25 November 2013


Spring is certainly not in the air, so a young man’s fancy does not turn to love. Rather, with the fall nip in the air, it’s time for that annual ritual of American corporate life, open enrollment for health care and other benefits. It’s time to find out how much your premiums and deductibles went up and your company’s contribution (inevitably, it seems) went down. But I’m not kvetching, really. I’m glad to have health care benefits, and I’m glad that the accessibility of that benefit now isn’t at risk should I, through choice or chance, cease to be employed. I am, however, kvetching over the assumptions that the corporate world lays upon the masses during this time of wonder.

The health of the average American is at a crisis level. Few would not argue with that; nor would I. But there’s a key word in that statement that gets forgotten in the application of large programs to large numbers of people: average. Yes, there is a problem with the average, but any average is made up of the proverbial bell curve, and people at both ends (as well as the middle) of that curve need to be handled appropriately. That often seems to be forgotten. A huge assumption gets made all too often that we are all average. We are not, and we shouldn’t be handled that way.

What spurred this ranting was a well-intentioned plan by Mighty Employer to encourage healthier lifestyles amongst its five-digit count of employees, not only out of concern for their general welfare, but with the hope of reigning in long-term healthcare costs. It’s a reasonable effort, and I repeat and phrase well-intentioned, because I ascribe no malice to this enterprise. It doesn’t take much looking to see plenty of people who could benefit from some changes. And nothing encourages like the Almighty Dollar, so Mighty Employer put some teeth behind their plan: this year, five hundred bucks of your benefit contribution is riding on making a reasonable effort to be healthy. So far, so good, nothing motivates like the Almighty Dollar. But here’s where things go sour.

Assumptions. America’s health may be in a sorry state, but that doesn’t mean you can assume that everyone’s health is in a sorry state. Yet it appears that they – if not the corporate benefits folks, then certainly the outfit they hired on to administer the program – do just that.

I’m not claiming perfection, genetic superiority, or general awesomeness. But despite my recent tendon and cloggy setbacks, I’m in pretty good shape, and to assume otherwise, and therefore tell me that I need to participate in programs to fix all the problems that you assume I have, well, that’s a little annoying to say the least, rather patronizing, perhaps even debatably insulting, but more important, it’s simply counterproductive.

Like many of these programs (yes, I’ve seen them before), there’s an elaborate point system, with the goal of amassing enough Magic Points to claim your Five C-Note Carrot. Family members are welcome to join in the fun, so Dearest Spouse and I sat down and filled out the online health assessment, which was harmless. We could win more points by placing an administrative burden on our doctor to fill out a form with basic stats (including, interestingly, neck size, thus guaranteeing more than just administrative work but an actual visit, burning their time and ours for something that never in my life have I had, or seen the need to have, measured). But that really doesn’t seem fair now, does it? Why place even more burden on Lady Doctor to work for free? Besides, that alone wouldn’t generate enough Magic Points, so we’d have to look further anyhow.

Ah yes, we can participate in Online Wellness Programs. What joy! Because, after all, if I was underactive, overweight, or otherwise afflicted, clicking on a web site would clearly change my behavior, right? Think of mom, smoking for fifty years, who ignores doctors and other real people, but who I’m sure would instantly change her tune when faced with the delights of a web site.

Skepticism of effectiveness aside, let’s consider the cornucopia of programs laid at my feet. A breadth of ten programs, all with cute names that needlessly trademark commonly used words, like the “Achieve® Cholesterol Management Program” or the “Care for Your Health® Chronic Condition Management Program”. Gosh, they had to trademark the phrase “Care for Your Health”?

So, let’s see… I can manage my cholesterol, which I’ve already done. I can control my blood pressure, which really isn’t a problem. I can care for back pain or those chronic conditions I also don’t have. I can manage depression or reduce stress, both of which running has pretty much handled (though programs like this are capable of inducing). I can sign up for a nutrition program, and while my diet isn’t perfect, I know what good nutrition looks like and what to strive for, and I really don’t care to be told to eat tofu on Tuesdays. Or I can quit smoking.

Question: Do I lose points if I start smoking, just so I can gain points by quitting?

Of course, I left one out of that previous list. It’s called “Energize®” (that trademark thingy again), and it’s the only one I can realistically sign up for which won’t constitute a bald-face lie. Now, I’m not into bald-face lies, especially just to get money, and yes, I certainly will exercise, so this isn’t a lie. So both Dearest Spouse and I plunged into this one.

Step back and consider that even in my injured and recovering state, I’m still tracking about a hundred miles a month. And Dearest Spouse, while not infected with the running bug, is highly active and hits the gym four or more times a week. So neither of us qualify as the Assumed American Couch Potato.

