A Call for Action and Civil Resistance for Penn State Employees

An Open Letter to Penn State Employees Concerning the University’s

New “Take Care of Your Health” Initiative

Dear Penn State colleagues,

Skyrocketing healthcare obligations are a serious problem that confronts employers across the nation. Although no organization is immune from the rising costs of healthcare, how organizations deal with medical inflation reveals something about their values. While there are no perfect solutions to ever-growing healthcare expenses, universities, like Penn State must resist the temptation to needlessly compromise its employees’ privacy and personal freedoms in a misguided effort to control costs.

Recently, Penn State University announced that, as part of its “Take Care of Your Health” initiative, employees would be required to “complete an online wellness profile” as well as undergo a “preventive physical exam” designed to “help employees and their spouse or same-sex domestic partner learn about possible health risks and take proactive steps to enhance their well-being.” Employees who fail to comply with this university-wide mandate will be subject to a $100 per month surcharge deducted from their paycheck, until they agree to comply or find other insurance coverage.

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.

It is, frankly, unrealistic to ask Penn State’s 17,000 benefit eligible employees to collectively refuse to participate in the program. First, the university’s $1,200 yearly annual penalty would represent a genuine hardship for virtually all university employees. Accordingly, it is unlikely that a call for a widespread boycott would generate meaningful support. Second, even if all Penn State employees refused to take part in such a program, the resulting fines 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.

To resist administrators efforts to implement this heavy-handed healthcare initiative, I propose university employees engage in acts of civil disobedience, designed to protect our rights, without subjecting individuals to the university’s draconian sanctions. To blunt the administration’s “Take Care of Your Health” initiative without enduring any needless hardship, I propose that university employees comply with the letter of Penn State’s demands in ways that undermine its potentially harmful consequences.

Step 1: Make arrangements to conduct Penn State’s “preventive physical exam” with your personal physician rather than through Highmark Blue Shield’s mobile medical teams.

Penn State’s human resource representatives have assured me that university employees will retain the right to have the “preventative physical exams” performed by their personal physicians rather than with Highmark Blue Shield’s mobile medical staff, provided their doctors fill out a form listing the results of the mandated tests. According to the July 11th press release, these tests include “a full lipid profile, random glucose, body mass index, waist circumference and blood pressure check.”

While I’m distressed that the university feels that it can require medical testing, there are several reasons why Penn State employees should take advantage of the opportunity to satisfy the mandate by scheduling a visit with their personal physician. First, scheduling a consultation with their doctor will ensure that this information is taken in a safe and comfortable environment, rather than in a mass clinic run by the university’s insurer. Second, as an agent employed by the university to contain healthcare costs, Highmark Blue Shield is not, by definition, always looking out for the employee’s best interests. By contrast, an employee’s doctor is entirely concerned with their health. By discussing their medical concerns with their physician, employees can be assured that the advice is tailored exclusively to their needs, and is not commingled with interests of the insurer. Third, 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.

For those who want to take this a step further, Penn State employees might want to consider asking their doctor for a note attesting to the fact that they have undergone all of the required screenings, but will not report the results on the certification form. Technically Highmark Blue Shield has access to these medical records. They can retrieve these results on a need-to-know basis. Therefore, if the university is really just interested in starting conversations about “possible health risks” and encouraging employees to “take proactive steps to enhance [employee] well-being” certifying that we’ve conducted the test and met with a doctor, should be more than sufficient.

Although I remain concerned by the precedent of mandatory health screenings, it would be wise for the employees to comply with the health screenings in a manner that minimizes Penn State’s involvement in the process.

Step 2: Complete your online “wellness profile” by feeding the database ludicrous information.

As an academic, I value truth as among the highest personal and professional virtues. Our profession is built on an honest appraisal of facts, and on the dissemination of truthful information. However, I’m also a firm believer in liberty and privacy. In coercing university employees to put their medical information online, Penn State has crossed so many ethical lines, I believe that the only reasonable response is to dutifully create the “wellness profiles” and fill them with junk. I, for one, plan to stack my profile with ludicrous information that neither discloses my personal medical history, nor provides the website sponsor (WebMD) with useful information that can be used to study Penn State employees.

