The "establishment" vs. the "insurgency." The former represents the traditional wings of the parties, while the latter -- the mad-as-hell Trump and Sanders supporters -- hate the cozy relationship between business and government. (True, they express that hatred in far different ways, but that's a topic for others to explore.)
Nothing epitomizes the disconnect between those two wings more than when employers "play doctor" by instituting employee wellness. This bald we-know-what's-good-for-you power grab by the elites is disdained or detested by almost every employee subjected to it. And for good reason -- these programs are hugely intrusive but don't improve health or save money, not even a little. Some are downright dangerous.
Both parties' establishments are at fault here, passing a bipartisan law that allows employers to hire unlicensed vendors to run a myriad of generally useless and occasionally harmful tests on employees. The law permits very little recourse...and proposed new rules will make it even harder for employees to decline this onslaught of overtesting.
By way of background, a typical workplace wellness program involves prying into employees' personal lives by making them fill out an anonymous form detailing their eating and drinking habits, as well as whether they feel depressed. Employees are then lined up to be poked with needles by a vendor hired to tell them how sick they are. Sick or not, they are then prodded to go get checkups, even though the science is quite clear that healthy people shouldn't visit the doctor for no reason. The shorthand for the combination of these three initiatives is: "pry, poke and prod" programs. After they are done being pried, poked and prodded, employees are often told to lose weight -- or forfeit money if they don't.
Wellness companies often refer to their programs as "just plain fun," or something similar. If these privacy-invading anti-employee jihads doesn't sound like fun to you, you're not alone. As we'll see and as mentioned above, most employees hate these programs. Or as my book, Surviving Workplace Wellness, says: "These programs are designed to make employees happy whether they like it or not." (At the risk of sullying the narrative with a nuance, I do need to point out that a few programs succeed, even as thousands fail. Those "outliers" are listed on the Validation Institute website.)
The "Establishment" View of Workplace Wellness
No lobbying group likes wellness more than the Business Roundtable, and no lobbying group screams "establishment" more than the Business Roundtable (BRT). While not technically a partisan group, the BRT has made it abundantly clear that their support for the Affordable Care Act (ACA) is contingent on "pry, poke and prod" and other wellness programs being front-and-center. One possible explanation for this obsession is that they are truly concerned about the health of their employees.
Or maybe not. Gary Loveman, who headed up the BRT's health-and-wellness program policy group, ran Caesars Entertainment, so he freely exposed his workers to more second-hand smoke than almost other any corporate CEO in the US. The clear deleterious effect of that second-hand smoke on worker health didn't appear to bother him. So instead of moving to a no-smoking policy for Caesars' indoor spaces, he instituted "pry, poke and prod" programs, which he insisted would increase productivity and reduce healthcare costs. He kept insisting this until he ran his company into bankruptcy.
And no wonder. While bad wellness programs were only a minor contributor to Caesars' demise, it is almost universally accepted that wellness loses money. Even the proponents of wellness admit that it's a failure.
That leaves another possible explanation for the BRT's advocacy: it's about the clawbacks. Up to 30% (50% for smokers) of the health insurance coverage required by the ACA can be made contingent on wellness program participation, or actual weight loss. The more unappealing the programs, the lower the participation, and the more money the BRT's member corporations can claw back from employees through fines and forfeited incentives.
Clawbacks were a dirty little secret of wellness, but a vendor called Bravo Wellness spilled the beans. Bravo accidentally mentioned this on its website, though the company took the offending language down once it realized such candor could get them in trouble.
It's not just Bravo. Last week another company urged employers to fine employees who refuse to get useless checkups, fines which they called "immediate savings" for the employer that are "legitimized" by the ACA.
Against all evidence, the BRT still pretends that wellness saves money and is good for employees, whether they like it or not. The BRT cottons no dissent to their viewpoint either. They arranged Senate "hearings" with the title: "Employer Wellness Programs: Better Health Outcomes and Lower Costs." No dissenters were allowed to raise the question of whether wellness actually works. Listen to the proceedings. With no dissenting witnesses invited, 100% of this Senate committee--and likely most of the rest of the Senate and House -- supported workplace wellness, regardless of party affiliation.
What Employees Really Think
On the other hand, consider the viewpoints of the actual employees subjected to these "pry, poke and prod" programs. CVS, Penn State and Honeywell would be excellent examples of employee pushback against this kind of program.
More evidence of employee resentment can be found in any list of comments to any article in the lay media on this topic. The occasional favorable comment is usually: "Why should I pay for a fat person's healthcare?" The answers are: (1) Using that logic, why should you pay for someone else to give birth? It's called health insurance; (2) overweight/obese people, during their working years, cost only slightly more than people of normal weight.
The most compelling evidence on employee attitude is simple economics: bribes and fines have surged to $693 on average and yet fewer than half of employees participate, and most of those just do it to collect the bribe or avoid the fine.
Employees' distaste for "pry, poke and prod" programs is not exactly a secret. Many conservative websites with "insurgent" readerships have been posting anti-wellness material for two years: Newsmax, the Federalist, and now Laura Ingraham would be the best examples. Ditto for many left-wing publications and blogs--the Guardian, Mother Jones, and the New York Times' economics bloggers (not "establishment" by any means).
The Ultimate Disconnect
Nowhere in politics is the disconnect between voters and politicians this great, even though no healthcare policy affects more people than wellness, with 75-million employees and spouses forced to submit or forfeit money. The political establishment's follow-the-money kowtowing to the BRT ignores not just the sentiment of their constituents, but also the ineffectiveness, bad advice/bad data, and actual hazards of these programs. Forced wellness is the epitome of bad politics and bad economics, all driven by the BRT and fueled by Citizens United. It's time for incumbents and candidates to stand up to the BRT or risk getting thrown out of office in favor of someone who will.