Starting in November, Penn State faculty and their university health care covered spouses and domestic partners were scheduled to be required to complete an online wellness profile (including questions like “do you plan to become pregnant in the next year” and “how often do you have arguments with your spouse”), a physical exam, and a biometric screening, including a full lipid profile and glucose, body mass index and waist circumference measurements in mobile units deployed by the University’s health insurance company.
If employees didn’t “volunteer” to do these things they would be punished with a $1,200.00 a year insurance surcharge. (My frienda in the military describe this kind of situation as being “volun-told”)
We’ve talked about these programs before, including how they have not been shown to be effective. We’ve also talked about the fact that body size measurements are not health measurements, and that even if they were people are different sizes for different reasons, and we have no idea how to change them long term which makes changing body size an ineffective healthcare intervention. The difference with this situation is that the employees reacted with a ferocity that warms my fat activist heart.
One of my favorite reactions was this one. It is a call for civil disobedience and the first thing I like about it was that it is written by an associate professor without tenure which I think is quite brave.
He states the point beautifully:
While university administrators may be implementing this program with the best of intentions, coercing Penn State employees to undergo medical testing and requiring that they disclose personal medical information to a third-party online database is ethically indefensible. University employees should respond accordingly.
He acknowledges that a full boycott is unrealistic because some faculty members simply can’t afford a $1,200 pay cut (note that the ability to insist upon one’s privacy is reserved for those who can lose $1,200.00 a year.) Not to mention that a boycott would “create an annual two million dollar windfall for the organization’s budget, thus rewarding the administration for inserting itself in our private medical affairs.”
He suggests alternatives that will allow people to participate by the letter of the program but still create an effective protest. My favorite of his ideas is for participants to get screenings at their regular doctor rather than at the mobile units (which HR assured him was allowed) because, among other reasons, “if ten thousand Penn State employees set up previously unscheduled doctor visits, (particularly if they are scheduled as full check-ups) it will have the effect of frustrating the university’s narrow budgetary objectives, making the cost of implementing these “basic biometric screening” simply unsustainable.”
He also makes an excellent point that such a program would never pass the basic approval process that is required for any academic study at the university that involves humans, because they utilize coercion and do not give participants the right to opt out of questions which they find embarrassing, threatening, or too personal.
This is one of many protests and interventions of the University’s policy, all of which met with the predictable group of people who insisted that there’s no use protesting things like this.
Today Penn State backed down. They are removing the surcharge for those who don’t participate and Administrators have agreed to work with a faculty and staff task force to study alternatives for implementing the wellness program.
Obviously this is a beginning and not an end to the work to be done around these issues, but I think it’s important to remember that these things can be fought and progress can be made. Obamacare does a lot of things that I appreciate (like making insurance available to me at all since I currently can’t get it because of my size) but it also allows for these kinds of carrot and stick programs – including the use of body size measurement as health measurements – so I expect we have many more of these fights ahead of us, but if we employ consistent activism and creative civil disobedience, I believe we can win.
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Sometimes I wonder if the right to privacy is going to be another ‘right’ we end up buying. These wellness coercions are appalling.
We’re already there— the 1% don’t wait in lines and have the TSA put there hands all over them. Also, the airlines will be having a new policy where you can pay an increased fare to avoid the security-line assault. So, the elite wealthy already have the “right to privacy”, it’s just the rest of us that have to go without. : \
Seriously? Because people with money couldn’t *possibly* be terrorists. /sarcasm.
YAY at least they got them to back down. these kind of victories always give me hope to keep up the good fight of fat activism.
At my workplace, they did the same thing, only instead of fining us for not participating, they offered us a half-day of paid vacation for participating. It was remarkably effective in getting people to comply, despite the qualms people had about privacy, etc.
Yes and YES! My work also has a similar wellness program with screenings and such… but it is truly voluntary and there’s no penalty for opting out… just perks for opting IN. We took our data and entered it into an online program and selected areas we’d be willing to learn more about to improve our health. Of course mine said weight control… along with blood pressure, diabetes and stress management/depression. I chose the stress management and depression areas to ‘learn’ about. I got a $75 gift card to a business of my choice for the first part, another $25 for completing the online lessons and then another $50 by keepingin contact with a ‘wellness coach’ by phone for 6 months.. 3 calls. It actually got pretty funny talking with my ‘coach’… he obviously was not prepared to deal with someone who knew more about health that he did. In the end, he sent me a pedometer and encouraged me to take walks to de-stress.