To fully appreciate the serious ethical breech that is being perpetrated by Penn State University, in requiring that we fill out these “wellness profiles,” consider how these tactics would be viewed if employed by any university professor when conducting an academic study. In a university setting, the use of human subjects, whether for medical experiments or survey research, is governed by an institutional review board (IRB) whose primary objective is to ensure that studies conform to high ethical standards. First and foremost, university IRBs require that studies involving human participants are conducted with their full consent, free from coercion (whether physical, financial or psychological) of any kind. Furthermore, even if participants do volunteer to participate in a survey, they retain the right to opt out of questions which they find embarrassing, threatening, or simply too personal.

A cursory look at the survey component of Penn State’s “Take Care of Your Health” initiative reveals that the university’s actions don’t meet either of these basic criteria. First, by definition, the University is securing participation in the wellness profile through coercion, docking employees $1,200 for every year that they refuse to take part in the online survey. Second, in order to complete the wellness profile, applicants are required to answer each and every question built into the survey. When asked if their doctor has diagnosed the respondent with colon polyps, ovarian cancer, prostate cancer or depression, the website options are simply “yes” or “no.” Similarly, male respondents are required to disclose if they perform a “monthly testicular self-exam.” Female respondents are required to report if they conduct regular “breast exams.” As it is designed, the online wellness profile prohibits participants from opting-out of questions that the respondent deems embarrassing, too personal or simply inappropriate. A failure to answer any of the survey questions generates a red flag beside the omission and participants are prohibited from advancing to the next page of the WebMD profile. Therefore, refusing to answer any one of the questions, makes it impossible to complete the profile, and under Penn State’s rules, subjects them to the full financial penalty for opting out of the mandatory “Take Care of Your Health” initiative.

It’s worth noting that, it’s entirely possible that these sort of intrusive questions and coercive tactics are permitted under the Patient Protection and Affordable Care Act. Whatever one thinks of Obamacare, the healthcare reform has had a number of unintended consequences. Even so, an act of Congress does not suspend the university’s moral obligation to secure participation in a fair and ethical manner. Whatever the legalities of this survey, if the online “wellness profile” could not withstand a basic IRB review, I do not believe that Penn State employees are under any moral obligation to feed this database with useful information.

As to the logistics of subverting this online system, I, for one, will fill the profile with absurd information, to emphasize that it is not my intent to deceive Highmark Blue Shield, but merely to comply with my employer’s unethical mandate. For example, by my profile, I’m 3 feet 8 inches tall, I weigh 50 pounds (the minimum values permitted by the website), and my last cholesterol test was performed when I was six months old. Others might be concerned that pumping the database with ridiculous information might raise red flags down the road. Some conscientious objectors might take a different tactic, opting to fill out their profiles as if they were in peak physical condition (6 feet 2 inches tall, weighing 180 pounds). Like me, I presume that most dissenters will opt out of disclosing any actual medical ailments.

When I raised the possibility that faculty might protest by filling these WebMD profiles with nonsense, Penn State’s HR representatives confirmed that the university has no way of verifying the veracity of the information placed in individual files. The university is operating under the assumption that employees are going to voluntarily turn over their personal information, even though we’re being coerced to participate in the program. By their estimation, we’re too docile to do anything but fully cooperate with the university’s demands. I believe the university administrators are in for a real surprise. Given the employee’s resentment at being forced to take part in this wellness profile, without any meaningful enforcement mechanism, I suspect participants will complete the survey. Nonetheless, I doubt much of the information will bear any relationship to their actual health practices or physical condition.

In calling on Penn State employees to engage in a passive resistance to the university’s “Take Care of Your Health” initiative, I’m not suggesting that the university surrender to skyrocketing healthcare costs, or sit on the sidelines when it comes to promoting healthy lifestyles. If the university wants to promote good eating, health clinics, and smoking cessation programs, they have my full support. If the university wants to encourage employees to take advantage of WebMD’s wellness profile, I don’t see the harm. As long as Penn State confines itself to gentle advocacy rather than outright coercion, it will enjoy the broad support of its employees, as well as the public at large.

