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Healthywage is helping Schlumberger employees crash-diet their way to better health

In the wellness industry’s epidemic of very stable geniusitis, Healthywage is Patient Einstein.

Somehow they recruited Russian trolls to convince Schlumberger that the best thing they could do to reverse their four-year stock price decline…

…would be to: encourage their employees to binge and then crash-diet.  So far Schlumberger is halfway through its 8-week crash-dieting contest. In case you’re keeping score at home following our initial posting, here are the standings:

Pound Town has lost 10% of its weight in 4 weeks. Figure — as a conservative estimate — the average participant weighed 200 pounds at weigh-in.  A 9.86% loss of body weight equates to more than 19 pounds, almost 5 pounds a week.  The Centers for Disease Control (CDC) recommends 1-2 pounds/week.

The better CDC recommendations include not crash-dieting at all, but rather improving your health and fitness, at your current weight, because rapid weight loss likely leads to rapid weight regain, and possibly even slows metabolism so that one could regain more than one loses.

However, the CDC recommendations didn’t take into account that weight regain is a big part of what makes this contest work. Employees can win the $10,000 in 2018 — and then regain the weight in order to enter again in 2019. Is this a great country or what?

Health has nothing to do with it, of course.  It’s about making Schlumberger shareholders proud again.

The NBER invalidation of wellness outcomes: Behind the headlines

There is a lot more to this study than meets the eye.

Just published today in American Journal of Managed Care:

Some tourist attractions feature an “A” tour for newbies and then a “behind-the-scenes” tour for those of us who truly need lives. For instance, I confess to having taken Disney’s Magic Kingdom underground tour, exploring, among other things, the tunnels through which employees travel so as not to be seen out of costume in the wrong “Land.”

Likewise, there have been many reviews of the recent wellness study conducted by the National Bureau of Economic Research (NBER), the first-ever randomized control study of a wellness program. This, however, is the first review to go beyond the “A” tour of the headlines.

By way of background, the headline is that the mainstream wellness program the investigators examined at the University of Illinois did not noticeably move the needle on employee health. They didn’t address return-on-investment (ROI), because there obviously was none. Achieving a positive ROI would require moving the health risk needle—not just by a little, but rather by enough to significantly improve the health of many employees. Then, since wellness-related events, such as heart attacks, would not otherwise have befallen these employees immediately, this improvement would have to be sustained over several years before there was a statistical chance of some events being avoided.

Finally, the magnitude of this improvement would have to be great enough to violate the rules of arithmetic, because it is not mathematically possible to avoid enough medical events to break even on wellness. For instance, it actually costs about $1 million to avoid a heart attack through a screening program.

This finding, therefore, represents an existential threat to conventional wellness programs.

It all boils down to: why would an associate professor (Damon Jones) publicly humiliate his own dean (Katherine Baicker — yes, the very same Katherine Baicker who always seems to be on the wrong side of every wellness debate) …unless he is absolutely sure he is right? 

She can’t fire him now because that would get picked up by the lay media. Perhaps she should have paid him $130,000 not to disclose the results.  

You can continue to the review here.

West Virginia teachers went on strike over…wellness???


I cannot make this stuff up.  While there were other issues too, here is the article.  Scroll down towards the end and you’ll see that getting rid of the wellness program ranked right up there with a pay raise in worker demands, becoming the key issue for them even after the pay raise was agreed upon:

It wasn’t so clear any longer that a pay raise could resolve them. Quite quickly, it was apparent that the union’s membership…would reject the deal. “I live paycheck to paycheck,” Katie Endicott, a thirty-one-year-old high-school teacher from Gilbert, told the Times. Then she recounted the program, mandated by the state’s new health-insurance program, that required teachers to download an app that would check how many steps they took each day.

“If I don’t earn enough points, and if I choose not to use the app, then I’m penalized $500 at the end of the year,” she said. “People felt that was very invasive.” 

The irony, of course, is that this is far from the most invasive wellness program we’ve ever seen. It wouldn’t even be subject to the forthcoming rules reflecting the AARP v. EEOC decision. Plus, taking some extra steps is a good idea in general, and especially in the state with the country’s second-highest obesity rate.

