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What Will Work?

This chapter will introduce new ideas which encourage employees’ to participate in the health movement. As discussed in "Regulations and Fads," society’s health problems are caused by lack of motivation and direction. The solutions in this section will aim at turning around this difficulty in an organizational setting. In "Regulations and Fads" it is stated the individual must take responsibility for his or her health. The methods and incentives encourage employees to take the responsibility of health upon themselves. The incentives will give workers rewards which are measurable and more importantly practical. Some facets of the solution are already used commonly in companies and businesses, but are necessary for the explanation of the total plan.

In order for workers to strive towards higher health standards, employers must offer incentives to workers who demonstrate habits leading to good physical health and encourage the organization as a whole to follow. By incorporating wellness and health into the workers’ daily lives, an organization will become more profitable by reducing health care costs, decreasing the number of absentees, and having a work force which has more energy and less stress.

In order to make the explanation of such a program easier, a fictional company, Kennedy & Komen Incorporated will be used in addressing issues and terms. Kennedy & Komen, a producer of athletic apparel and equipment, employ two-hundred and fifty employees in Indianapolis, Indiana. The organization makes athletic apparel and equipment. Kennedy & Komen have approxiamently one-hundred and fifty workers in their factory on the assembly line. The rest of the one-hundred and fifty employees are assigned to marketing, accounting, advertising, and other executive tasks. Kennedy & Komen has a president and three vice presidents on their board of directors. All employees of the company work nine hour shifts, which includes a one hour lunch break. The company provides health insurance for all employees and their families. In the past year, Kennedy & Komen calculated that $5,292 are spent on each employee for health insurance premiums. Kennedy & Komen have many problems with people living a sedentary lifestyle and roughly fifty percent of their workforce engages in smoking, thus creating a work force with a large amount of health risks. Many workers have experienced long illnesses over the last five years and their absenteeism decreased the profits of Kennedy & Komen greatly. Two thirds of the employees are male, and eighty-five percent of the workers are married. Of the workers married, they have an average of 1.8 children. The average age of all employees is 41.6.

The first step in creating an occupational health program is to decide who will be in charge of the plan. Kennedy & Komen believe health promotion must start at the top and employees high in the company must set an example for others to follow (Pelletier 67). A vice president is put in charge of the plan and its implementation. Six other lower employees who practice a healthy lifestyle will be assisting the vice president in the creation of a health promotion program for the company. The official title of the seven- member group is Planners for Productivity. The word productivity is chosen to show other employees how a healthy lifestyle will not only benefit them but Kennedy & Komen as a whole.

Before starting an occupational health program, Planners for Productivity must address several issues. A major issue of such programs is the amount of money the business is willing to invest in a plan. Worksite health programs can have costs without benefits, but they cannot have benefits without costs (Opatz 113). Before starting any blueprints, the program must have substantial financial backing. The dollar value of all costs in the program must be calculated along with benefits from implementing certain ideas. Kennedy & Komen feel they can cut health care premiums by $1,500 per employee in five years’ time. The vice president decides to spend $800 on health promotion for each employee per year for five years. This figure does not include health insurance only promotion. The expenditure amounts to a total of $200,000 per year and $1,000,000 over the course of five years. They plan on reducing health care premiums by $300 each year per employee. Predictions of savings for the first year are $75,000, second year $150,000, third year $225,000, fourth year $300,000, and fifth year $375,000. The total savings for five years amount to $1,125,000. This amounts to a profit of $125,000 or $500 in savings for each employee over the course of five years when subtracting health insurance costs from investments in health promotion. After five years the investment in health promotion produces even greater yields. If the company reduces health insurance by $1,500, Kennedy and Komen will save one million dollars over a ten year period. This figure equals $4,000 in savings over a decade for each employee. This dollar amount is not taking into consideration higher worker productivity from increased morale and energy or the money saved from fewer absentees.

Another important agenda which needs to be addressed is the area of health to focus on. Planners for Productivity plan to have everyone given a health assessment on a yearly basis screening for tobacco use, percent body fat, blood pressure, total cholesterol, oxygen uptake, and flexibility (Opatz 169). The physical will give the organization a definite answer on what it needs to concentrate on in order to have greater overall health. Employees input into what the health promotion program covers is also very important. Planners for Productivity give a survey to all employees and find what interest them personally. People will be much more likely to participate in any activity if they are intrigued by it (Tannahill 43).