While I am a proponent of diet and exercise, and I recognize the financial advantages of healthy living, Penn State University must respect the personal choices of its employees. If its efforts to encourage healthy living aren’t enough to change people’s lifestyles, then I, for one, am willing to bear that additional cost. In the end, privacy and personal freedom are more important than securing modest healthcare savings many years down the road.

Whatever its merits, the use of financial penalties to compel compliance with its paternalistic “Take Care of Your Health” initiative is simply a bridge too far.

Sincerely,

Matthew Woessner, Ph.D.

Associate Professor of Political Science and Public Policy

University Senator, Penn State Harrisburg

59 thoughts on “A Call for Action and Civil Resistance for Penn State Employees

  1. Does HIPPA permit an employer to do this? And can an employer force an employee into an invasive procedure (blood taken)? I would be very interested in learning more about the legal frameworks that apply.

    • I am not sure how to post a comment here. like the idea of civil resistance but I have a question about giving wrong answers – the insurance company has access to our doctor’s notes. If someone gives false answers to this survey, would it be considered insurance fraud? Extending this line of thought, if someone accidentally understates a certain personal practice (e.g drinks per week etc), but actually drinks more than that, and their doctor’s notes reveals this, would it be considered insurance fraud? This biometric screening and wellness survey are very invasive and Orwellian. Our doctors can take care of our health – the insurance companies and employers are motivated by the bottom line – please don’t interfere with an individual’s health care! I like the idea of boycotting the biometric screening. Thank you for taking a stand… can the faculty collectively take legal action?

    • In that case, if 3rd parties can share, as long as those they share with are HIPPA-compliant, couldn’t the same be said of “4th parties”? “5th parties”? Where does it stop? HIPPA, in my view, applies to the FIRST party – period.

      It’s like having a secret, and everyone who shares it can just justify breaking trust by saying, “now, this is in the strictest confidence, okay”, until eventually everyone knows. Simply ridiculous.

  2. Professor Woessner, thank you for helping to lead public resistance to the Penn State Administration’s unethical health insurance initiative. It is a violation of the most fundamental of privacy and personal rights, and no employer should have the power to treat its employees this way. I will be joining you in this civil resistance against it.

    One more step for all employees (whose job allows them to do it) to consider: Schedule the screening exam with your private physician during weekday hours after the start of the academic year in August. If an employer coerces employees to undergo testing, it is a kind of work duty and can be done during work hours and displace other productive labor.

  3. I am so frustrated and feel violated and completely trodden upon by the University I once loved: My alma mater. I did complete the wellness profile with accurate ifno and now I regret it. Also, since I’ve completed the online questionnaire, I have been getting notifications that “new health information has been imported to my profile.” I am dismayed to find regular dumps of my claims data occurring-my past visits with presenting symptoms /diagnoses and prescription medications are populating my profile. We need to stand up to this stressful invasion and coercion- FOR OUR HEALTH!

  4. By entering FALSE information, does an employee run afoul of any federal or state laws? If so would the violation be criminal with a sentence for a felony or misdemeanor, or just a civil violation with an extra fine? Alternatively, would it be grounds for termination of employment or benefits? Either way, it would establish a record that you are willing to lie, and that record could dog you later in life.

    In my view “civil resistance” means to intentionally break “X” and being willing to accept the consequences. That’s hard to do when we don’t have a reasonable belief as to what “X” entails.

