Health Care in America - What you better know! Insights by Dr. Jon Robison

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Dr. Jon and sidekick Lady

Jon Robison

Dr. Jon Robison at salveopartners.com

What Do the EEOC, Wellness Industry, Urban Dictionary, Humpty Dumpty and George Orwell Have In Common?

May 18, 2016

                 "A word means what I choose it to mean—neither more or less.”                                                                                                                            --Humpty Dumpty

Written Together With Al Lewis 

The wellness industry is rejoicing at the EEOC’s final rulings on workplace wellness programs. The results boil down to this. The programs can require participation, compel employees to hand over medical information from screenings and health risk assessments (and even their DNA) and punish them if they don’t comply, as long as the programs are voluntary.

If you are having trouble reconciling the words require, compel and punish with voluntary, so were we. In fact, befuddled by the EEOC / Wellness Industry’s use of the term “voluntary” we went to the source seeking answers.  Google helped us to look more deeply into definitions of “voluntary” to make sure we weren’t missing something. Here are a couple we found:

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                        Dictionary.com -- done, made, brought about, undertaken, etc., of one's own accord or by free choice

·                   Merriam Webster -- done or given because you want to and not because you are forced to: done or given by choice

No less befuddled, we were determined not to give up! We thought: “This definition has got to come from somewhere; they cannot just have made it up. Perhaps a more updated, hip source is needed here. What about the Urban Dictionary?” And sure enough, there we found the answer:

Urban dictionary -- do it or you will lose your job

Now we were getting somewhere. In the eyes of the wellness industry and now also apparently the EEOC, “voluntary” means “coerced, pressured, incentivized, and/or punished.” In other words “voluntary” means “involuntary.” (In the wellness industry, defining things as their opposites is par for the course. Health Fitness Corporation’s Chief Medical Officer has famously described the difference between making “life-saving catches of 514” Nebraska employees with cancer and admitting that these employees never had cancer at all as “semantics.”)

Fascinating! We wondered if there might be any literary precedents for defining this particular word as the opposite of what it really means.

Then we remembered George Orwell’s Animal Farm. Consider Napoleon’s decree that, in addition to an already 60-hour work week, the animals would be asked to work on Sunday afternoons as well:

          “This work was strictly voluntary, but any animal who absented himself              from it would have his rations reduced by half.”

Lessons Learned

We might take solace in the fact that the EEOC and the wellness industry settled on punishments of "only” 30% (roughly $1800) for employees who choose not to volunteer. Interestingly, one politician didn’t think that punishment would generate enough voluntary participation. He said we should impose penalties for all programs of 50% (now possible only for smokers); he must have been a big Orwell fan.

Aside from the self-serving albeit admittedly highly creative use of the English language, here are the problems with these guidelines:

·          It has been proven that forced voluntary wellness programs (the “pry, poke and prod” variety of programs) have not paid and cannot pay for themselves;

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            Even the so-called best programs –the ones that win the Koop Award -- show trivial risk reduction (before adding back in dropouts and non-participants), and fabricate their savings figures;

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             Screenings and HRA’s are more likely to lead to overdiagnosis and overtreatment than to health improvement;

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          Many workplace programs--like those for weight loss--are completely ineffective, that is, when they are not busy harming employees;

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         Thirty years of consistent and definitive research that the incentive approach being recommended does not lead to sustained behavior change and engenders a wide variety of iatrogenic consequences;

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           These type of programs are highly unpopular with employees, which means they are much more likely to diminish than enhance employee engagement.

The real question here is not how much employers can punish employees who refuse to submit to forced “wellness or else” programs. The real question is: are these initiatives a good idea? And the answer, according to all the research not financed by the wellness industry itself, is a resounding NO! So how about asking Congress to put an end to involuntary, voluntary wellness programs, and instead allow only truly voluntary, voluntary ones?

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Health Care in America - What you better know! Insights by Dr. Jon Robison

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Dr. Jon Robison and sidekick Lady

Jon Robison

Dr. Jon Robison at salveopartners.com

Top 10 Reasons To…JUST WALK AWAY!

May 23, 2016

Business is certainly booming for wellness at the workplace. Especially since the passage of the wellness provisions of the Affordable Care Act, new employee wellness promoting entities are popping up like dandelions in the spring.  And more and more companies are spending considerable amounts of money on these programs. In fact, in the next few years, the workplace wellness industry is predicted to grow by almost 8 and 1/2% annually, leading to revenues of more than 12 billion dollars in the United States alone. Unfortunately, as health care expert Leah Binder wrote in Forbes in 2014:

“This rapid escalation in employer investment has spawned a “Wild West” kind of market for wellness and disease management, with thousands of vendors overwhelming employers, often touting exaggerated claims of effectiveness.”

With this in mind we propose some simple guidelines (with links for additional information) to help you just walk away from proposals (suggested by vendors, consultants, brokers, relatives, etc.) that are more likely to interfere with rather than enhance employee engagement and well being. From the least to the most egregious we propose;

The Top 10 Reasons to - JUST WALK AWAY:

10. Someone tells you they can save you money on health care costs                                by instituting bio-metric screens and/or HRA’s at the workplace.

 9. Someone suggests that you will have a better chance of showing savings from       employee wellness programs if you use VOI rather than ROI.

 8. Someone uses the terms participation and engagement interchangeably.

 7. Someone suggests that a healthy organizational culture has to do with gym            memberships, broccoli in the cafeteria and stress management programs.

