The Whole Foods, Obesity, Health Care Insurance Debacle

After coming under fire recently for criticizing health care reform efforts underway in Congress, the CEO of the popular grocery chain Whole Foods, Jeff Mackey, is making headlines again for a program by which employees will receive certain discounts and benefits based on a set of health incentives. In a letter to store employees, Mackey writes, "these measures include blood pressure, cholesterol, body mass index (BMI), and being a non-nicotine user."

He explains that the effort is being made to rein in how much the company spends providing health insurance to employees: "One of our goals is to control our healthcare costs as best we can - this benefits Whole Foods Market, and also benefits our Team Members through lower year-over-year insurance premium increases."

The plan seems misguided on many fronts. While encouraging employees not to smoke is sensible, given that tobacco use obviously hinders global health, but the other factors being used in the plan are not likely to be effective. In particular, the use of the BMI index as an indicator of good health is coming increasingly under fire by medical experts. A study in the journal obesity of Canadian adults found that "when compared to the acceptable BMI category, overweight appears to be protective against mortality. Obesity class I was not associated with an increased risk of mortality." Similarly, the American Heart Association has found that "the evidence that a heavier America is healthier is not convincing, particularly because we know that the majority of overweight in the country does not reflect healthy lifestyles, the only biologically plausible explanation. Even more important, we know that more often than not, overweight children and adults eventually become obese children and adults. Sending the message that a little extra weight is all right may discourage these individuals from adopting lifestyle changes that can thwart the development of chronic diseases and extend years of healthy life." There's also other issues to consider, like poverty and genetics playing crucial roles in a person's weight - and having bad genes or coming from a poor neighborhood shouldn't have to count against you in the workplace.

Using indicators like blood pressure and cholesterol also stretch the limits of the amount of privacy an employee should be allowed to expect from an employer. Testing both blood pressure and cholesterol can involve invasive procedures that aren't appropriate in a work setting, and could potentially be used against the employee once they've submitted to being tested. The bottom line is that by linking benefits to anything other than exemplary work performance is a slippery slope. Whole Foods might be best off putting this ill-conceived health care insurance cost-reduction plan plan back on the shelf.