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Ilya Bernstein, R.N. Headshot

Obamacare, Employee Health and Wellness, and Associated Costs

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Conservative hopes of repealing the Affordable Care Act of 2009
were dissolved last week, with the reelection of Barack Obama and
House Speaker John Boehner conceding that Obamacare is now "the law of
the land."

While he went on to explain that he is still against the law, his
acceptance of the law was significant, given the Republican party's
attempts to frustrate the act in virtually every stage of its passage.

Others opposed to the legislation, which will provide health
insurance to about 32 million Americans in 2016, have begun publicly sharing their strategies for circumventing the new
law. The most prominently reported on have been Papa John's CEO John
Schnatter's claims that his company will be forced to raise prices by $0.11 to $0.14 per pizza, and reduce his employees' hours to less than the 30 per week that requires employers provide health care.

While contributing to underemployment in America may be an option
for the restaurant industry, many other businesses, such as those who
compete in a complex, global market and cannot simply increase prices,
or those who depend on traditional "nine-to-five" work schedules, may
not be able to adapt to the Affordable Care Act this way. These
employers have little option but to absorb the cost of providing insurance for their employees.

However, by simultaneously investing in also "Employer-Based Wellness
Programs," as encouraged by Section 4303 of the ACA, employers can minimize the fiscal
effect of this new policy on their businesses. In fact, a 2010 report
produced by economists at Harvard University showed that for every
dollar spent on an employee wellness program, medical costs decreased
by about $3.27 and costs related to employee absenteeism dropped by
$2.73.

A more detailed look at employer-employee medical costs -- the
total amount spent on health care by both employer and employee -- was
published this month in the journal Health Affairs.
The authors followed a group of 92,486 employees for an average of
approximately three years, administering a 47-question survey, as well as
record some basic biometric data, such as their blood pressure,
cholesterol levels, and so on.

After adjusting for age, gender, and industry, among other things, the
findings indicate that nearly a quarter of all employer-employee
medical costs are related to a handful of characteristics that can be
changed by employer-based wellness programs. The biggest offenders,
according to the report, were having a body weight below or above
normal limits, which raised an employee's total health cost by 27.4 percent;
high blood pressure, an increased cost of 31.6 percent, high blood sugar, an
increase of 31.8 percent, and most significantly, depression, which increased
employer-employee health costs by an astounding 48 percent.

Additionally, some employees may have more than one condition, thereby
compounding their increased cost. The authors are careful to note,
though, that changing employment policies based on applicants' health
is not only unwise, given that these are all increasingly common
conditions in the United States, but also illegal. Thus, rather than
screen these individuals, it is of more benefit to employers to design
programs that aid employees in becoming healthier individuals, both
physically and mentally.

In addition to the aforementioned return on employer investment and
improving the health of employees, it may also help companies attract
top talent. For the fourth consecutive year, Google, a company
renowned for employee perks which include a fitness facility and
on-site medical care, was the first choice employeer for business graduates from all over the globe.

A hard look at the evidence indicates that regardless of incentives
provided by the new "law of the land," employee health and wellness
programs are a positive intervention that benefits both individual
health and corporations financial bottom line. So why aren't they
everywhere?