Rewards, not penalties, in reform

Rewards, not punishment, for making healthy choices.

Our proposal, a bipartisan amendment to the healthcare reform bill that garnered strong support in the Senate Finance Committee, gives employers and employees more of the tools they need for success. Employee wellness programs offered by a growing number of employers are similar to the rewards that auto insurance companies use to promote safer driving or better behavior. Americans receive discounts on their car insurance costs if they receive higher classroom grades or take safe driving classes. Likewise, employers should also be able to use behavior-based rewards to promote healthier lifestyles among their employees.  

In short, we believe that comprehensive healthcare reform should give employers and employees adequate tools to help them address the underlying causes of poor health that have led to one-third of Americans being overweight or obese today.

Under the current system, employers and insurers are allowed to award discounts of up to 20 percent on premiums, copayments and deductibles to those workers who meet a particular health standard. Our amendment increases the existing reward from 20 to 30 percent. Additionally, it gives the secretaries of Labor, Health and Human Services, and Treasury the authority to increase that reward to 50 percent if they deem the system to be successful.

Our amendment also would have the added benefit of lowering overall healthcare costs in the long run by encouraging participants not to ignore but to focus on their health today, rather than needing more healthcare services tomorrow.

We know for a fact that unhealthy behavior is expensive — about 70 percent of healthcare costs are driven by our own behavior. Research shows that risk factors like smoking and obesity contribute to a long list of chronic health conditions, such as heart disease, cancer, stroke and diabetes, which in turn, drive up health expenditures. 

If we succeed in convincing more Americans to take personal responsibility for their health now, we will reduce the number of Americans with chronic conditions from entering an already overburdened healthcare system later on.

We have seen examples of these cost savings in companies like Safeway, which has kept its per capita health costs flat while most American companies’ health costs have increased by about 40 percent over the same four years. We can all agree that cutting healthcare costs by 40 percent is a significant savings. 

What if the federal government also could realize savings like that over such a short time?  Or what if every company that implemented a healthy behaviors program saw even half of these savings? We could see a real reduction in healthcare spending and a real increase in healthier Americans all at the same time.

Some out there would like to scare Americans into thinking our bipartisan amendment would allow employers to discriminate against employees. In fact, our approach builds on existing law and focuses on encouraging and rewarding healthy behavior. At the same time, it includes strong protections against discrimination and privacy infringement for employees. We even require employers to offer reasonable alternatives or waivers to those who are medically unable to achieve a certain reasonable health standard.

We believe strongly that incentives and personal responsibility in this healthcare reform bill will help motivate people to adopt healthier behaviors. And that will lower overall healthcare costs for all Americans.
Ensign and Carper are members of the Senate Finance Committee’s Subcommittee on Healthcare.