is driven, the companies say, by soaring health insurance costs. They say that the fitter their workers are, the fewer claims they are likely to file. But some workers rights groups worry that these programs, while well intentioned, set a precedent for allowing employers to get involved in private aspects of people's lives.
"Do we really want employers conducting an extensive survey of employees' every unhealthy lifestyle choice? Do you really want your boss asking you what you eat and what you do for recreation?" said Lewis Maltby, president of the National Workrights Institute, a spinoff of the American Civil Liberties Union.
PacifiCare is among the more ambitious in its incentives. In addition to cash, the health management company offers its 9,100 employees rewards for participating in classes to stop smoking or to manage their diabetes or asthma. Workers can also earn credit for non-health-related activities, such as trying to manage their personal finances better, learning about art or music, washing their car or teaching their children not to play so many video games. The credits can be converted into iPods, spa certificates, water noodle toys for the pool and other goodies.
A number of other companies are trying similar approaches on a smaller scale. Many efforts focus on smokers, and some are not voluntary.
A Florida sheriff's office is requiring some applicants to take a polygraph test with questions about their smoking habits. Omaha-based Union Pacific Corp. last fall stopped hiring smokers in seven states. And Navistar International Corp., a Warrenville, Ill., truck manufacturer, is introducing an extra charge of $50 per month for health care coverage for those who smoke.
The question of how far companies should go was raised recently when seven employees resigned from Weyco Inc. of Okemos, Mich., in January rather than submit to a nicotine test.
The degree to which companies can impose health-related requirements on employees varies across the country. Thirty states, including Virginia, plus the District of Columbia have laws preventing discrimination against smokers, while others, such as Maryland, do not. Thirteen states prohibit employers from regulating alcohol use during non-work hours. But only four states -- California, Colorado, New York and North Dakota -- have passed broader privacy laws protecting people's activities away from the job.
The question of how deeply employers should get involved in their workers' health arises as half of all deaths in the United States continue to be attributed to a limited set of largely preventable behaviors. The Centers for Disease Control estimates that each year there are 440,000 deaths from tobacco use, 400,000 deaths from poor diet and physical inactivity, and 85,000 deaths due to alcohol consumption.
PacifiCare's incentives program is the brainchild of Sam Ho, the company's chief medical officer and executive vice president. Ho is a self-proclaimed health nut who practices yoga religiously, is a vegetarian and prides himself on needing only three to four hours of sleep a night.
Ho said his inspiration came from an assessment program the health management company uses to grade physicians' performance. Once doctors were told what they were doing right and what they were doing wrong, there was a marked improvement in patient treatment, he said. Ho theorized that he could apply those lessons to employees and their own health.
PacifiCare officials declined to say how much the company is spending on the program, except to describe the amount in the "high six figures." Ho predicted the program would more than pay for itself over the first two years in health care savings.
"Everybody knows we have a health care crisis, exemplified by both cost inflation and an obesity epidemic, in the United States. It was only a matter of time before employers started taking action," Ho said.
Health insurance premiums have skyrocketed since 2000, growing 59 percent, far faster than the 12.3 percent rise in average pay, according to the Kaiser Family Foundation, a nonprofit research firm in Menlo Park, Calif. Studies have shown that nonsmokers alone save companies an average of $1,000 a year.
When PacifiCare's health credits program was announced last summer, the reaction from employees ranged from enthusiasm to suspicion. About half the employees signed up, with about 15 percent doing enough to qualify for the $15 biweekly credit.
"Some people said I don't want anybody to know this stuff," said Jennifer Horn, 31, chief of staff of the corporate health services group.
More... http://www.washingtonpost.com/wp-dyn/articles/A38566-2005Feb19_2.html (registration required)
If Graham would try to eat better and exercise, PacifiCare Health Systems Inc. offered a novel reward: cash.
So now, once every 24 hours or so, Graham logs on to a computer system managed by his company and types in everything he has eaten: packet of instant oatmeal (104 calories), can of V-8 juice (35 calories), mini box of raisins (42 calories), Mandarin chicken (280 calories), wedge of banana cream pie (300 calories), pepperoni pizza (560 calories), eight cups of water (0 calories) and so forth. He then inputs any exercise he has done, which on this particular day happened to be nothing but is usually 25 minutes on a treadmill and 20 minutes on a stationary bike.
For keeping track of his food intake and his fitness routine, PacifiCare pays him about $15 every other week, or $390 a year.
The monetary incentives are part of unconventional new programs being rolled out by PacifiCare and other corporations around the country to try to coax, push -- or even force -- workers to become healthier.
The move is driven, the companies say, by soaring health insurance costs. They say that the fitter their workers are, the fewer claims they are likely to file. But some workers rights groups worry that these programs, while well intentioned, set a precedent for allowing employers to get involved in private aspects of people's lives.
"Do we really want employers conducting an extensive survey of employees' every unhealthy lifestyle choice? Do you really want your boss asking you what you eat and what you do for recreation?" said Lewis Maltby, president of the National Workrights Institute, a spinoff of the American Civil Liberties Union.
