By MATTHEW BRODSKY, senior editor/Web editor of Risk & Insurance®
The numbers are big, getting bigger. The direct costs of obesity in the United States are estimated at $75 billion, $139 billion if you tally "indirect" costs. Of that, employers pay $45 billion in medical expenses and excessive absenteeism. And this doesn't even include presenteeism, when employees are at work but not as productive as they could be. Then add the workers' comp price tag, which could be nearly seven times higher for medical costs and 11 times higher for indemnity costs for obese versus "normal" workers.
The bad news is that overweight is beginning to be the "normal" state of the American worker. According to last week's report from nonprofits Robert Wood Johnson Foundation and the Trust for America's Health, titled "F as in Fat: How Obesity Policies Are Failing in America 2009," adult obesity rates rose in 23 states and fell in none.
About two-thirds of states now have obesity rates above 25 percent; in 1991, no state had a rate greater than 20 percent. Meanwhile, adult diabetes rates increased in 19 states, and in seven states more than 10 percent of all adults have type-2 diabetes. And let's not even get into the numbers for childhood obesity, which are downright depressing.
"We're just beginning to get our arms around it, and this study certainly underscores the fact that we need to be paying more attention to it," said Marcia Carruthers, president and CEO of the Disability Management Employers Coalition (DMEC).
"Employers need to step up to the plate and serve as a role model," she said.
AT THE PLATE
But of course the obesity epidemic isn't news to most employers, or the health and disability insurers who serve them.
"We are dealing with the aftermath of the obesity epidemic," said Tracie Foster, director of product management/business development for the life and disabilities business unit at Indianapolis-based WellPoint Inc. "We see it and we feel the pain."
Many employers have known for years that "healthier employees are happier and they cost less money," said Bob Berglund, vice president of employee benefits and insurance at Boyd Gaming. The real news, he said, is that the current situation provides an opportunity for employers to embrace employees and give them the tools and education to solve their own health problems.
So the recommendations from the authors of "F as in Fat" might seem generic to employers already up to their neck in obesity and the costs of diabetes and cardiovascular and musculoskeletal problems that go with it. Employers are already wrestling with what types of healthy lifestyle programs they can offer employees, how to convince them to sign up, and how to keep employees productive and on the job, said Foster.
The true test now for employers is creating an overall culture of wellness and reinforcing that across the organization, across their health and wellness, disability and behavioral health programs, said Foster.
It's of course the larger employers that have taken the lead with integrated health management benefits. Berglund said Boyd, an employer of about 16,000, is working toward this goal, utilizing such "health awareness" programs as biometric screenings, health coaches, a consumer-directed health plan with telephonic advisors, disease management programs with guidance from nurse practitioners and mental health benefits. The "next frontier" for Boyd will be to tie it all together with absence management.
Still, the "F as in Fat" report should be a "clarion call" to all employers, no matter their size, said Carruthers.
One wonders if smaller employers have the resources to take these programs as far as larger competitors ... or if they should even if they could. Larger employers are deeming obesity not just a personal issue for their workers. Some are taking a harder line, moving past rewarding employees for participation in wellness and health management programs and penalizing them for failing to participate, as a recent survey on benefits from Towers Perrin indicated.
A crackdown by large employers could backfire. "I think it's a dangerous place to go, particularly with obesity since it's such a sensitive issue to begin with," said Foster about negative incentives. "I am still a big believer in positive reinforcement."
So is Berglund. He sees employers heading toward "bifurcated" benefits plan--with employees willing to take health risk assessments, say, getting a higher level of benefits--but he also believes that many employees welcome any assistance and resources given to them. Up to 40 percent of his workers go to health screenings voluntarily, he said.
The politicians in Washington seem to get this as well.
"The government has got their arms around this (health awareness and wellness), and it's going to survive no matter how this thing (healthcare reform) shakes out," Berglund said, who has been invited to join other employers in a meeting next week with policymakers on Capitol Hill. "This is not a time to be scared. This is the time to embrace this."
July 7, 2009
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