    There is an interesting alternative, which is to present yourself 100% ready, willing, and able to comply, at least with the parts of the program that do not legally require our consent, but stop short of agreeing to waive any legal claims one might have related to the procedures or record keeping if things go badly wrong. There is a possibility such language exists in the fine print for both the biometric screenings and WebMD. Since I’m not a lawyer, you should read it yourself or get counsel to review it before you accept it all. You can do that, using your PSU login, at the PSU yammer thread on point which is

    https://www.yammer.com/psu.edu/#/Threads/show?threadId=309290982
    (notice that begins https, not http)

    This alternative approach is for those willing to comply – who is against better health after all – but who are not willing to waive any right to sue if things go badly wrong. Presumably ICH will not do the screening, and if you know that the terms and conditions of WebMD take effect when you use the service, then you go that far and document your computer activity, but then its up to you to quit since you know the terms if they do say something you reject. Can the employee still be sanctioned $100/month? Beats me what the law says. In fact, I would not be the least surprised if such a case would chart new legal waters. But it would take litigation to find out.

    Meanwhile, the people who right the checks will naturally start deducting the surcharge from your paycheck, so those willing to go this road should be prepared to live with the deductions now that they took their stand, or else be prepared to sue to recover the money if you think it was wrongly withheld. For $1200/year no one is likely to risk the expense of solo litigation. So if this happens, it sounds like a class action lawsuit.

    That approach does not entail the use of falsehoods, which as a practical matter can come back to bite you in numerous unknown ways, and if you go in for that classical master of civil disobedience/resistance M.K. Gandhi, this approach preserves the integrity that is the root of all effective movements for meaningful change.

    Me? I’ll follow some part of the herd that wants to use the truth, whatever they do. I haven’t made up my mind as to which one.

    • I too am concerned about lying to anyone, including WebMD. Therefore, in my proposal I call on employees to enter information so ludicrous, it won’t be taken seriously. For example, I’m registered as 3 feet 8 inches tall, and 50 lbs. My point is, while I would prefer not to input incorrect information, since I am being coerced to take this survey, and I am not under oath, I retain the right to fill the database with junk. It’s my private health profile. I’ll fill it with what I prefer. You make a fine point that true civil disobedience entails taking the penalty. Sadly, PSU set the fine so high, they would be delighted to collect a bonus two million dollars from the employees. And this isn’t just about college professors. For many PSU employees, a $1200/year fine would not be financially possible. As I see it, the only way to fight back is to comply in a manner that frustrates their grand design. Thank you for your thoughtful comments. – Matthew Woessner

      • Your plan overlooks two things, however.

        The small overlooked thing is the WebMD terms and conditions probably allow for purging of nonsense from their servers, which would leave you in the same boat as those who opt out.

        The large overlooked thing is the administration’s Plan B: simply raise everyone’s premiums by $________. (more or less than $1200, I don’t know).

        I’ve got no problems with efforts to “frustrate their grand design”, but without a specific alternative goal doing so seems rather pointless. Do you have suggestions for a more palatable way the administration could try to hold down costs? Before you say “make it voluntary”, recall that we’ve had an opt-in program for 10 years that has had only spotty participation and costs are still “careening out of control”, as HR Director Basso put it on WPSU. I suppose they could ratchet up the things people could volunteer to do, and the size of the carrots. But money to do those things has to come from somewhere. Without increased revenues, whose budget or salaries should be cut to pay for it?

  5. in the recent wpsu interview (http://wpsu.org/radio/single_entry/LL-4758/stories), when asked how penn state identifies who is a smoker, penn state’s vp for human resources replies, “it’s very much an honor system…and like any employer, we have every reason to expect that our employees are of the highest caliber of honesty and integrity and that they would in fact *disclose on their wellness profile* whether or not they were a smoker or a tobacco user.”

    so, while we have been assured that the data in wellness profiles will be used for aggregate reporting only, apparently this is not the case.

  6. rx, It’s my guess that the claim “PSU does not have access” is based on the framework whereby the records are actually in the custodial care of a Highmark “vendor”. I wonder if that means WebMD is a legal “agent” and Highmark is its “principal”? If so, does that mean for purpose of record keeping and reporting there is an “Agent and principal” relationship between PSU and Highmark also?

    I’d like to see a diagram of the information flow from the WebMD server to the printer that spits out paychecks and tax statements. A legal amateur, I wonder if a person can truthfully say “PSU does not have access”, if they might are carefully using their words in a common language context? Probably. The bigger question is whether that is still true when the issue is discussed under the technical legal language governing “agent and principal”?

