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Mache Seibel, MD

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Overweight Can Leave You Underpaid

Posted: 04/11/2013 5:15 pm

It's official. The United States is switching from getting well to staying well. And the reason for this sudden burst of transformation: It's not only better to stay well than to get well -- it's cheaper.

As increasing numbers of America's workforce find themselves overweight with high blood pressure, blood sugar levels that are creeping upwards and risky cholesterol numbers, the cost of insuring them is more than companies want to pay -- especially since many of these parameters are reversible with a healthier lifestyle.

Incentive programs to improve employee health didn't work very well, so the new mantra is becoming, "If your numbers aren't good, it's going to cost you (the employee) more money."

The parameters I mentioned above are in fact a medical constellation known as metabolic syndrome, and are associated with a higher risk of stroke, heart disease and diabetes. It's a bit cumbersome but briefly, it is defined by a person having three of the following five criteria (see "Metabolic Syndrome" music video below):

  • Waist ≥ 35 inches for women; ≥ 40 inches for men
  • Blood pressure > 130/85
  • Blood sugar > 100 mg/dL
  • Triglycerides > 150 mg/dL
  • HDL < 40 mg/dL for men; < 50 mg/dL for women


The companies don't call it metabolic syndrome, but those are the very parameters some companies such as Michelin North America, Inc. are requesting their employees to divulge in order to determine whether the employee may be required to pay more for health insurance than those with healthier numbers.

New York Mayor Bloomberg was unsuccessful in his recent attempt to remove super sized sodas from the city to eliminate a major source of empty calories. There is a lot of resistance to being told what to do, even if in concept it is good for us. But this new trend from industry is very telling -- we've reached a tipping point and there is no going back.

The reasons are pretty straightforward; health care costs are soaring (according to the Wall Street Journal, the industry is expected to pay $12,136 per employee this year) and the majority of illnesses could be reduced or prevented just by eating less, eating healthier, exercising regularly, getting more sleep and having regular checkups.

If individuals choose not to take steps to stay well, companies who stand to lose money by paying higher premiums are going to increasingly take a more aggressive role. They didn't succeed with the carrot of incentive programs, so they are going to use the stick of financial penalties.

To be fair, individuals are going to have to do more to stay well by developing healthier habits of eating less fast food and less restaurant food (too much salt, too many calories), getting 30 minutes of exercise daily, eliminate smoking and maintaining good sleep hygiene. As George Burns said on becoming 100, "If I'd known I was going to live this long, I would have taken better care of myself."

But companies can do more also. The culture of industry has to change. From the CEO to the truck drivers who get their products to market, too much time is spent sitting. We need to get rid of the cubicles and open the prairies. Have more walking meetings, stand when we talk on the telephone, have standing desks and more gyms and walking paths and yoga classes at work. We have to eliminate poor choices from the food options in the workplace -- if people can't live without a donut, they have to either bring it with them or go out and buy one.

Managers and human resources are going to have to be advocates for health and make health a priority in the workplace.

It may also be time to bring back the in-house physician. In the old days, larger companies like Gillette and Polaroid had a physician in house. This made preventive measures and testing easy for employees. People didn't have to take off an entire day to go for a 15-minute appointment.

Without question, there is much to work out. Some people will be paying more, and issues of discrimination and where the intrusion ends need to be established. But at the current trajectory, by 2020 half the country will be either diabetic or prediabetic (blood sugar above normal but not quite diabetes), and that is not financially sustainable for the country. It's also terrible for the affected individuals. The good news is that the discussion of shifting the focus from treatment to prevention is now on the table. And that sets the stage for reversing the decline in longevity that the next generation is facing, as well as helping to resolve the runaway increases in health care costs.

Click here for my free three-video Health Accelerator Series and learn what tests are essential, how to prepare for your annual exam and five things you can do today to jump-start your health.


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