Still, the fact that an activity tracking program was considered repugnant enough extend a strike over is Exhibit A that WillisTowersWatson is right: employees hate wellness. Not all wellness, of course, but rather forced voluntary wellness programs just like this one.

The wellness industry’s terrible, horrible, no-good, very bad year just got worse.

The Wellness Industry’s Terrible, Horrible, No-Good, Very Bad Year  just got worse. Seems like CMS (Medicare) and Modern Healthcare are also ganging up on the Health Enhancement Research Organization (HERO) and all their cronies.

The headline in today’s Modern Heathcare turns out to be a bit of an understatement:

Wellness programs aren’t generating Medicare savings

Read farther the article and you’ll come up with gems like:

Utiization and expenditures actually increased among program participants… The results mirror those in the corporate world.

Asked for comment, the National Business Group on Health’s very stable spokesgenius, Steve Wojcik, said:

So, while it didn’t reduce healthcare expense or utilization, it seems to have had a positive impact…by preventing or delaying normal deterioration that comes with age.

Where Mr. Wojcik came up with this spin, creative even by wellness industry standards, is anyone’s guess. Nothing in the program suggests it and when he finds something that does prevent age-related decline, I will be the first to nominate him for a Nobel Prize.

The curious thing is this failed approach is not “wellness or else” as Jon Robison calls it. Instead these programs are truly voluntary. Also unlike corporate wellness programs, vendors aren’t harassing healthy employees to eat more broccoli but rather focusing on unhealthy ones.  Instead of making healthy 30-year-olds get unneeded checkups, they’re encouraging 70-year-olds with chronic disease to get more medical care.

And yet the programs still don’t work. Color me surprised. I genuinely thought (and I honestly still think) that willing participants in voluntary programs who have chronic disease would benefit from these programs. Perhaps when they re-review another year’s data they will find a benefit.

Alternatively, instead of trying to maintain the revenue streams of their members, perhaps HERO could actually try to find a new model that does provide a benefit. Certainly there are plenty of vendors out there with possibly better mousetraps, but they all have one thing in common: they have no use for HERO’s pet vendors, any more than companies that make solar panels have a use for coal.

Speaking of HERO, let us review HERO’s comments from just last week:

Teddy Roosevelt said, “complaining about a problem without posing a solution is called whining.” It’s a quote that also reminds me why I’ve not thought of angry bloggers who target health promotion [vendors] as bullies. Though they relish trolling for bad apples, their scolding is toothless, more the stuff of chronic whiners.

Not to mention:

We’re fortunate to work in a profession with a scant number of vociferous critics. My take is that there is one thing these few angry loners want more desperately than attention: that’s to be taken seriously.

Just like wellness vendors like to define “voluntary” as “forced,” I guess in wellness-speak “scant number of vociferous critics and chronic whiners” mean “every commentator,”  and an “angry blogger” is any blogger with a great big smile on his face.

The Outcomes, Economics and Ethics of the Workplace Wellness Industry: A Review by Tom Emerick

A bunch of months back I published a comprehensive, richly sourced, linked and footnoted review of the three greatest failures of the workplace wellness industry’s leading vendors, consultants and promoters. Those three greatest failures, of course, would be: outcomes, economics and ethics.  Hence the title.

The paper is quite uncharacteristically, rather dry, as befits publication in the country’s leading law-medicine journal. However, I’d encourage everyone to download it and at least skim it.

To get you started, Tom Emerick just now reviewed it in Insurance Thought Leadership, so that might be a good place to start. If that catches your attention, then you can link through to the main event. (And, yes, there is a juicy tidbit in there.)

PS The journal issue includes four other articles on wellness too, including one by The Incidental Economist. They couldn’t find anyone unconnected with the wellness industry to defend it, so the entire issue is an evisceration of its shortcomings.



The wellness industry’s terrible, horrible, no-good, very bad year

OK, this time I’m not the one causing the kerfluffle in the wellness industry, though I will confess to being a force multiplier.

Not since 2014, when the very unstable morons at the Incidental Economist made fun of the very stable geniuses who give out the Koop Award and also unequivocally concluded wellness loses money — combined with continued fallout from the Penn State debacle and the Nebraska scandal — has the wellness industry had such a bad year. And it’s only February.

