I’m back to my usual comments after my long series on the many ways family physicians deliver better care at a lower cost.
When our article came out that I’ve been commenting on, I was in the middle of griping about Dr. Oz again. I’ll pick up where I left off. My comments are about a YouDocs column on April 29. He said:
“And when companies offer incentives and rewards (cash) instead of penalties for losing weight, quitting smoking and reducing high blood pressure and lousy LDL cholesterol, employees see lasting improvements in their health, and companies see huge savings.”
I won’t argue about the improvement in health, but the promised savings are pure bunk.
A recent systematic review in the American Journal of Managed Care found poor general study methodology and decidedly mixed results on all outcomes in the worksite wellness literature, including costs. Other recent reviews and critical analyses have reached the same conclusion, including a report from the RAND corporation.
A huge problem with his statement is that it assumes that treating all of the listed conditions saves money in the first place. Decades of cost-effectiveness research finds the opposite. Healthcare economics works more like regular economics: better outcomes cost more money.
However, the final problem with this rush to corporate wellness is that it is yet another diversion from the deeper problems of cost and inefficiency in the U.S. healthcare system. Some benefits managers of even large corporations are putting their employees through these mostly useless programs, which divert their attention from the more costly problems of over-testing, over-treating, and paying too much when testing or treatment is appropriate.
Only when the 82% of the economy that is not healthcare pushes back against the 18% of the economy that is healthcare will corporations and their employees achieve enough savings to grow incomes and grow jobs.
Another excellent post, Richard. Another flaw is the assumption that anything that is published is true; interesting piece recently in the Economist on how, of course, that is not so for a variety of methodological reasons, for a desire to publish positive results, etc.
Keep up the great work.
Thanks Joshua. It means a lot. I guess this means I’ll have to keep going.