Business of Well-being

Balancing Corporate and Personal Responsibility

If we really believe in free choice, why not put cigarette machines in the company lobby...?

By now we have all seen the statistics, the costs of obesity, smoking, lack of exercise, and poor diet choices, and their impact on both health care costs and productivity. We know that over 50% of health care costs are driven by unhealthy behavior, and we know what those behaviors are.

We know that health care costs are totally out of control and are taking up more and more of the company's and the nation's budget every year. The impact of health care costs on the ability of a company to increase wages or make additional investments in innovation, jobs, or infrastructure is clear.

For many large organizations the financial cost related to health care is in the hundreds of millions to billions of dollars and escalates each year by anywhere from 6 to 10%. There are few other costs in the organization that are this large with such a significant related year over year increase.We all bemoan these facts in meeting after meeting and conference after conference.

We blame the insurance companies for being greedy. We blame the health care system for working on care in a piecemeal way, incentivized to treat a patient as individual body parts instead of as an integrated system. We blame the focus on high-cost specialist care as opposed to focusing on the power of a strong primary care physician who focuses on the person as whole system.

We blame fast food restaurants for serving unhealthy food in gigantic portions. As employers, we foot the bill for the majority of the cost for the health care for our employees and more often than not, for the families of our employees. We also bare the brunt of the productivity loss from health related absences.

Over the past 20 years, we have slowly begun to notice that there is a direct link between health, costs, and productivity. We all recognize the problem, the question is, "What can we do?"

Environment, Culture, Responsibility and Action

Many of our employees spend at least 40 hours a week with us. We communicate with them; we interact with them; we influence them. The culture of our organization affects their stress level, their emotional health, their physical health, and their overall well being. It would be naive to believe that what happens at work doesn't also have an impact on the health of their families and vice versa.

The role we play as employers comes with a great level of responsibility to these employees and their families. The environment that we create impacts them, their families and their local communities. Culture is most simply thought of as a 24 hour a day training program. The culture of our organization teaches us what to do and what not to do.

We see others get rewarded for certain actions and understand what to do; we see others get punished or isolated and we learn what not to do. Most organizations do not have an explicit cultural strategy related to the health and well-being of their employees.

Sure, the benefits manager may have statement that is written down, or the company may have a value on a coffee mug that says something about people being their most important asset, but when was the last time that the CEO or the Board of Directors spent more than a couple hours a year discussing the purposeful strategy of the organization as it relates to the culture of health and its impact on the bottom line?

How many leaders have looked at themselves in the mirror to see how the culture that they have created, influenced by policies and procedures, benefits design, training, rewards and recognition, leadership, and compensation directly impact this culture and, in the end, this cost?

I have met with and have spoken to leaders in organizations all over the country who are unwilling to make real changes to the culture of their organizations. They say things like,

  • I think I can impact our health care costs without changing our policies;
  • I don't think we really need to bother the CEO with these issues;
  • We may look at this in the coming years; I'm afraid that we may cause a lot of upset if we make a big change;
  • We've looked at that, but we're not able to make that change now;
  • We're not really interested in that big of a change;
  • Our Chief People Officer really focuses on executive compensation;
  • I don't think legal would let us do that.

How can we make these statements and still look with awe at the skyrocketing costs of health care? How can we shy away from simple moves like non-smoking worksites or tobacco surcharges, and complain of the costs of smoking to our bottom line? How can we shy away from getting the deep fryer out of the company cafeteria or putting healthy food in the vending machines?

Are we really taking our direction from a group of lawyers? How can we let city governments be more progressive than we are with respect to trans fats and smoking? Oftentimes, we hide behind the statement that proposed health-related changes in the workplace are too "big brother" and that we want to encourage and protect "free choice."

If we really believe in free choice, why not have cigarette machines in the lobby of your corporate office? If we really believe in free choice, why do we have reams of policies that govern everything from dress codes to appropriate behavior, to whom you can date at work and how much money you can spend for dinner when on a business trip?

We hide behind free choice because it's an easy out for us - an easy way for us to hide from making real change. Real change takes courage, and apparently, there aren't many of us that have the courage to make real change. The job of a culture is to resist change. The job of a leader is to create a picture of what's possible in spite of the barriers that exist and make it happen.

The reality is that we have the opportunity to positively impact the lives of the people within our work community.... to give people the gift of more quality years with their kids, of watching their children get married and their grandkids grow up. As always, a handful of leaders do exist that push the envelope, who understand the positive impact that they can have and the financial impact that comes along with it.

The problem is that these leaders are the exception while the rest of us sit by and watch with our excuses and rationalizations. We worry about executive compensation and other issues that are more "important" while the biggest chance for us to make a difference and the biggest cost that we're responsible for continues to grow.

If there was ever a time for leadership with respect to these issues, the time is now. Now is the time to push personal responsibility into health and productivity within our organization. Now is the time to share the cost of health care and productivity with our employees - to make them aware of why changes are coming.

The time is now to create a work environment that focuses on making healthy options the default option, not the exception. The time is now for holding people responsible for the choices they make with respect to their health. The time is now to support our employees and their families in these choices with systems and processes at a community, organization, and individual level.

We must strike a balance between corporate responsibility and personal responsibility. We have sheltered our employees from the costs of employer sponsored health care for decades. We shouldn't be surprised by the behavior that we have created.

In creating change, we must help individuals understand the impact of the decisions they make with respect to their health and the related cost by removing the parental system that we have created. As corporate leaders, we must also take responsibility for creating an environment within our organizations that supports a culture of health.

Free choice is a powerful principle. The power comes from the implications and outcomes, both positive and negative, associated with free choice and the responsibility that is inherent in these choices.

Let's shift the conversation to one of personal responsibility, to a conversation that really is about free choice and the responsibility associated with the choices we all make. Change is hard, and inaction is always an option. It's time to choose another way.

About the Author

Chris Cigarran is the Vice President of the Employer Solutions Market at Healthways. An outspoken advocate of health and well-being, Chris leads Healthways' Employer Solutions Market. He and his team are responsible for developing and implementing customer focused strategic plans that reduce costs and increase the well-being of their people.

Before taking on his current role, Chris spent five of his ten years at Healthways as Chief Human Resources Officer (CHRO) building a strategy to improve well-being for the company's colleagues around the world.

His leadership led directly to several national honors for Healthways, including being named to the 2008 FORTUNE 100 Best Companies to Work For list, and receiving two National Business Group on Health gold medals.Prior to joining Healthways in 2001, Chris spent several years as a consultant. He earned his undergraduate degree from Bucknell University and his Masters in Organization Development from Pepperdine University.

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