Let’s review what’s happened so far in 2018. First, a federal judge ruled that voluntary wellness programs need to be — get ready — voluntary. The EEOC’s responded with the legalese equivalent of:  “Fine, be that way.”

Next, WillisTowersWatson did something that might get them in hot water with the very stable wellness industry leaders: they were honest. They published a study revealing that employees hate wellness even more — way more — than they hate waiting for the cable guy to show up.

Finally, the very unstable National Bureau of Economic Research conducted a controlled study finding basically no impact whatsoever of a wellness program.  More importantly, they specifically invalidated the “pre-post” methodology.  Even more importantly, they specifically invalidated 78% of the studies used in Kate Baicker’s “Harvard Study” meta-analysis.

Here is an interesting piece of trivia. The lead researcher is an assistant professor at the Harris School of Public Policy. Why is this interesting trivia? Because Katherine Baicker — the Typhoid Mary of Wellness, whose THC-infused 3.27-to-1 ROI is the basis for essentially every subsequent genius wellness outcomes claim — is now the dean of that very same Harris School.  I’m just guessing here, but I’d say it’s gotta be a trifle embarrassing when your own subordinate publicly disproves your own study. I mean, it’s one thing for me, RAND, Bloomberg, and anyone else with five minutes, internet access and a calculator to do it, but…your very subordinate?

On the other hand, the researcher, Damon Jones, just demonstrated not just amazing competence, but amazing integrity as well. In other words, he has no future in wellness.

The Wellness Empire Strikes Back

How does the wellness industry respond to these smoking guns threatening their entire revenue stream? Apparently, there is little cause for concern on their planet.

Let’s start with America’s Health Insurance Plans (AHIP), the health insurance industry lobbying group. Here is AHIP’s oxymoronic Wellness Smartbrief (January 26), on the NBER research. Yes, it summarizes the same wellness-emasculating study as the one above, though you could never guess it from the headline:

Continuing, AHIP said:

Offering incentives for completing wellness activities might be more cost-effective than offering incentives for wellness screening, a recent study of a comprehensive program found. 

Perhaps AHIP has been infiltrated by Russian trolls, because here’s what the NBER article actually said about “completing wellness activities”:

We…do not find any effect of treatment on the number of visits to campus gym facilities or on the probability of participating in a popular annual community running event, two health behaviors that are relatively simple for a motivated employee to change over the course of one year.

AHIP continues:

Wellness programs might attract mostly employees who are already fitness-conscious, but the potential to attract healthy employees whose medical spending is already low could nonetheless be a boon to employers, the researchers found.

And on the subject of “the potential to attract healthy employees” being a “boon to employers,” the authors actually said:

We further find that selection into wellness programs is associated with both lower average spending and healthier behaviors prior to the beginning of the study. Thus, one motivation for a firm to adopt a wellness program is its potential to screen for workers with low medical spending. Considering only health care costs, reducing the share of non-participating (high-spending) employees by just 4.5 percentage points would suffice to cover the costs of our wellness program intervention.

In other words, you can apply some workplace eugenics to your company by using wellness to weed out obese employees, employees with chronic or congenital diseases, and so on. Good for you!

Soon, if AHIP and others have their way, there will be no need for guesswork in eugenics: employer wellness programs will be able to screen these employees out based on their actual DNA.

AHIP’s take on AARP v. EEOC

And now, AHIP’s take on this landmark case, their ace reporters scooping everyone with this February 2 headline on the December 20th court ruling:

Here are more typical headlines on that court ruling, headlines that came out the same month that the court ruling came out. Perhaps AHIP used the interim six weeks to focus-group various verbs until they settled on…tweak???

AHIP:  It’s not just the headlines

One prominent healthcare executive recently attended an AHIP conference and reports:

I just returned from one of the dumbest meetings I’ve ever attended in Washington. Report of a new “study” by AHIP. Turns out people don’t mind health costs all that much, they just want more benefits. And everything is hunky-dory with their health plans, people like them so much. They love wellness benefits and crave more. Prescription drug prices have been nicely controlled thanks to the competitive marketplace (no, I am not making this up or exaggerating for drama). For every $1 employers spend on benefits workers get $4 in value. Priorities for SHRM rep: Fitbits for all employees, solving the outrage that only 20% of her employees got an annual physical. 85 cents of every dollar spent on health care goes to chronic disease.

