Many employers are struggling with the concept of workplace wellness for a number of reasons. At the outset, some employers simply do not feel that they have any responsibility for the health of their employees. They feel that this is a very personal responsibility that should be determined by the interest and enthusiasm of each individual. Fortunately, this group is in the minority, however, they are still out there. The majority of employers do see a role for themselves in the health of their employees for the following reasons:
- Healthy employees are more productive and have fewer accidents due to not being overweight, tired, out of shape, stressed or lacking sleep.
- Healthy employees experience less absenteeism. Some employers have reduced their absenteeism by 40 percent with a good wellness program.
- Healthy employees have lower health care costs, which can be very expensive for an employer, depending on how much of the cost of health insurance is absorbed by the employer.
- Employers with a good wellness program usually have a good corporate culture which greatly improves their ability to attract and retain the best employees.
So What is the Problem?
The problem, very simply, is that many employers do not have a good idea about what constitutes a quality workplace wellness program. Even though workplace wellness has been around for nearly 40 years, there is still a great deal of confusion about what wellness really is, and what the best ways are to achieve it. Given that over 80 percent of chronic illness is preventable, why does the United States have the most expensive health care system in the world, with some of the worst health outcomes? And, why do employers continue to experience increases in the cost of their health care far beyond the rate of inflation?
Some Barriers to Wellness
The following are some of the well-established barriers to more effective, safer and less costly health care in the US:
- Our system of healthcare is based on treating symptoms, not preventing and reversing chronic disease. Nationally, we only spend five percent of every health care dollar on prevention, even though 80 percent of illness is preventable.
- Our doctors and hospitals get paid for treatment, not prevention. There are very few incentives for them to help people become healthier.
- Insurance companies make more money if the health care costs are higher. This is also true for doctors, drug companies and hospitals — again, because of our treatment-based system with few incentives for good health.
- Obama Care has introduced the possibility of higher premiums for employees who are less healthy, however, very few employers are taking advantage of this aspect of the program.
- Employees do not trust their employers with information about their health. Many employees think that their employer may use this information against them in some way. They even imagine that they could get fired if the employer knew that they were experiencing an expensive health condition.
- Employers, at least a majority of them, have been reluctant to invest what they should in wellness because they are not convinced that they will get a reasonable return for their investment.
- Employees don’t really want to make difficult changes in their lifestyle and would prefer to take the chance that nothing will happen to them, or that the health community will take care of them if something does happen.
- And finally, given the relatively low priority for wellness, existing programs are usually ‘window dressing’ and do not seriously address the health care issues faced by many employees in an effective, safe and cost-efficient manner.
What is Serious Wellness?
Most wellness programs concentrate on fitness, weight loss and other fairly soft wellness targets. Certainly, fitness and weight management are important, but standing alone, they will not bend the cost curve very much. Many employers do provide blood tests and encourage their employees to talk to their doctors about the results, however, most doctors are not trained in preventing or reversing disease, so their best advice is usually how to manage a disease with medication. Surgery is also an option in some cases, such as gastric by-pass for weight loss or knee replacement for severe arthritis. However, these are often not the best solutions, and the side effects, or long-term consequences, are often not favorable.
That brings us to the better solutions, which we can refer to as Functional Medicine. This natural form of medicine has also been called Holistic Medicine, Alternative Medicine as well as many other names. Today, the best term is probably Functional Medicine because the concentration is on how the body functions and which natural treatments have been scientifically proven to both prevent and reverse chronic disease.
The prevention and reversal of chronic disease is where the action is because, as was mentioned earlier, 80 percent of all chronic disease is preventable and reversible. The science is very solid on this fact. Large studies in the British medical journal, Lancet Oncology, and the Institute of Medicine, have established the effectiveness of Functional Medicine for nearly every chronic disease. And, Business Week Magazine reported in May of 2006, that conventional medicine only has scientific evidence to support 20-25 percent of what they offer. For this very reason, the Cleveland Clinic decided to switch their emphasis to Functional Medicine. The CEO of the Cleveland Clinic stated that Functional Medicine was more effective, safer and less costly, and thus, should be considered the medicine of the future. 1
When will Workplace Wellness Get on Board?
The change over from Allopathic to Functional Medicine will not be an easy one. Many doctors, hospitals and drug companies will protect the status quo to the bitter end. Doctors do not learn very much in medical school about Functional Medicine, and only a dozen or so medical schools have seriously incorporated it into their curriculum. Hospitals and drug companies depend on the treatment of symptoms for nearly every dollar they make, and this is a lot of dollars.
