I started this blog in June 2008 with a note entitled "The Health Obligation: a Japanese Example" where I presented a fascinating example of what I call the health obligation. For over two years, in all the conferences that I conducted, I pinpointed the emergence of new social norms that we must comply with. One of them is the health obligation: We have to do everything possible to stay healthy at all times. We have to feed ourselves well, avoid smoking, drink moderately (if at all) – from which stem the various campaigns on nutrition, anti-tobacco and anti-alcohol drives. Failing to follow this new standard not only puts our health at risk but also endangers society as a whole, of which we end up becoming a financial burden.
The USA gives us an even more dramatic example. We must first remember that social security coverage is the responsibility of individuals and one of the criteria for choosing a job is the extent to which companies takes charge of this coverage (its Health Care Plan).
Last April 14, Steven Burd, CEO of Safeway (the 3rd largest U.S. supermarket chain) stated before the World Health Care Congress: "We took advantage of a little-known fact; that is, that 70 percent of healthcare costs are driven by behaviours". As a result, Safeway has implemented a "Healthy Measures" Health Care Plan, aimed at making its 200,000 employees accountable. This strategy is what the Americans call "Market Based Health Care." The principle is simple:
- This program is voluntary. To date 76% of the 30,000 non-union employees have volunteered (the plan is being extended to unionized employees who are covered by special health plans).
- Each voluntary employee (and spouse) agrees to undergo an annual health evaluation test, including a buccal sample (to prove they are non-smokers), measuring their levels of cholesterol, blood-pressure and weight.
- As the purpose is to fight against obesity, risks of heart disease and cancer, employees are made "accountable" by linking health results to the sums that are to be paid by them as contributions.
- "Good health" levels are therefore specified for these risk indicators (blood-pressure, cholesterol level, weight, tobacco).
- Those whose results are "good" (about 75% of the volunteers) have seen their premiums reduced by an average of $800 per person per year.
- Those whose results are not "good" are offered a programme for improvement: "To complement our program of incentives, we reinforce the message of good health through a holistic approach and mutually-reinforcing programs available to all employees and spouses - access to the Fitness Centre, discounts on gym memberships, care management programs, health and wellness programmes, information seminars to employees "... and pay a premium that is 51% higher than the others.
This program was a success: there was a 13% reduction in health expenditure per person at Safeway. At Walmart - which organized a similar program called "Personal Sustainability Project" - "…nearly 20,000 associates have quit smoking. Collectively, associates have lost more than 184,000 pounds (83,000 kg)".
I predicted the appearance of "nutritional rehabilitation centres" in my note of 22nd June: we see here the first realization.
But Walmart's example - illustrated by the following video - shows that the company has taken account of the difficulties encountered by their employees, the vicissitudes of their lives, and wished to help in overcoming them. Fascinating America....