Now that’s a system I could just about get behind.
Yeah, I think as long as it’s actually voluntary instead of fake voluntary, and as long as it’s actually evidence based, things like this can be useful.
Yippee! People power for the WIN!!! This kind of coercion is utterly unacceptable. Obamacare has good aspects, but I do worry that it’s going to become fully available ONLY to people fitting their criteria – i.e. with ‘normal’ body mass index readings. The National Health Service in the UK is moving towards that as well – people classed as ‘obese’ will be given ‘help and advice’ towards reducing weight, and there’s a distinct likelihood that obese patients will not be offered surgery or treatments at the same level as ‘normal’ people.
I work for a hospital and you should see our new yearly “health” question form! I will be forwarding your post to administration. The next step is simply not hiring anyone that does not fall within a “healthy” BMI. That already happens certainly, but with these “health” forms and the like it is now going to begin to happen “legally”.
Apparently the university hospital near me is so over the top on pushing bariatric surgery, they keep encouraging my nurse practicioner (who works in the burn and wound clinic) to do it. Talk about overstepping boundaries.. she never asked about it or for the advice. Sheesh.
I love civil disobedience! It’s a fabulous tool.
Awesome!
There are some fantastic book recommendations in the comments. I wonder if buying them and anonymously leaving copies in front of HR’s and the CEO’s door would alter my company’s wellness shit…
Probably not… but it would be deeply satisfying, and you never know.
I’m a state employee (in South Carolina) and I’m dreading the day our none-too-bright state politicians get an idea like Penn State’s into their heads. Of course, our state is fighting the Affordable Care Act at every turn (refusing to expand Medicaid, refusing to set up its own health insurance exchange, etc.) so perhaps the upshot of that is that they will keep their noses out of our medical records. One can hope, anyway….
My nutrition counseling practice is in Maryland, but I live in Pennsylvania. Right now, feeling very proud of that!
So happy for the Win! Worried that privacy is on the big slide downward and good to know that activism, and clever thinking got the big win in this case. Let’s keep fighting for our rights at every turn! Thank you for sharing this Ragen, another wonderful blog post!
Intimidation attempt and shame-brokering defeated, for now. Good job by the associate professor, and GREAT POINTS made. Will need to watch and see what the consequences are for him; he will pay some sort of price for this, you can be sure. (Sadly.)
I remember a time when we used to be worried about switching insurances every two years (as schools often do) because they would refuse to cover folks who had ‘existing conditions’. like cancer, depression, diabetes, etc. As a group, most of the faculty chose to not give histories on our forms to the insurance company. If felt really awkward for me to not complete my form as requested, but in the end, I knew I did the right thing.
One of the comments there at the bottom of the page, by a doctor Jon Robinson, said the sure-fire way to ensure poor health was the increase stress. Which is exactly what these “wellness” thingies are. Same with any visit to a doctor really.
I was denied employee benefits due to an HR error (I was considered a “late” applicant because my application was not forwarded on time.) While they denied that they used BMI, as I pointed out it was unscientific, their defense was that they only used height and weight to make the determination. I was told that I had to lose over 110 lbs to be eligible. I haven’t been that weight since I was 12 years old! Thankfully, my employer (since it was his obligation to provide these benefits) switched carriers. I did some research and found that Health Canada fully support insurance companies using BMI to screen out participants. BTW – low blood pressure, low cholesterol, no insulin-resistance and in better shape than all of my co-workers who have diabetes, high-blood pressure and one triple bypass survivor.
Is anyone looking into wether this violates the 4th amendment right to be free from unreasonable searches and secure in our persons and papers?
Presumably it doesn’t, since that only applies to the government. Jobs can, by and large, put any ridiculous requirements on employers that they want.
This is why I am soo waiting for the Affordable Care Act to begin. Then people some will have a choice and can hopefully avoid these bullshit employer anti-fat and anti-women penalties because the employee can cut their employer right out.
(note: I do realize that some companies that offer healthcare pay all or most of the healthcare cost — so even with the ACA, it may not be a financially viable option for a lot of people.)