A rebuttal from Goetzel? Of course not.  The Wellness Ignorati deal in secret missives to the media, not open discussion. Or, in the case of the proposed Code of Conduct urging vendors not to harm employees or lie about outcomes, stonewalling it. What they never do is, engage with this blog. We’re good enough for Slate, STATNews, and the Chicago Tribune (and that’s in the last 3 months alone), but not the Wellness Ignorati.

However, we did manage to get a thoughtful response from a third party, Michael Prager. He raises some excellent points.

First, Ron says (and has said variations of this on many occasions) “most diseases are preventable” by wellness. That statement is flat-out wrong. Had Ron said — and this is Michael’s take on what he meant to say  — “most people eventually die of chronic diseases that, had they made better choices in their life, might not have developed until later in life,” then he would have been right. Fact is, heart disease and diabetes are leading killers. Just as Michael says.

Ron got it totally wrong, though, with his most-diseases-are-preventable mantra. Only a few diseases are preventable through corporate “pry, poke and prod” programs. Just look at Ron’s own HERO guidebook. It lists diabetes and heart attacks and a few other ICD 9 codes as “potentially preventable hospitalizations.”  Meanwhile, there are about 14,000 other ICD 9 codes (or 60,000+ ICD 10 codes) which are not preventable through workplace screenings, though one study tried to credit a wellness program with a decline in cat scratch fever.

Think of all the diseases or other expenses or health programs you yourself (assuming you are a non-smoker) have endured in your lifetimes. How many would have been prevented by one of Ron’s pry, poke and prod programs? Or, as Wellsteps’ Steve Aldana says, by eating one more bite of a banana? (He really did say that, but the STATNews website seems to be down this very minute.)

Now, if employees were covered for their entire lives by employers (they aren’t), and if employers could get them to reduce their risks (they can’t), then corporate wellness could work, and might possibly save money.

Second, Michael also points out that I distinguish disease-related “events” from the diseases themselves.  These events are — and Ron’s HERO guidebook agrees with me on this — the only place an employer actually realizes savings from wellness, offset by many other costs.  However, very few events caused by these conditions take place during our actual <65 working years. Like the annual odds of a heart attack for commercially insured people <65 are about 1-in-800. Using a few generous assumptions about program effectiveness, that already-low rate means it costs companies about a million dollars to prevent one through pry, poke and prod.

Finally, you should know a little about Michael’s back story. He did in fact turn his own health around through rigorous attention to diet and exercise, and I applaud and respect him for that.  He encourages others to do the same, as do I.  However, “encouragement” and intrinsic motivation are a lot different from, for instance, Michael O’Donnell’s recent diatribe that employee health insurance premiums should (at least in part) be assessed on a per-pound basis, sort of like when ordering lobster or mailing a package.  That system, Mr. O’Donnell says, will get employees to lose weight.

Alas, if there is one thing wellness vendors can’t do, it’s get people to lose weight. The best example would be Ron’s buddies at the Vitality Group. They couldn’t even get their own employees to lose weight.

I am shortcutting Michael’s comments, so do go take a looksee on your own. It was a thoughtful response (two words you won’t see in succession in any other TSW posting) and is worthy of a careful read.