Into the woods! We dive in. And we are each faced with a multi-page survey of our present activities, how often, for how long, what do you think about this, that, and the rest. These queries are of course fraught with the usual, “I’m a robot and don’t understand reality” issues, such as when I tell it that I hike, which isn’t every week, but when it happens, often comes in the form of Adirondack Death Marches and the like, it wants to know, “How many minutes?” It rather freaks out when I tell it that I’m on the mountain for twelve hours. Whatever… We are both amused at the question, “Do you think exercise is boring?” to which we both answer a solid ONE on the one-to-ten scale where one is “I Live to Exercise!” and ten is “YES, It’s God-Awful Kill-Me-Now I-Can’t-Stand-This BORING”. OK, it didn’t use those phrases, but you get the idea.

You’d think the magic automated program might catch on, given an answer like that. But no, it assumes we are all…average. And so it takes over and generates a customized plan, just for you! Yes, with lots of exclamation points! I didn’t add those!

You can guess where this is going. The seventeen page (!) document produced is comical only to the extent that it not entirely sad, insulting, and completely irrelevant. Never mind the simple programming bugs (for some reason, every apostrophe comes out as three question marks), the content is largely inane and the attitude is patronizing at best.

It acknowledges that I’m “Staying Strong”, in the top tier, stage four of their lingo (good thing this isn’t about cancer!). But since Mighty Employer paid real money to Health Program Consultant who likes to Trademark Programs, they have to tell me that their Energize® program can help me improve my sense of well-being, manage my stress, maintain my weight, and tone my body. Yes, all this can be yours, just for the price of a few hundred clicks on a web site.

It gets better. I’ll quote directly a few times here while you hold your head out the window and vomit: “You're not alone. A lot of men in their 50's lose sight of their own needs.” Note to Composers of Introduction: I haven’t lost sight. They tell me how many men find it hard to stay active. Note to Perky Twenty-Three-Year-Old Copy-Writer: I don’t have that problem. They tell me I can keep up my current level of exercise, which they had to acknowledge exceeds the amount that experts recommend, and still have a life. Note to H.R. Benefits Staffers: I do have a life. They tell me that most people find that exercise gives them a net gain in energy. Note to those who can’t imagine it: DUH, why do you think I already do it? Their perkiness knows no bounds… “Great! Read on. It only gets better.” Good God, really? I’m only on page two!

I cannot begin to enumerate the masses of mindless mush that this customized report pours into the dumpster of my soul. I’m told why I like hiking. I’m told that if I’m overweight (which I told it I’m not), I should avoid running. I’m enlightened that mowing the grass with a power mower is an example of cardio activity. Really? Gosh, I didn’t know that! Do I get bonus points for my human-powered squirrel-cage manual mower? I’m given basic math lessons: if I add ten minutes of walking, I’ll make it to Portland, Maine, by the end of next year. Of course, if I ran during the time I spent on this program, I’d make it to Portland, Maine, by next month. But my favorite part has to the section where they state that, “Since you are already active, we suggesting building on what you’re already doing,” at which point they suggest (I’m not making this up) that I pace while I’m talking on the phone, take an extra lap around the grocery store, and when I run errands, park farther from the door.

Seriously. This is building on what I’m already doing? Do these folks realize that when I run errands, I run errands? I run to the bank. I run to City Hall. I run to the doctor. Heck, I run to the store if the object I’m buying is small enough. Can I park any farther from the door than that? Oh, and does using a bathroom on a different floor of the building (another real suggestion) really add to the exercise of one to two hundred (or more) miles per month? (Note to Clueless Writers: My home office is in the basement. There are no bathrooms here.) That’s why I use words like patronizing and insulting. Even before page fourteen, where they tell me how to cope with their view that I think exercise is boring. Hello?

I could go on, but you should be spending your time exercising rather than reading this blather. And that’s my point entirely: the time I spend clicking on their web site, playing their games, gaming their system, would be far better spent either actually exercising, or really working. Remember work? After all, I do think they want me to do that.

I can, and probably will have to, waste time clicking on their web site, trying to convince it that a hard interval workout at the track does satisfy the need for twenty to thirty minutes of moderate walking. But as I noted, it’s simply gaming the system. I called the benefits folks and tried to reason. I’ll send you training logs and spreadsheets. I’ll send you race results. You name it. Just don’t waste my time. No dice. I do have a senior manager in Human Resources lined up for a chat next week, and I am hoping to find some sanity in that meeting. I’ll happily eat my words to the extent success there guides.

At this point it’s no surprise to you when I say I can be as sarcastic about these kinds of programs as the most jaded and acerbic person out there, so it’s worth reminding you of my point. I get it. I see what they’re trying to do. I see the need, and it’s dire. There’s no question about that. I’ll also concede, sarcasm aside, that even though of questionable effectiveness, web-based programs (to be fair, in some cases followed up with human phone calls) are a tool in addressing a large population. But there has to be a safety valve, a sanity lever, a willingness to look around and recognize that a portion of your population is doing what you want them to do, so trust but verify, ask them to show you evidence, but believe them, embrace them, encourage them.

All I ask is that you don’t assume we’re all average.

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