The question-and-answer period is now underway.  

If you are just joining the thread, this is Part 6 of The Great Debate, a November 2015 exchange between Ron Goetzel and me, at the Population Health Alliance Annual Leadership Forum. Part 5 is here.  You can download the audio here. 

1:09:00

To the question: “What would you do to reduce healthcare costs?” Ron replies that he is “focused on prevention.” And that’s the issue.   I point out that “too much of anything is bad for you, ours is already the most over-prevented society on earth, and these programs are all out of compliance with guidelines.”  All these programs screen everybody far more than guidelines advise. Here are the guidelines. Find anything other than blood pressure where the wellness industry’s obsessive annual screens are recommended.

[Postscript: after the debate, the Connecticut study came out, showing that overprevention through wellness increases costs, as one would expect.]

1:12:20

The moderator asks how can Quizzify be the most effective company in employee health education.  He challenges our 100% guarantee of savings. This is ironic. No wellness company offers any meaningful guarantee of savings, for the simple reason that it is mathematically impossible to save money in wellness.

Somehow in wellness, guaranteeing savings is a bad thing but losing money is a “good thing.” (Really, a direct quote — click on it.)  It’s curious to challenge someone’s own willingness to guarantee their own results as part of their own business.  Obviously, if my business judgment is wrong, Quizzify will fail. And what I didn’t say because I didn’t want to brag, is that people questioned my last business venture too, Matrix Medical. Fast forward: Matrix is now the most valuable population health company start-up of this millennium.  (Before you ask me to lend you money, we mostly sold out on the “cheap” in 2013 to a private equity firm named Welsh Carson.)

1:13:40

Ron Goetzel endorses Quizzify. He went on the website and played the game. “It was a lot of fun. Very clever.”  Then he asks — quite justifiably — how Quizzify can make problems like obesity and smoking go away.  The answer, of course, is that Quizzify isn’t going to make obesity and smoking go away any more than wellness does.  For example, consider McKesson’s Koop Award-winning program, where both weight and smoking went up.  We can’t do worse than that. If we did, we could win a Koop Award.

Instead, Quizzify guarantees reductions in overall healthcare spending on “low value care.” As you can see from the demo on the website, we also educate people on hidden sources of sugar, of which there are more than you can count, but we don’t expect immediate savings from this and other nutrition/smoking education questions. Immediate savings are provided by our emphasis on avoiding low-value care.

1:15:00

Consistent with his theme of running away from his own work, Ron now runs away from his own HERO Report.  Keep in mind two things as you listen to this section:

• Ron is disowning his own report. He is on the board of HERO, a tidbit which he overlooks in this hasty retreat;
• Within days of this debate, he was circulating his famous poison pen letter to the media completely owning it, and accusing me of reading it too carefully.

The moderator (who otherwise moderated fairly) for some reason jumped in and said Ron and the HERO Guidebook just used an allegedly hypothetical example to show losses.  Since their “example” costs were $18/employee/year as opposed to the more typical $100 AND since the HERO example failed to control for the countrywide decline in wellness-sensitive medical events, the HERO example grossly underestimated losses from wellness.

Ron says “those numbers in [my HERO Guidebook] are wildly off,” and “have nothing to do with reality.”  He says I “misrepresented and misinterpreted” these figures.  But they are right there: A program costs $1.50 PEPM and saves $0.99.  What’s to misinterpret?   Ron apparently hadn’t noticed that his little Guidebook accidentally told the truth until I pointed it out — exactly like he hadn’t noticed that Eastman Chemical/Health Fitness self-invalidated. In both cases if fell upon me to point it out to these Einsteins.

Here is a posting showing what happens when you adjust those HERO figures for Mr. Goetzel’s alternative “reality” — losses skyrocket, just like Health Affairs showed in the Connecticut study.

Perhaps HERO would have more credibility telling us that wellness saves money if their own allegedly* “fabricated” example and any of the legitimate literature supported that claim. I’m just sayin’…

*The word “allegedly” is used because the example in the HERO guidebook is not a “fabricated” or “hypothetical” example. The words “fabricated” or “hypothetical” do not even appear in the chapter. Instead the example is an actual report. That’s why the Guidebook says it’s a report, and gives very specific details of the report–in the past tense, no less, as you would for a completed report. A “hypothetical” would use the present tense throughout, along with saying that it’s a hypothetical.

And like:

So Ron’s whole argument about this being somehow a hypothetical is shot, just like all his other arguments, by showing his own data.

To summarize Ron’s view so far in this debate: everyone who thinks wellness is a total waste of money — including RAND, basically all the media and every economist who has looked at it in the last six years — is wrong.  Every time his own materials accidentally tell the truth and say wellness loses money, they’re wrong.  

And as we’ll see in the next installment, every employee who hates their company’s wellness vendor is either in a bad program or they are a bad employee.

Basically everyone is out of step but Ronnie.