Progressive employers may be the best opportunity to accelerate this paradigm shift, because they are the ones, along with their employees, who must pay for the ineffectiveness of the existing medical system. Here are some basic facts about just how costly the existing system is:
- The US pays nearly two times more per capita than countries like France and England who have single payer health care systems. 2
- Prescription drugs cause 700,000 emergency room visits every year and over 41,000 deaths. 3
- In 2007, over $100 billion was spent on angioplasty and coronary artery by-pass surgery, with only 3 percent of patients experiencing a prolonged life span. 4
- One hundred people need to take a statin drug for cholesterol before even one person lives longer. 5
- We spend nearly 20 percent of our GNP on health care now, and a British economist has estimated that we will spend 100 percent of our GNP on health care by 2065. 6
The current health care system is simply unsustainable. Employers can change this by insisting that their brokers begin to shift over to Functional Medicine. There are certain steps they will need to take, but for those that do, the rewards will be substantial. Not only could they stop the double digit increases in their annual health insurance premiums, they could see costs reduce as much as 40 percent over the first four to five years, depending on how quickly and seriously they make this change. The basic steps they will need to take include the following:
- Self-funded insurance plan – This is the only way for employers to gain control of their wellness efforts.
- Adequate funding – At least $100 to $200 per employee per year will be needed to achieve good results for a wellness program.
- Functional Medicine – This is the only way to prevent and reverse chronic disease and get significant health improvement. Employers should use conventional medicine only when treatments are backed by good science.
- A quality wellness plan – Use the Healthy at Work Wellness Audit Tool to perform an honest assessment of existing wellness efforts, and then develop a quality wellness plan with specific measurable results.
- The Wellness Team – To properly implement the wellness plan, every organization needs the following wellness team elements:
- A wellness committee comprised of key decision makers.
- A wellness staff leader with a background in wellness and real understanding of and appreciation for Functional Medicine.
- A team of wellness advocates trained and located throughout the organization.
- Proper health assessments – The normal conventional blood tests are simply not adequate. They do not identify health problems soon enough. The following tests should be added to the regular blood panel:
- Vitamin D3 – High levels protect against cancer.
- Glucose tolerance test – This test is better for early detection of Type 2 diabetes, especially for overweight employees or those with a history of Type 2 diabetes in their family.
- C-reactive protein – This test is better to determine the risk of heart disease than cholesterol.
- Homocysteine – This test is also important to determine the risk of heart disease.
- Urine pH Balance – This test is good for protection levels against all diseases.
- Thermography – This test is better than mammograms for the early detection of malfunctioning breast cells.
- Education – Qualified Functional Medicine educators should be used to ensure that every employee has the best information possible to help them make intelligent decisions about health improvements.
- Incentives – Employees should use the Obama Care incentive that allows employees to be charged 30 percent more for health insurance if they have a chronic disease or are overweight. Very few employers utilize this very powerful and effective incentive program. Employers could also offer lower deductibles or co-pays for healthy employees.
This is just an overview of the challenges employers face regarding healthcare and the ways they can begin to truly address this challenge. The Cleveland Clinic has already initiated a corporate wellness-consulting program, and is helping over 40 large employers to prevent and reverse chronic disease with amazing success. There is also a number of smaller wellness consulting firms helping employers with fewer employees to achieve similar results.
Any employer can begin this journey to better health for their employees, but this can only happen if they accept the reality that they are probably not doing wellness the way that it should be done. If they continue to think they are doing wellness, even though they are not getting very good results, then they will continue to remain in that group of employers that experience higher premiums every year. This is because their employees were not given enough knowledge to be able to prevent and reverse chronic disease. Functional Medicine is the scientific and economically proven way to accomplish this, and the employers who get on this wagon train now will have an amazing advantage over those employers who do not.
- Goldman, E. Cleveland Clinic Gets “Functional.” Holistic Primary Care. 2014:15(3):1.
- Global Health Report, Prevention vs. Treatment: a False Choice, January 2009. (Originally from Don Wright, M.D., U.S. Department of Health and Human Services.)
- Available at: http://www.cdc.gov/homeandrecreationalsafety/overdose/facts.html. Accessed January 6, 2015.
- Available at: http://www.huffingtonpost.com/deepak-chopra/the-medical-myth-of-more_b_265526.html. Accessed January 6, 2015.
- Carey, John. Do Cholesterol Drugs Do Any Good? Business Week. 2008:16(1).
- From the print edition, “Patient, heal thyself.” The Economist, March 17, 2011.
Julian J. Varela holds a M.S. degree in Exercise Science and Health Promotion and is a Certified Strength & Conditioning Specialist. Julian also holds a M.A. in Clinical Psychology, Marriage & Family Therapy and is a registered MFT intern with the Center for Human Understanding and Growth.
He can be contacted at firstname.lastname@example.org