U.S. expert: Incentivize healthy lifestyles

With health-care costs spiraling out of control, fueled by unhealthy lifestyles and rising obesity, U.S. experts say businesses could do more to encourage workplace wellness. 


Employers and insurers can do more to incentivize healthy habits, such as exercising and eating well, in an effort to control health-care costs. 

Doctors from the U.S. based Cleveland Clinic, in the Cayman Islands for a conference on workplace wellness, suggest that insurers may even need to look at classifying smoking and unmanaged obesity as “risky behavior” leading to higher premiums in an effort to control spiralling costs. 

James Merlino, the clinic’s chief experience officer and a keynote speaker at the 2013 Cayman Islands Healthcare Conference last month, said a large chunk of health issues and associated costs come from conditions caused by preventable lifestyle choices. 

Obesity, driven by poor diet, failure to exercise and sedentary lifestyles, is a key culprit in both the Cayman Islands and the U.S. 

Dr. Merlino said employers would benefit from “workplace wellness” schemes through a healthier, more productive workforce, and cheaper overall health-care costs. 

On a global scale, he believes insurers could begin offering policy rebates to non-smokers and people who exercise in an effort to incentivize healthy lifestyles that place less of a burden on the healthcare system. 

Even without that, he said, it is in employers’ interests to ensure workers are healthy. 

“It is critically important, since everyone on the island is touched by business, that we help them improve workplace wellness. 

“One of the burning issues for health care is cost increases driven by chronic disease and preventable illness.  

“There are some very simple things that employers can do. Studies show that every dollar you spend on prevention saves you six dollars on cure.” 


Wellness policy  

He said the Cleveland Clinic has introduced a wellness policy for its staff, including hiring only non-smokers and introducing free smoking-cessation clinics for existing staff. 

Every employee gets free membership to local health clubs; sugared drinks and fried foods have disappeared from vending machines and canteens; and employees who take part in an exercise monitoring program get a rebate on their insurance premium. 

Employees with illnesses, such as diabetes, are given rebates based on their success in meeting health-care goals. 

“Our organization is self-insured, so we understand those costs very well. We had nearly 1,000 employees with diabetes who were not seeing physicians on a regular basis. As you get older, the disease gets worse, you have complications, increased risk factors. If you manage it well, you decrease the risk of complications.” 

Dr. Merlino believes firms in the Cayman Islands could set up similar workplace wellness strategies on a smaller scale. 

“Any company can start thinking about wellness. It is the right thing to do. Any company can incentivize membership to fitness clubs, take the deep fat fryer out of the canteen and put a treadmill in a room for employees to exercise on their break.” 


Lifestyle matters  

The U.S. spends around a fifth of its annual budget on health-care costs – more than the entire budget of France, which is the fifth largest economy in the world. 

Dr. Merlino says lifestyle is a big factor. 

“There are 58 million people overweight in the U.S. It is absolutely incredible. It is not just a problem in the U.S., it is an epidemic worldwide. It is a significant contributor to premature mortality, chronic disease and increasing health-care costs.” 

With people spending more and more of their time at work, he believes employers have a big role to play in helping change lifestyles. 

And he believes insurers could also do more to punish risky behavior and incentivize healthy lifestyle choices. 

“We don’t want to get in a situation where people don’t have the right to do what they want to do, but there has to be consequences for high-risk behavior If you smoke, you should pay more; if you don’t exercise, you should pay more; if you ride a motorcycle without a helmet, you should pay more – these are things that are a burden to society.  

“These are things people have a right to do, but the cost of that right should not be passed on to everyone else.” 


Dr. James Merlino, the Cleveland Clinic’s chief experience officer, was a keynote speaker at the 2013 Cayman Islands Healthcare Conference.