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A New C-Suite Member – the Chief Wellness Officer ?

by Scott MacStravic

In their insightful books, “Discover Wellness: How Staying Healthy Can Make You Rich” and “Discover Wellness at Work: The Ultimate Solution to the Health Care Crisis”, the authors make the case for adding yet another member to the “C-suite” = a Chief Wellness Officer.  They also make the case for each individual becoming a “CWO” for each’s own health and care use.

In addition to making a strong case for focusing on wellness, in order to reduce the “drag” of the $2 Trillion-a-year sickness care system on our economy, global competitiveness, and health (given the horrifying numbers of medical errors, adverse drug events, nosocomial infections, and other negative impacts of sickness treatment).  But in addition to other arguments for individuals becoming wealthy and employers helping them to do so, they cite the many ways in which this can make both employees and employers rich!

Well, “rich” may be too strong a word, but they make some pretty good economic arguments, citing the many ways in which people can gain by being or becoming healthier, in addition to the ways that employers can do the same for their firms.  While we have had relatively modest success at best in persuading or educating individuals and populations toward better health, perhaps making them rich, or at least considerably better off financially, will make the idea as popular among employees as it is becoming among employers.

There are clear connections between health and wealth, though these are rarely covered in full by most who have described them.  The more obvious ones arise from avoiding direct out-of-pocket costs due to being sick.  These include not only the lost time/pay from work that many suffer if they have no disability or sick leave, but the increasing portion of sickness care costs workers are being asked to pay, from higher premiums to deductibles, co-insurance and co-pays.   Even if they get disability pay, it is normally only a portion of what they would be making if working.

To these must be added the indirect costs of “unhealth” on what employees earn in the first place.  If they are paid on a productivity or performance basis, sick employees naturally produce less or perform worse than they would if healthy.  With chronic conditions, as well as risks such as obesity, they lose productivity/performance-based compensation, to say nothing of promotions and raises that would likely have been offered to them had they been healthy.

Moreover, pursuing unhealthy lifestyles often costs a lot of what would otherwise be “discretionary income”.  Cigarettes can easily impose an “addiction burden” of thousands of dollars each year.  Alcohol and drug use adds widely-ranging amounts as well.  Eating unhealthy fast food compared to healthy home-cooked or employer-subsidized meals can add thousands of dollars to the annual food bill.  Of course, mitigating these costs may be the out-of-pocket costs that individuals incur in joining fitness clubs, buying exercise equipment, wearing out walking shoes, etc.  Fortunately, employers often subsidize or obtain discounts from sellers on such items, thereby reducing costs to employers.

Moreover, employers are increasingly offering employees bonuses for participating in wellness programs, with amounts often in the $1000-2000 range each year.  Or they may impose similar-sized penalties, in the form of premium share, or other increases in sickness care costs.  Healthy employees can far better afford to take the risks involved in Consumer-Directed Health Plans, and if they keep their sickness care costs low, they can save on insurance premiums, as well as build up hundreds of thousands in tax-free HSA accounts in preparation for their retirement.

It has already been shown that giving people a “scorecard” to use in keeping track of how much better off they are for engaging in EHM efforts is a good way to keep them interested and participating.  Making that scorecard a financial one is almost sure to be more powerful than scorecards based on “health age”, “health-wellbeing scores”, etc. and similar direct health measures.  It can also represent a continuous threat, since money gained and likely to be gained in future can easily become lost if employees or their family members “relapse” into unhealthy habits and sickness costs.

The idea of a CWO for individuals, with a helpful partner chosen from among a wide range of health professionals to help, is matched by the idea for a CWO in business and other organizations.  Such an “officer” would at least be useful for keeping track of the full scope and amount of economic value that employers tend to gain through EHM.  Since the vast majority of employers count less than half of the economic benefit they are already gaining, and that among those who count it at all, this could make both a challenging and worthwhile career in business.

Understandably, given their training in chiropractic medicine, the authors make pretty good arguments for looking past physicians as prospects for the CWO position in business, or the preferred partner for individuals who act as their own CWO.  Given the growing shortage of primary physicians in this country, it is unlikely that we can afford to spare any more to become CWOs or even partners for individuals, though hundreds are already doing so in “concierge medicine”.  Of course, how employers and the insurers that serve them decide who would make the best CWO is up to them, as is true for consumers as well.

On the other hand, the authors are not promoters of chiropractic alone as an appropriate background for CWOs.  They note that other