The business decides to concentrate on implementing exercise programs, smoking cessation programs, and education about proper nutrition. Studies have shown that health insurance for smokers is nearly thirty percent greater than non-smokers, which makes smoking cessation programs a logical choice for one of Kennedy & Komen’s health promotion programs in order to decrease health insurance costs (Houchens). Health promotion programs must target the most common and expensive types of health care claims which are circulatory and muscoskeletal problems to be successful (Opatz 45). With the chances of such problems being decreased greatly, the premium for health insurance an individual pays will go down simply because the risk of illness is less.

For a health promotion plan to be successful, the results must be measurable in order to make needed changes or improvements. Possible measurement tools the company can use are medical benefits per employee, volume of medical services used, disability income payments per employee, workers’ compensation per employee, turnover rates, absences from work, productivity measures, and health risk factors (Opatz 123). In the case of Kennedy and Komen, the business has decided to measure their program through the cost of medical benefits per employee, which is money spent on health insurance per employee in this case.

Kennedy & Komen research occupational health services and find that the National Institute of Fitness and Sport on the campus of IUPUI offers many of the services planned in their health program. NIFS has a wide variety of exercise classes, a 200 meter track, a trained professional staff, many educational seminars, and offers fitness assessments at no charge to all members (NIFS). A major factor in the company’s decision was NIFS being only a five minute drive from Kennedy & Komen’s work site. This will allow employees to get in a workout during lunch if so desired. Kennedy and Komen feel NIFS will offer an attractive place to exercise and maintain one’s fitness. The executives of the company are pleased to see health assessments, employee tracking, and educational services are offered at no additional cost. This will make the task of Planners for Productivity much simpler by combining all their plans into one facility (Cooper 172). Kennedy & Komen also believe employee membership at NIFS is a perk which will attract better employees in the future. The initiation fee at NIFS for a corporation is $150 and a yearly fee of $390 is assessed for all employees. The total cost for Kennedy and Komen to join NIFS will be $97,650 the first year and $97,500 the following years. The five year total for membership at NIFS will be $487,650 (NIFS).

Kennedy and Komen must make changes in their working environment as well (Bunton 22). The company realizes the harmful effects of second-hand smoke and decides to ban smoking inside their building. Workers may smoke outside during breaks if they wish, but are discouraged from doing so all together because smoking goes against the goals of the health promotion program. Cigarette vending machines inside the building have also been taken away. Vending machines offering healthier options and baskets of fresh fruit are now offered for employees while taking a break.

Kennedy & Komen know that in order for the plan to be successful, the employees must be given incentives to work towards their health and fitness goals (Pelletier 30). The workers are told that each time they visit NIFS and spend a minimum of thirty minutes participating in a physical activity, they will be given a dollar. At the end of the year each worker will receive a check for the total number of days they spent at NIFS. If a worker exercised 105 times, he or she will receive a check for 105 dollars. Planners for Productivity calculate a sound estimate on participation at NIFS is 140 visits per person over the course of a year. This would amount to around 2.7 visits per week by each employee. The cost of these incentives would be $35,000 for one year or $175,000 for five years.

If a person meets with a member of Planner for Productivity and explains he or she already exercises at home and does not have time to go to NIFS, the individual will be given 200 dollars for exercise and health purposes. The remaining 190 dollars will be spent on health assessments and tracking the person would have received at NIFS. The money for the expenditures comes from the $390 which would have been used as a NIFS membership.

An additional benefit will be aimed directly at the reduction of health insurance premiums. For each dollar an employee reduces his or her health insurance premiums by, the individual will receive a check representative of 50 percent of the amount his or her premium was reduced. For example a male worker currently has a health insurance premium rate of $7,211 per year, but reduces his insurance rate to $4,118 over a period of five years. The employee will receive a check for $1,546.50. An employee can also receive a check on a yearly basis if desired. If the total employee reduction in health care premiums is an average of $1,500 per employee, the goal stated above, in five years this plan will cost $187,500.

