Wellness programs are meant to be one of the ways in which employers—crippled by healthcare insurance costs, like the rest of us—are trying to rein in costs. But do wellness programs reduce costs or improve health?
Companies that provide wellness programs claim that, for every dollar spent in bringing a structured wellness program into the workplace, four dollars are saved, a 4:1 savings that, you’d think, would be sufficient to ratchet back healthcare costs considerably. Is this true?
No, it is not. The evidence quoted by workplace wellness programs are proprietary, observational, and subject to selection bias. Let me explain.
Imagine we have two mid-level executives, Chris and Jeff, both of whom work for the same company. Chris is health conscious, exercises, takes nutritional supplements that he believes improve health, doesn’t smoke nor drink excessively, doesn’t text while driving or engage in other high-risk behaviors. Jeff, on the other hand, eats Cheetos and Pringles almost every day, loves ice cream and cake, thinks that playing pinball is a form of exercise, smokes on weekends and drinks too much. Both Chris and Jeff are offered an opportunity to enroll in a wellness program at work. Because Chris is interested in maintaining health, he enrolls, answering questionnaires, using a new on-site yoga studio, and follows recommendations to take a statin cholesterol drug, aspirin, and adhere to a schedule of colonoscopies and prostate exams. Jeff, who barely blinks an eye at health issues, does not, enjoying pizza, lying on his couch, and football- and beer-filled weekends and does not enroll in the wellness program.
Track healthcare costs incurred by Chris and Jeff: doctor visits, prescription drug costs, hospitalizations. Chris takes a minimum of prescription drugs and enjoys life without hospitals, while Jeff takes 7 drugs, has to follow-up with his doctor every 3 months, and was hospitalized 4 months ago for atrial fibrillation followed by a bill for $40,000, only $36,000 of which was covered by insurance. Chris’ costs over the past year: a few hundred dollars. Jeff’s costs: $42,000. Conclusion: Enrolling in a wellness program saved $42,000 in one year.
As obvious as this seems, this is how workplace wellness programs justify their approach. This is called selection bias: Craft a process—offering a program for health that appeals to the already healthy—and does not appeal to people who are sedentary, suffering joint pain, fatigue, depression, leg edema, bowel urgency, psoriasis, rheumatoid arthritis, etc. and incur greater healthcare costs for chronic conditions, and you can “prove” that wellness makes people well, reduces the burden of disease, and cuts healthcare costs: selection bias. To make matters worse, much of the data are tracked by the wellness program providers themselves, meaning that bias is inevitable, just as studies conducted and paid for by Big Pharma almost always come out in favor of Big Pharma.
It’s all nonsense, just as cutting fat and eating “healthy whole grains” is built on a dietary house of cards that does hold up to scrutiny and, in fact, accomplishes the exact opposite: weight gain, high blood sugar and diabetes, autoimmune diseases, disruption of bowel flora, gastrointestinal distress, neurological impairment, and on and on.
The one and only truly prospective study—not observational, not proprietary, not subject to selection bias—the University of Illinois Workplace Wellness Study–demonstrated that wellness programs have virtually no effect, at least over the first year. (The benefits are small, but maybe will become evident over longer periods—hardly a life- and health cost-savings bonanza.) Perhaps over 5 or 10 years, wellness programs will save a few dollars and yield better health . . . but don’t hold your breath. Here’s a graph from the study showing the difference in monthly healthcare costs in people who did not participate in the wellness program versus those who did:
No difference in costs. There was also no difference in health. In short, wellness programs do not work: they don’t save money, they do not make people healthier.
This should come as no surprise to all of you acquainted with Wheat Belly and Undoctored principles. Can you really expect that “being physically active, cutting fat, eating healthy whole grains, and adhering to the drug prescription schedule ordered by your doctor,” messages delivered by conventional workplace wellness programs, really restore health and save money? Fat chance. It doesn’t work in the general American population. So why it would in the workplace? It does not.
“Know your numbers”? That’s just a wellness-speak message friendly to the rules set by Big Pharma and blindly followed by doctors. That may reduce hospitalizations for congestive heart failure, but does nothing for overall health for everyone else.
It does not mean that quitting smoking and knowing your blood pressure values have no role—they do. But that is like spitting in the ocean of health: It makes almost no difference (especially since success of cigarette smoking cessation programs is less than 10%.) Regaining health and slashing healthcare costs not by a few dollars, but by huge margins requires a different approach. But that is what Undoctored is all about.
Imagine cutting healthcare insurance costs because people are healthy, slender, more youthful, and take no prescription drugs, i.e., the Undoctored way. (Meaning Chris in our example above would not even need the silly statin drug—you know, the drug that doctors push on people but yields virtually no benefit.) The power of the Undoctored program is now going to be delivered at the workplace through our new Undoctored Health program, a comprehensive program to restore genuine health to employees and paid for by employers. This is how we undo the monopoly of predatory doctors, hospitals, drug companies, and the others hoping to profit from your health misfortunes, nearly all of which are avoidable. Stay tuned for developments.