Over these same two hours, I’d estimate about a thousand employees were misinformed, harmed or harassed by wellness vendors, roughly equal numbers of  employees got useless annual checkups, employers spent about $200-million on healthcare and 40 people died in hospitals from preventable errors. But I’m being such a Debbie Downer! I’m going home to read Why Nobody Believes the Numbers to remove myself from this alternative universe.

Enter the Health Enhancement Research Organization (HERO)

HERO’s Prevaricator-in-Chief, Paul Terry, is demonstrating his usual leadership abilities in this crisis, of course. After all, HERO is the wellness industry trade association and these three items — the NBER invalidating their product, employees hating their product, and a federal judge forbidding them to force employees to use their product — represent existential threats to his “pry, poke and prod” members.

Here is quite literally his only blog post on any of these three items:

Teddy Roosevelt said, “complaining about a problem without posing a solution is called whining.” It’s a quote that also reminds me why I’ve not thought of angry bloggers who target health promotion [vendors] as bullies. Though they relish trolling for bad apples, their scolding is toothless, more the stuff of chronic whiners.

I suspect he is talking about me here as the “chronic whiner” who is  “scolding” them. Or perhaps he is referring to the “angry bloggers” at  the Los Angeles Times, the New York Times, Slate, or STATNews, since those “toothless” publications seem to be scolding wellness vendors more than I ever have.  For instance, I’ve never called wellness vendors’ offering a “scam” or a “sham.” I simply quote these very stable wellness geniuses verbatim, as above or below, or last week.

Being quoted verbatim, not angry bloggers, is their worst nightmare. (One thing I would concede, though, is that “Paul Terry and the Angry Bloggers” would be a great name for a rock band.)

Yep, looks like the implosion of his industry all my fault. Otherwise, I’m not quite sure who is the “angry blogger” he is referring to, other than to note that Mr. Terry himself seems to blog a tad angrily himself, both above, and here

Why I choose to ignore the blogger critics: We’re fortunate to work in a profession with a scant number of vociferous critics. My take is that there is one thing these few angry loners [Editor’s note: the complete “scant list” of the 220 “few angry loners” who have been “vociferous critics” can be found here] want more desperately than attention: that’s to be taken seriously. What they fail to comprehend is that as they’ve gotten ever more farfetched and vitriolic in search of the former, they’ve cinched their inability to attain the latter.

Baiting people with misinformation and offensive insults (but just a tad under highly offensive) is a pesky ploy that trolls hope will eventually land a bite that confers credibility where there is none. Even reading such drivel is a form of taking the bait; responding is swallowing it whole. Some say dishonesty should not go unchallenged and I respect their view; nevertheless, I’m convinced responding to bloggers who show disdain for our field is an utter waste of time. I’ve rarely been persuaded to respond to bloggers, and each time I did it affirmed my worry that, more than a waste, it’s counter-productive.

and especially here, a seemingly incongruous decision to “act out” by someone who claims to be “choosing to ignore the blogger critics.”

Having read years of my “drivel” alongside Mr. Terry’s posting explaining why you shouldn’t “swallow this bait,” perhaps readers might opine here: which of us, exactly, is the “chronic whiner”?

Coincidentally, when I run live health-and-wellness trivia contests, the first of our 3 rules is: No Whining. Seems to me that he would have just violated it. Indeed the only rule HERO hasn’t violated so far is #3 below. Not that I want to put ideas in their head.




Al Lewis — uncut, unedited…and uncombed

Dear Welligentsia Nation,

For some reason there seems to be a ton of interest in the podcast that Josh Luke just did with me. I’m a bit embarrassed because most podcasts are audio and hence I didn’t really gussy myself up in anticipation of video, but nonetheless worth a looksee. Even in the best of circumstances I do look like I just fell off a mountain bike — and that’s after making an effort to look presentable, as in these shots from a couple of trivia contests.

This podcast covers everything you want to know about how wellness got to the state it’s in, how I stumbled into figuring out that it wasn’t working, and how Quizzify arose from its ashes.





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