PacifiCare is among the more ambitious in its incentives. In addition to cash, the health management company offers its 9,100 employees rewards for participating in classes to stop smoking or to manage their diabetes or asthma. Workers can also earn credit for non-health-related activities, such as trying to manage their personal finances better, learning about art or music, washing their car or teaching their children not to play so many video games. The credits can be converted into iPods, spa certificates, water noodle toys for the pool and other goodies.
A number of other companies are trying similar approaches on a smaller scale. Many efforts focus on smokers, and some are not voluntary.
A Florida sheriff's office is requiring some applicants to take a polygraph test with questions about their smoking habits. Omaha-based Union Pacific Corp. last fall stopped hiring smokers in seven states. And Navistar International Corp., a Warrenville, Ill., truck manufacturer, is introducing an extra charge of $50 per month for health care coverage for those who smoke.
So now, once every 24 hours or so, Graham logs on to a computer system managed by his company and types in everything he has eaten: packet of instant oatmeal (104 calories), can of V-8 juice (35 calories), mini box of raisins (42 calories), Mandarin chicken (280 calories), wedge of banana cream pie (300 calories), pepperoni pizza (560 calories), eight cups of water (0 calories) and so forth. He then inputs any exercise he has done, which on this particular day happened to be nothing but is usually 25 minutes on a treadmill and 20 minutes on a stationary bike.
For keeping track of his food intake and his fitness routine, PacifiCare pays him about $15 every other week, or $390 a year.
The monetary incentives are part of unconventional new programs being rolled out by PacifiCare and other corporations around the country to try to coax, push -- or even force -- workers to become healthier.
The move is driven, the companies say, by soaring health insurance costs. They say that the fitter their workers are, the fewer claims they are likely to file. But some workers rights groups worry that these programs, while well intentioned, set a precedent for allowing employers to get involved in private aspects of people's lives.
"Do we really want employers conducting an extensive survey of employees' every unhealthy lifestyle choice? Do you really want your boss asking you what you eat and what you do for recreation?" said Lewis Maltby, president of the National Workrights Institute, a spinoff of the American Civil Liberties Union.
PacifiCare is among the more ambitious in its incentives. In addition to cash, the health management company offers its 9,100 employees rewards for participating in classes to stop smoking or to manage their diabetes or asthma. Workers can also earn credit for non-health-related activities, such as trying to manage their personal finances better, learning about art or music, washing their car or teaching their children not to play so many video games. The credits can be converted into iPods, spa certificates, water noodle toys for the pool and other goodies.
A number of other companies are trying similar approaches on a smaller scale. Many efforts focus on smokers, and some are not voluntary.
A Florida sheriff's office is requiring some applicants to take a polygraph test with questions about their smoking habits. Omaha-based Union Pacific Corp. last fall stopped hiring smokers in seven states. And Navistar International Corp., a Warrenville, Ill., truck manufacturer, is introducing an extra charge of $50 per month for health care coverage for those who smoke.
The question of how far companies should go was raised recently when seven employees resigned from Weyco Inc. of Okemos, Mich., in January rather than submit to a nicotine test.
The degree to which companies can impose health-related requirements on employees varies across the country. Thirty states, including Virginia, plus the District of Columbia have laws preventing discrimination against smokers, while others, such as Maryland, do not. Thirteen states prohibit employers from regulating alcohol use during non-work hours. But only four states -- California, Colorado, New York and North Dakota -- have passed broader privacy laws protecting people's activities away from the job.
The question of how deeply employers should get involved in their workers' health arises as half of all deaths in the United States continue to be attributed to a limited set of largely preventable behaviors. The Centers for Disease Control estimates that each year there are 440,000 deaths from tobacco use, 400,000 deaths from poor diet and physical inactivity, and 85,000 deaths due to alcohol consumption.
PacifiCare's incentives program is the brainchild of Sam Ho, the company's chief medical officer and executive vice president. Ho is a self-proclaimed health nut who practices yoga religiously, is a vegetarian and prides himself on needing only three to four hours of sleep a night.
Ho said his inspiration came from an assessment program the health management company uses to grade physicians' performance. Once doctors were told what they were doing right and what they were doing wrong, there was a marked improvement in patient treatment, he said. Ho theorized that he could apply those lessons to employees and their own health.
PacifiCare officials declined to say how much the company is spending on the program, except to describe the amount in the "high six figures." Ho predicted the program would more than pay for itself over the first two years in health care savings.
"Everybody knows we have a health care crisis, exemplified by both cost inflation and an obesity epidemic, in the United States. It was only a matter of time before employers started taking action," Ho said.
Health insurance premiums have skyrocketed since 2000, growing 59 percent, far faster than the 12.3 percent rise in average pay, according to the Kaiser Family Foundation, a nonprofit research firm in Menlo Park, Calif. Studies have shown that nonsmokers alone save companies an average of $1,000 a year.
When PacifiCare's health credits program was announced last summer, the reaction from employees ranged from enthusiasm to suspicion. About half the employees signed up, with about 15 percent doing enough to qualify for the $15 biweekly credit.
"Some people said I don't want anybody to know this stuff," said Jennifer Horn, 31, chief of staff of the corporate health services group.
More... http://www.washingtonpost.com/wp-dyn/articles/A38566-2005Feb19_2.html (registration required)