When you are in the “countererrorism” business like we are, it’s important to have a zero tolerance for errors. Occasionally one slips through. In that case the important thing to do is to admit it, rather than fire the Attorney General and the Special Prosecutor and have your secretary erase the tape.
Vik and I wrote a posting for The Health Care Blog, the upshot of which was that the Affordable Care Act should no longer require insurers to cover adult checkups. Free checkups are ubiquitous in self-administered plans. On balance, our posting shows what grownups in health services research already know: they are worthless. Not completely satisfied with their innate worthlessness with a full subsidy, many employers — guided by benefits consultants — attach additional money to them: you are either fined for not getting one or else receive a bonus for getting one. Our proposed solution was/is quite simple: employers that attach bonuses or fines to physicial exams need to disclose that checkups are a waste of time and money. That simple disclosure requirement would end forced checkups.
It turns out, however, that adult checkups are not required by ACA. It was a complete benefits consulting urban legend and we fell for it. So we were wrong.
Here are the lessons from this.
First, if someone proves us wrong, we admit it. See? Admitting error is a concept that is lost on the wellness and benefits consulting industries. For example, after we pointed out that Mercer’s client British Petroleum got completely snookered by Mercer Staywell, the response of Mercer to BP wasn’t: “We apologize to for letting your vendor snooker you.” It was: “Let’s nominate this program for a Koop Award,” which naturally they won because both Mercer and Staywell are represented on the board of the group that gives out the award.
Second, the particular someone who proved us wrong, Chris Glason, did not “bully” us. He merely asked a tough question that invalidated a (minor) premise of our argument. However, when we do something quite similar, the people who are wrong (or lying) say we are “bullying” them. But all we did was ask 11 questions to clarify what someone already said — and offer him $1000 to answer the questions. Trust us: if Chris Glason had offered us $1000 to look it up and get back to him, we would have. (Instead we were rather dismissive, to put it mildly, for which we also publicly apologize.)
Third, our mistake was to assume that benefits consultants actually know something about, well, benefits consulting. We know they know nothing about wellness—Mercer and Milliman have both basically self-immolated by participating in the aforementioned Koop Award Committee and getting snookered four times by dishonest vendors. On two occasions the Committee was forced to backtrack as a result of our exposes, though they never admitted they got snookered. We kind of assumed that since benefits consultants don’t know anything about wellness, the only way they could stay in business was to actually know the first thing about benefits….and we listened to them.
Sidebar: a few benefits consultants are highly competent. We recommend the ones whom the Validation Institute (which is not connected with us but which we have a lot of respect for) has certified. (Don’t strain your eyes–no one from Mercer or Milliman appears on their listing.)
Fourth and most importantly, the answer doesn’t change: End “pry, poke, prod and punish” programs — especially the “prodding” part, now that even benefits consultants can see that prodding someone to go to the doctor when they aren’t sick is a complete waste of time and money.
“I made a mistake. I listened to the experts.”
— John F. Kennedy