    Here are a couple important quotes from a 2012 article. (Reader beware…. passage of Obamacare includes an expansion of employer wellness programs effective sometime in 2014)

    “,,,,it’s becoming typical for large brokers and employers to add progressive requirements to wellness programs, going from simple questionnaires in the first year, to physical tests in the second, to required outcomes such as being tobacco-free or thinner in the third.”

    “If an average family pays close to $20,000 a year in health insurance premiums, and the health-factor differential could ultimately go up to 50% — you do the math.”

    http://commonhealth.wbur.org/2012/09/wellness-program-legal-limits

    Just for the record, I support a well thought out mandatory wellness program that comes with a feeling of community ownership. The only way to get there, I think, is with a much broader dialogue and running the show through the offices of Highmark’s participating primary care physicians, whom we all have to see for an exam anyway, and who already have all our records.

  7. I have a friend who attended the Biometric clinic and she has been harassed ever since she attended the clinic. They have called her numerous times at work, sent countless emails, and made her sign a release form that stated that she would seek immediate medical assistance. She went to see her doctor yesterday and she was 6 pounds less than the biometric screening, her blood pressure was 116/75 and at the biometric screening is was 136/90, and her sugar was 134 in the afternoon after eating breakfast and lunch and at the biometric screening it was 194 and she fasted for 14 hours.

    I can’t believe that they would intentionally skew numbers, but if they are, shame on them!

  8. Here’s a question: What about pregnant women? At 30 weeks pregnant, my waist circumference and weight are hardly valid or meaningful measurements and, in fact, these numbers alone without any other information put me in the category of “obese.” Will the insurance company now consider me obese? What’s more, many of these lab tests require a 12-hour fast. A fast of that period could be detrimental to my health and the health of my unborn child: No reputable doctor would ask that a woman in her 3rd trimester of pregnancy fast, so why should an insurance company or Penn State? Is Penn State willing to risk the health of their pregnant employees for this lunacy?

  9. This is a well crafted assessment of what PSU is doing with regards to their health plan. Unfortunately, PSU administrators, of late, do not have a good track record for being open and honest on most issues – as witnessed by the recent events pertaining to the football program. The health plan that has just been announced came solely out of Susan Basso’s office and any comment by that office to indicate there was a “buy in” by any faculty/staff group or committee is plainly untrue.The concept of giving ridiculous information on biometric information is a good one if the goal is to thwart the idea that the employees are coerced participants in a medical study. However, it is a sad indication that the bad behaviors on the part of PSU administrators – lack of being openness and honesty – are now being suggested as the only way to for the staff and faculty to mount a protest. The irony is not lost on me.

  10. To add to the comment about pregnancy, what about people with pre-existing conditions? My now-adult son was diagnosed with Type I diabetes at age 6. He is meticulous about his health, but he may not fit Blue Cross/WebMD’s definition of “healthy.” Is his blood sugar sometimes high? Yes, that is the nature of the disease he has. His overall control, however, is outstanding. He visits his endocrinologist 4 times a year, has regular blood work done, takes his medications, eats healthy foods, and exercises. But – according to some charts – his BMI is considered overweight. His doctor has told him not to worry, he is taking care of himself responsibly and does not need to lose weight (it is difficult for a Type I diabetic to do this, because it requires a constant balance and re-balance of meds, exercise, and diet). I fear the day pencil-pushers and bean-counters can over-rule the opinion of doctors, and penalize those who are self-aware and making good (for them) decisions.

  11. A technical question to the public – how can we fulfill the requirements and bypass ICH at the same time? How can we keep our personal information between us and our own physicians? The PDR form, http://ohr.psu.edu/assets/benefits/forms/PSUPDR.pdf, requires the info. to be faxed to ICH so it will end up in the same hands.
    My second question is if the Univ. tries to stay clear away from using the data to the disadvantage of their employees, what reason do we have to trust the multiple third-party partners of the insurance company?
    My third question is if the Univ. only wants to use aggregated data to figure out a “University health profile”, why should the info. be submitted individually with ID attached? Why can’t we just go get measured on campus anonymously?

