Health crimes and punishments: Employers -- and employees -- can decide

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Turns out, those employer wellness programs are not the benignly helpful initiatives that some Americans might have perceived them to be. Sure, they encourage workers to act in their own best health interests, but they’re now also having an impact on those who don’t. Ultimately, they could ... well, who knows.

And that’s the point of today’s Los Angeles Times story on healthcare overhaul. It begins:

‘Who could object to rewarding people who quit smoking, lose weight or start to exercise? The American Cancer Society and the American Heart Assn., for starters.

‘Some companies are charging lower insurance premiums to workers who meet benchmarks for healthy living. The Senate’s healthcare overhaul legislation would expand the trend.

‘But instead of cheering the proposal, some patient advocacy and health groups are worried that it could mean higher rates for less-fit Americans, possibly pricing them out of their employers’ insurance plans.’

That story: Insurance discounts for healthy habits spur debate in Washington

But it’s open enrollment time, and the debate is more than theoretical. It’s personal and now faced by millions of Americans of varying states of health. Another recent L.A. Times story notes that some companies won’t let workers sign up for health insurance until they sign up for risk assessments that were once optional. It says:

‘If the assessment discovers manageable problems, you may be encouraged to join a fitness or smoking cessation program. Do that and you’re likely to get bigger financial incentives -- somewhere in the neighborhood of $100 to $500 annually.

‘But if you don’t, your employer might restrict your health insurance choices to plans that demand higher deductibles and offer fewer services and benefits, which could cost you hundreds of dollars.’

That story: This open enrollment period, expect rewards and penalties

Don’t like the approach? You could take a stand. And pay for it, of course.

Not wild about helping to pay, in a roundabout way, for your smoking colleague’s medical costs? Here’s your chance to get just a little bit even and benefit from your own, perhaps wiser, choices.

Either way, the trend’s increasing prominence suggests each of us should ask what such ‘incentives’ might ultimately entail -- for good or ill.

Here’s a recent Washington Post look at the issue. And an NPR story on Safeway’s incentive programs.

-- Tami Dennis