Business of Well-being

Carrots and Sticks? How about Personal Accountability!

Over and over I hear the analogies of our trade, "It's easier to attract bees with honey," "You can lead a horse to water but you can't make him drink" or "It's better to motivate change with carrots than to punish a lack of progress with a stick."

Passionate wellness team members at numerous organizations desperately try to motivate employees who more often than not, simply don't care. Perhaps they care, but just not enough to change behaviors. Many employers already pay in excess of $6000 per employee per year for health benefits and it is growing.

Too often, rather than appreciation - many employees are indignant, feeling that even the slightest increase in their payroll contribution, co-pays or deductibles are unfair. Employees feel like victims of the benefit plan rather than the beneficiaries. Do they have any idea that they are the only ones really capable of reducing the cost?

It is widely accepted that 70 - 80% of all healthcare spending is spent treating conditions that are lifestyle driven and largely preventable. Employers who ignore this and continue to offer "one size fits all" health benefits are the real victims. I recently attended an annual employee benefits meeting where a company introduced their annual plan changes.

They used a different approach this year, no cost increases but your plan deductible was going to be tied to your lifestyle choices. Their $1250 deductible could be reduced to only $250 if they maintained cholesterol below 200, blood pressure below 140/90, body mass index below 30 and were a non-smoker ($250 per category).

One employee, offended by the concept, stated "Is that the best you can do? It's none of your business whether or not I smoke." The company president quickly replied: "I'm not telling you that you cannot smoke. I'm telling all of your co-workers that they no longer have to pay for it!" - The room erupted in applause.

A rapidly growing number of American workers are ready for this concept. Employee lifestyle choices most certainly are an employer's business. Health benefits are often the second highest expense on an organizations balance sheet! Suppose that your company provided group auto insurance instead of group health insurance.

If you had a few employees who had five at-fault accidents each year, a DUI and several speeding tickets and that caused the rates for the entire company to go up 30% each year, the good drivers would be infuriated. They would demand a discount and they would demand that those responsible for the increase bear more of the cost.

Health plans are really not that different. Have you ever listened to the chatter that occurs before employee benefit meetings? "What are they going to do to us this year?" or "Here we go again, no raises and higher benefits cost." Finally, employers are starting to respond with, "What have you done for yourself this year? Lose weight? Quit smoking?

Get your diabetes under control? If the answer is "yes" you may not see an increase at all." Reward those who never smoked and don't need to lose weight with the best plan and/or lowest cost of all. After all, the only ones who can control costs are the ones who can avoid claims by making healthier choices.

Even employees who don't personally like this message rarely say that they think it's unfair. In this current age of entitlements, laziness and "victims" expecting a bail out because of their poor choices there are indeed glimmers of hope and success stories from those who have instead chosen to take personal responsibility and show some grit determination.

Individuals who have maintained a high credit score can find unparalleled deals in this economy. Banks that didn't cave into the sub-prime mortgage lending pressures are enjoying stability and strong reputations that can fuel growth. The only Detroit auto-maker to refuse a bail out is the only one now posting a profit! Well done Ford!

History has taught us that doing for others what they can and should do for themselves never produces lasting success. This applies directly to your wellness plan as well. Yes, many people need help. Yes, there are special circumstances that warrant intervention and exceptions. We need more coaching, more outreach, encouragement and support programs, but at the core of all of these initiatives is personal accountability.

Employers should not feel guilty for expecting individuals to be a part of the solution or accept the consequences. This happens in performance reviews every day. I recently presented to a group of about 50 insurance brokers. Following the meeting, dinner was served. And then - the largest piece of cheesecake I ever saw was placed before me.

Those at my table jeered "Oh, the wellness guy can't eat that!" and they watched to see what I'd do. I explained that my company doesn't tell anyone what they can or cannot eat. The crux of our message is that if I choose to eat that cheesecake and I do nothing to burn the fat and calories off - my co-workers shouldn't have to pay for it.

The bell finally rang! They understood what results-based wellness incentives were all about. If you are training an animal, you know that rewarding desired behavior causes repeat behavior. It also creates an expectation of a bonus "reward" for doing what they should be doing anyway. Remove the reward and the behavior usually stops.

If instead you beat an animal into submission with a stick, you will see behavior change but you will often also see a broken spirit and resentment. The good news about your wellness program is that you don't need a carrot or a stick. With adult human beings, try communicating the problem, suggesting solutions, listening to feedback, soliciting alternative ideas that accomplish the same goal and executing a strategy.

Seek understanding, not consensus (and certainly not a unanimous decision). Tying employee costs to their healthy choices actually works. Every organization is a little different and cultures must be respected, but the cultures can also change.

Given a chance to be a part of the solution and an expectation to make meaningful lifestyle changes, many employees will rise to the occasion and surprise the skeptics.

About Bravo Wellness

Bravo Wellness offers services to employers and business partners that are desiring results-based incentives for wellness. Customers experience immediate cost savings by linking employee incentives to participation and results. Bravo Wellness recognized the potential legal challenges of health insurance law, including HIPAA non-discrimination regulations, and has unique expertise in the practical application of wellness regulations for group health plans. Bravo Wellness is headquartered near Cleveland, Ohio. For more information, call 877-66-BRAVO or visit

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