If an employee practices a lifestyle totally against the goals of the plan, no penalty will be assessed unless his or her cost of health insurance goes up for reasons which were reasonably preventable. For example, if a person starts smoking, drinking, and does everything to make his or her insurance premiums increase, caused by a greater risk of developing a disease or illness, he or she will pay the rate hike by having the expense deducted from his or her paycheck. The seven member health promotion committee headed by a vice president will decide these cases on an individual basis. It is unfair for other employees to be unable to reach company goals because of a few individuals. If a lack of accountability exists, no incentives are in place for the employee to be accountable for lifestyle behaviors having a dramatic effect on health care costs(Opatz 161). For example, if schools did not give grades and everyone automatically graduated, how many students would work hard to learn material? A person will not be penalized for growing older or having children which increase health insurance costs. In the future, Kennedy & Komen will only hire employees who do not conflict with the goals of health promotion and the company itself in the future. The hiring practice will not discriminate against people who are not in top physical shape, but will weed out people with daily habits detrimental to proper physical health such as alcoholics and smokers. Planners for Productivity believe this will allow their program and the company to prosper long into the future.

The additional $149,850 left for health promotion after calculating costs for plans and incentives will be used on an individual basis. For example if a person would like to run the Indianapolis Mini-Marathon, Kennedy & Komen will pay the entry fee. The organization will pay for all physical activities as long as the price is not over $50. An individual will be limited to expenditures of $500 over the course of five years. If a person needs counseling in any area, Kennedy & Komen. will pay the fee for the individual. Planners for Productivity would like workers to feel that the company cares for their welfare and well-being.

Several examples exist where health promotion has been used to reduce health care costs and the number of absentees by employees. Blue Cross/Blue Shield of Indiana, in a 4.75 year study, saw a mean difference in health care costs of 24 percent between participants and nonparticipants in the company’s health promotion program. This translated into a savings of $519 a person during the study (Opatz 89). At GE Aircraft Engines in Cincinnati, a study was conducted to see whether employees’ use of the company’s fitness center reduced health care claims. Medical claims of approximately 800 members were examined for six months before and twelve months after joining the center. A group of 2,700 nonmembers served as the control group. The members before joining the center had 35 percent higher mean medical care costs than nonmembers, $1,044 to $773 a person. After joining the center, mean medical costs dropped to $787 a person for members. The control group’s average rose to $941, which is consistent with medical care cost inflation during the study period (Opatz 88). A lower amount of medical costs will lower the cost of health insurance.

Examples also exist where health promotion increases job productivity. Investigators at NASA administered questionnaires to participants six months and twelve months after entering NASA’s fitness program. Of those members who exercised three or more times a week, 90 percent reported better health and greater stamina, and nearly 50 percent felt their work performances improved (Opatz 85).

Health promotion has been found to contribute to a reduction in absenteeism. In a study conducted at Mesa Petroleum in 1986, it was found a difference of 1.5 days of sick leave between fitness program participants and nonparticipants existed (Opatz 80). The relationship between absenteeism and cardiovascular fitness has also been studied. 8,301 employees of corporations nationwide that participated in a health screening program were the subjects. A strong inverse association between sick leave and fitness level was found. Employees in the poor fitness group had 2.5 times the rate of high absenteeism, defined as absences of five or more consecutive days, compared to those in the excellent fitness category (Opatz 81).

While arguments against health promotion seem unlikely, they do exist. Objections against health promotion include it forces people to adapt a certain lifestyle or habits, but does not address the factors causing the problems (Bunton 46). For example, critics say health promotion should not force people to give up poor health habits such as smoking, but instead should focus on limiting tobacco companies from producing cigarettes. In the case of Kennedy& Komen, health promotion did focus on limiting the factors which could allow people to practice an unhealthy lifestyle in the working environment. For instance, the company took away the cigarette vending machines and junk food and replaced them with nutritious food. Although the company does encourage people to give up smoking, Kennedy & Komen gave resources to the employees to help them quit the habit.

"Good health is the bedrock on which social progress is made. A nation of healthy people can do things that make life worthwhile, and as the level of health increases so does the potential for happiness"(Bunton 16). This quote by Marc Lalonde, former Canadian Minister for Health and Welfare, can also be applied to the success of a business organization. A company will be better off in all situations with good health. How many people perform to their best ability when they are sick? If the individual can never perform to his or her best when ill, then how will a group of ill people work together? A healthy lifestyle allows for the individual to be free from the distractions caused by sickness and disease and perform to the best of his or her abilities. A healthy person can give one hundred percent in life.




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