The health risks associated with obesity present unprecedented challenges to large employers by increasing health care costs and making health coverage less affordable for small and medium
employers. This is particularly evident
when the indirect and direct costs of obesity are considered in tandem with the link
between obesity and the most expensive,
chronic health care conditions.
“With almost two-thirds of the U.S. adult
population either overweight or obese,
America is experiencing an obesity epidemic,” says Sally Stephens, president of
Spectrum Health Systems. “The simple reason why obesity is on the rise is that many
people eat too much and exercise too little.”
Obesity is such a serious issue that some
employers are beginning to offer additional, more drastic, weight loss options in
their health care packages. Bariatric surgery is now an option many business owners are considering including in their health
care plans.
Smart Business spoke with Stephen
about the new weight loss concern for
employers and using bariatric surgery in an
attempt to treat the problem.
Why is a personal issue, such as an employee’s weight, a concern for employers?
Employers have to be concerned with an
employee’s weight and overall health
because it correlates with company costs
and an employee’s performance.
According to a study in the American
Journal of Health Promotion, obesity-related conditions cost employers $12 billion a
year due to higher health utilization and
medical claims, lower productivity,
increased absenteeism, and higher health
and disability insurance premiums.
Another study, from General Motors’
health plan, concluded that overweight and
obese individuals had annual medical bills
up to $1,500 higher than persons with a
healthy weight. The obesity epidemic creates significant challenges to the U.S. work
force. Obesity and its related health conditions hurt the health and well-being of the
current work force.
In addition, the increased incidence of obesity among children and adolescents —
which large employers pay for as dependents — poses an even greater problem.
What weight loss options can employers provide their employees?
Today, there are far more options for
employers to address the obesity issue. In
2003, a coalition of large private and public
sector employers and health organizations
founded the Institute on the Costs and
Health Effects of Obesity. The Institute’s
broad strategy is to leverage corporate
resources to respond to the nation’s obesity epidemic.
Employers can encourage healthy
lifestyles and support national efforts to
reverse the rising trend of obesity. Some
options include: provide education about
the negative effects of obesity; through
active health promotion programs, encourage people to become more active and fit by
using internal staircases, fitness centers and
participating in brisk walking programs;
include company and union representatives
in all health-oriented planning; set up cafeteria and vending choices that emphasize
healthy and low-calorie snacks and drinks,
and that include content information, especially calorie and fat grams on all food items;
emphasize stress management programs; offer health plans that provide health risk
appraisals with physician/nutritional counseling; and encourage health plans to
include aggressive healthy lifestyle and
weight-management programs.
How is offering bariatric surgery a benefit to
an employer?
The main reason employers would cover
bariatric surgery is for the return on investment. There is evidence that aggressive
treatment for obesity, especially morbid
obesity, reduces the risk of chronic conditions, resulting in reduced costs. Health policy analysis and business groups, even those
intrigued by case studies, describe research
as mixed on the question of whether this
sort of disease management effort will actually save money in the long run. This is
mainly due to employee turnover.
Does an employer have any say in who qualifies for this coverage?
Yes. As the prevalence of morbid obesity
increases, employers will be forced to look
for cost-effective strategies to improve the
health of their employees. However, it
seems that employers are not necessarily
jumping on the weight loss bandwagon, and
the numbers of those qualifying for the surgery are relatively small in number. A 2003
study by Mercer Human Resource
Consulting, showed that 52 percent of
employers did not cover bariatric surgery at
all.
Until recently, nearly all private insurance
carriers accepted the guidelines laid out by
the 1991 National Institutes of Health as
qualifications for weight loss surgery. The
recent explosion in the number of surgeries performed has resulted in many carriers adding qualifiers to the NIH guidelines,
such as six or 12 months of a continuously
medically supervised diet.
SALLY STEPHENS is president of Spectrum Health Systems.
Reach her at [email protected] or (317) 573-7600.
