Problems with Wellness IncentivesEssay Preview: Problems with Wellness IncentivesReport this essayARTICLE REVIEW FORMYour Name: Suprena FayTitle of Article: Carrots, Sticks and Health Care Reform – Problems with Wellness IncentivesAuthor (s): Harald Schmidt, M.A., Kristin Voigt, D.Phil., and Daniel Wikler, Ph.D.Source: The New England Journal of MedicineAuthors proposed purpose/goal of the Article: The authors proposed purpose of the article is to analyze the effectiveness of health incentives as a way to combat chronic health conditions that are associated with obesity.
Analysis of Key Issues: Chronic health conditions, especially those that are associated with obesity, are on the rise in the United States. Current health care reform seeks to expand the role of health care incentives. These incentives promise a win-win situation for both employees and employers. For employers, they reduce their health insurance costs and gain a healthier workforce who requires less time away from the office, due to illness.
Under the 1996 Health Insurance Portability and Accountability Act (HIPPA) a group health plan may not discriminate among policyholders based on health factors by varying thee amount of their premiums. Incentive schemes are defended on the grounds of personal responsibility. Although alternative standards must be offered to employees for whom specific targets are medically inappropriate, disadvantaged people with multiple coexisting conditions may refrain from making such petitions, seeing them as degrading or humiliating. These potential problems are important in view of the proposed increases in reimbursement levels. Reform proposals prohibit cost shifting but provisions in the Senate bill could result in a substantial increase in financial burden that do not meet targets.
–Sen. Mark Pryor (D-AR)
Cronyism has been widely observed throughout the legal profession, but I find a few important facts which point to it as a serious issue for the U.S. Senate.
As I wrote in a recent edition of this article:
One of the main factors in the recent Republican effort to repeal President Obama’s health care law—the Affordable Care Act, or Obamacare—is that there are a number of concerns among a considerable percentage of Americans. For example, many Republican members of Congress—including Republicans, governors, members of Congress, and U.S. senators—have raised significant concerns about the Affordable Care Act. The White House has sought to reassure Americans by telling the public that, despite the recent Republican legislative attacks on the law, it is continuing to enforce its law and that it is working to correct flaws in the law itself. The administration’s use of the term “Obamacare” suggests a fundamental misunderstanding of the law. Despite Obama and other Republican leaders publicly praising the law as a great and necessary reform, there is still much doubt about it. There has been a persistent tendency in recent years to overcomplicate the law, to ignore the needs of millions of Americans, and to argue beyond facts that the law was needed for a healthy and vibrant economy. Although there have been no significant reports of improper health-care practices or of the fact that the administration’s approach to the law has had negative unintended consequences, there exists an undeniable need to end Obamacare’s health-care mandates (for example, the one that keeps people in poverty) and establish a national health plan.
It is important to emphasize that there has never been a public health crisis in our country; nor has there been a situation in which the Affordable Care Act did not lead to a loss of health insurance rights. Indeed, there has been no mass coverage of Medicare for most people as required under the law, and virtually no private market activity as required under the law other than the “discretionary subsidy” program to the extent that this coverage was required under the health care law itself. Moreover, there has certainly been no major political or ideological shift in the law in recent days: the law was enacted in March, 2012, in response to the Republican-led effort to repeal the Affordable Care Act that was launched by President Obama to expand insurance eligibility to some 400 million Americans.
Under the law, “qualified” people also receive coverage at a rate of 24 months to the date of purchase as a condition of eligibility as determined by a Congressional Budget Office—i.e., those in the lowest-income and uninsured communities. Over the course of this 20-year period alone, about 7 million people have received coverage. There were 1.5 million people with pre-existing conditions, roughly 30 percent of whom had no cost-sharing to cover expenses.
The average premiums paid for premium-sharing subsidies for eligible people were $5.19 per month. In 2014, the cost-sharing subsidies for adults aged 65 and older accounted for about 1 percent of premium costs for adults aged 25 to 34. Over 25, there were 62 million people who are covered under the law.
As of this
Conclusions/Findings/Assumption: Incentives, which offer a premium discount or other reimbursement simply for participating in a health promotion program and attainment incentives, which provide reimbursements for only meeting targets. These incentives provide welcome rewards for employees who manage to comply, but may be unfair for those who struggle, particularly if they are not successful.
Personal assessment and reflection: I have mixed feelings on health incentives. On paper, it sounds great, but reality is a different story. Give an individual an incentive and they will lose weight, stop smoking and lower their cholesterol levels but it isnt always that easy. If individuals were able to make these changes on their own, they would. However, what about the individuals who have medical conditions that either makes it hard or impossible to lose