6. Someone suggests that pry, prod, poke and punish “wellness or else”                        programs will improve engagement and lift employee morale. Also:                        http://www.firstreportnow.com/articles/debate-employer-sponsored-                  wellness-programs

5. Someone offers you an employee weight loss program, contest, competition,         app, or a secret weight loss berry from the Amazon. Also:                                            https://www.linkedin.com/pulse/poodle-science-what-can-teach-us-weight-      health-jon-robison?trk=mp-author-card                                        

4. Someone suggests that they can show you how to turn extrinsic motivation            into intrinsic motivation with or without a magic wand.

3. Someone suggests that in order to get employees to participate in wellness            programs you need to be more aggressive or stern with them, make                        participation mandatory or perhaps have them find another job if they don’t.

2. Someone cites Katherine Baicker’s 2010 wellness ROI publication as proof            that wellness saves money. Also http://ift.tt/1xB22Hb

And, without  a doubt, the current number one reason to just walk away!

1. Someone suggests that your wellness program is voluntary even though you pay employees to participate and/or fine them if they don’t.

We hope this list will save you from spending time and money on initiatives that have only minimal efficacy and a high likelihood of iatrogenesis.  So, the next time someone proposes one of these to you, remember the immortal words of the hit single of the American baroque pop band - The Left Banke – rated by Rolling Stone as #220 of the 500 greatest songs of all time -  and - Just Walk Away - Renee. (Four Tops cover Here)

ps - As we continue the process of ushering workplace wellness into the 21st Century, please feel free to add your own reasons to just walk away – and, in the interest of saving time and energy, I am guessing someone will want to add - just walk away – if someone (like me) suggests you should just walk away(for any of the above 10 reasons).

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When Does Health Care Reform Start Now that the Health Care Bailout is Done?

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Memo to President Obama - Stop Protecting the Institutions and Start Helping the People!

Am I the only person in America who sees a smokescreen of hypocrisy in the actions of our professional politicians? No, the many readers who have expressed outrage at the efforts of the president and congress to protect the institutional forces of health care, the "so called" health care providers, in other words those pharmaceutical companies, insurance companies, hospitals and medical practitioners now guaranteed enormous ongoing profits at the expense of the patients, those readers see through the smokescreen and know the truth.

Thanks to Obama and his Democrat controlled congress we Americans are on the spiraling road to huge deficits and eventual bankruptcy because of the health care reform legislation passed earlier this year. It is time we took stock of just what "yellow brick road" Obama is leading us down in the name of health care reform. And yes, this charge applies to the Republicans whose efforts to amend the bill were shot down by the Democrats, those Republicans who fought just as hard to protect the rich at the expense of the victims as the president.



Why are we paying health care providers to keep us sick rather than rewarding our health care providers to make us healthy? There is NO INCENTIVE FOR ANY ELEMENT OF THE HEALTH CARE DELIVERY SYSTEM TO BENEFIT FROM MAKING US HEALTHY, whether the pharmaceutical giants, the insurance providers, the hospitals or the medical professionals! Right now the millions of campaign dollars flowing into our politician's campaign accounts is the only incentive for presidential or congressional action, and the billions of dollars in return on investment for the health care providers makes healing unprofitable.



The Obamacare farce is just more of the same, driving up the cost of health care in the US which is already the highest in the world, with a strategy to profit from sickness, reward maintenance of diseases, prolong useless treatment and create a house of cards that profits solely from the degree of illness in the patients, the victims of a system that is broken.



As reported earlier in the Coltons Point Times, ever since Wall Street got control of the health care industry with stock offerings in the late 1940's and early 1950's health care success has been measured by the bottom line, the "return on profit", rather than the health of patients. Greed, Wall Street style, has driven us to the most expensive and least effective healthcare system in the world. When the money changers took control of the financing of health care the wellness of the people became secondary to the profitability of extended health care treatment.



On that foundation is built the health care industry in America. On that foundation is what drives the pharmaceutical giants to focus on extended treatment rather than cures. On that foundation is what drove the medical schools of America to give career advice to students based on how much money you should make in the health care industry rather than how many people you can cure, because money is not made with cures, just prolonged treatment.



Now the practitioners of ancient medical techniques from the Chinese herbalists to Indigenous Native medicine people have been nearly wiped out of existence and are being replaced by a new breed of alternative medicine people driven by greed and materialism. Isn't it ironic that the true medical giants throughout history like the Hopi medicine people, the Chinese herbalists, even the pioneering doctors of the more modern era such as the seer and psychic prophet Nostradamus of the 1500's who fought the plague while fighting off the Religious Inquisition, never asked for money for healing people.



Nowhere does the Bible talk of Jesus charging for medical miracles. What does that say about the current state of medical practices in America?

The Hippocratic Oath is an oath historically taken by doctors swearing to practice medicine ethically. We should take a look at the original oath written in the classic days of the Ancient Greek Empire. Little is known about who wrote it or first used it, but it appears to be more strongly influenced by followers of Pythagoras than Hippocrates and is often estimated to have been written in the 5th or 4th century B.C.E.



In this oath medical doctors swore to use every effort possible to heal the sick and to use the most ethical practices possible to achieve this. Unnecessary treatment, treatment with potential deadly side effects, even the required 26 vaccinations of modern medicine that inject poison into our children's bodies were condemned. The goal of all medicine was to cure.

The following is a direct quote from the classic Greek Hippocratic Oath:

"If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot."



If medicine were true to the ancient pledge to heal and cure rather than diagnose and treat people most of our current medical practitioners would be out of business or in jail. Health care can never be reformed until the mission and goal of health care is returned to healing and curing and not generating the maximum return on investment. You see, some purposes in life transcend the greed of modern American society and Wall Street. Until we redirect our emphasis to healing and provide incentives for healing we are players in the greatest hypocrisy in history, the selling out of the gift of healing.

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