To fire up the base, I’m upping the ante in this HISTalk.  Judging from the number of click-throughs to TSW, a lot of people read this blog. (Frankly, way more than read this one.)

If you read through it, you’ll see there are actual people and companies called out. I don’t know what more I can do to get them to sue me.  Most have enough sense not to take the bait, but Bruce Sherman stepped up when I observed that he thinks healthcare spending correlates with industrial waste, and that health status correlates with healthcare spending and that wellness programs can improve health status and — connecting the dots — wellness programs can reduce industrial waste. Here are his exact words:

Similar cross-sectional data linking workforce health with work quality have been reported in a manufacturing firm, where average employee healthcare costs (as a proxy for health status) correlated directly with waste production as a percentage of final stock value across 5 locations,²² …. At a location-specific level, using annual revenue per employee estimates, differences in healthcare costs of $1000 per employee were correlated with higher quality sufficient to increase stock value production (and therefore, revenue) by $2000 per employee. 

I can’t quite figure out what this means. Read verbatim, it seems like higher healthcare costs are associated with more revenue, but I think he means lower healthcare costs, and just accidentally said the reverse of what he intended to say. He said “employee healthcare costs correlated directly” when he meant to say “correlated inversely.” An honest mistake. Could happen to anyone (in the wellness industry, that is).

The two may or may not correlate positively or negatively, but that’s like saying growth in the population is correlated with my age.  The two move in tandem, of course, but have nothing to do with each other. Healthcare spending is driven by many things, of which health status, which itself is driven largely by social determinants, is only one. Local pricing/contracting, outlier events, surprise bills, aggressive providers and overdiagnosis/overtreatment, composition of the workforce…all those drive healthcare spending much more.

But now let’s take the next step and connect all the dots to say that a “pry, poke and prod” program will somehow reduce industrial waste. This is a key part of the argument. Otherwise, it’s just academic.

If anything, one might argue the conventional “pry, poke and prod” wellness bag of tricks increases industrial waste.  Cajoling employees to reduce their blood sugar will make them more sluggish, urging them stop smoking will annoy them, and trying to make them lose weight encourages cheating.  (By far the most popular TSW post is How to cheat in a corporate weight loss contest. ) Hard to see how sluggishness, nicotine withdrawal and dishonesty — not to mention all the time being screened, and following up on false positives with doctor appointments — reduce industrial waste, but maybe I’m missing something.

I did in fact say that Dr. Sherman believes that prying, poking and prodding reduces industrial waste. And in an offline conversation, where he asked for a retraction, I offered that retraction — provided he publicy admits that there is no way prying, poking and prodding employees can reduce industrial waste.  Or even that conventional wellness could never reduce industrial waste but that creating a better workforce culture might do that. That way I’ll know I misunderstood him…and would be happy to apologize.

If you haven’t already done so, by all means read the interview.  You’ll want to pop some popcorn and settle into your Barcalounger, because interviews don’t get more entertaining than this one.