  12. By the way, professor Woessner and Steve and others, I admire how outspoken you are. Many employees without tenure protection chose to grouchily comply. In this free country, too many still don’t have the freedom to part the job. With high respects.

    • Thanks, but I’m just a lowly adult student who happens to be insured in this plan through my PSU-employed wife. I did, however, take the lessons learned on the way to my Eagle Scout to heart. Citizenship entails participation, and the dialogue must be “trustworthy”, or it is all pointless. If my wife ends up with a slit professional throat because I still “believe” all that junk, then there is a much more serious problem at PSU than out of control health care costs. But yeah, I have qualms. And the only answer to all this is simply “The Truth shall set you free”.

      Which is why, in the Yammer thread I’ve linked before, I have listed various documents I would like the faculty senate to track down and make available.

      Maybe there IS a problem…. show us! Maybe there WAS research consulted… don’t show us what exists, show us what was used in the decision! Show us the actuarial report Dir Basso referenced, all the docs her team provided during “consultations” with PSU constituencies, and a diagram showing how the info will flow from ICH/WebMD to the printers that generate paychecks, compliance reports, and tax forms.

      If HR’s plan and the process they followed merits praise, there should be nothing to fear in making all these documents readily available.

      A lowly adult student doesn’t have much chops for asking for such things.

      But I hope the senate considers doing so, and making it all very public so we can make an informed assessment regarding the plan.

  13. Pingback: Penn State To Penalize Workers Who Refuse Health Screenings | Health Guide

    • I do want to point out that should you “click through” to the NPR transcript from which this was taken, you may find it a bit difficult to read. The transcript was apparently generated by Voice Recognition software that was not up the task. Having said that, Dr. Matthew Woessner, the author of the original open letter appeared on NPR this morning, Friday, August 2, and we do want to pass along what was said about Dr. Woessner’s comments. Thank you.

  14. They could have played this two different ways. First, they COULD just charge everyone $100 more per month as “just the way it is under Obamacare–and we wanted it, right?” Or they could flip the incentive, and instead of charging a penalty for NOT doing it, they could give you a $100 credit for each month for 12 months following the month you comply.

    Would you respond as negatively to a “reward”? Would you comply as readily if it wasn’t a “penalty?” Will Academics ever realize the folly of supporting Obamacare?

    Perhaps all rhetorical questions…

  15. regarding entering false info: i don’t believe this to be breaking any rules or laws, because this type of survey is outside the scope and realm of the doctor-patient relationship, and has no bearing on insurance coverage. The only thing it has any bearing on is invading privacy and increasing the cost of the participant’s health insurance.

    i don’t go to PSU but i wholeheartedly support this effort, and wish you the best successes. i am incredibly concerned about these new “wellness initiatives” taking place to invade our privacy, bypass HIPAA, and interfere with unbiased medical care.

    i am an ex-pharmaceutical industry employee, and the Big Pharma org employing me initiated one of these programs before I left. While they did not penalize employees who did not participate, they rewarded employees with a big gift card if they signed up. I was honest in my answers. i quickly regretted participating at all, and wish i’d provided “perfect” answers to their questions. They made assumptions based on the types of prescriptions I was taking, and started sending me mailings about the disorders they assumed I had based on the prescriptions. They called me several times a week trying to sign me up for various extra programs. I would ask to be removed from these lists, only to be told they had no control over the lists, as it came from my employer. Finally after many months, someone who called was able to remove me from the lists, after I explained I did not sign up for the program in order to receive any kind of health literature or phone solicitations and that my health was being managed by the providers on my healthcare team. The representative was quite nice, but this was after months of weekly (or more frequent) phone calls and dozens upon dozens of mailings.

    My favorite part of the online profile was when it asked for lots of dietary choices and information. I eat a plant-based vegetable-heavy diet (less grains), so it immediately told me I wasn’t getting enough fiber (eat more whole wheat!) or protein (eat more meat!)… both of those are bad for my health personally (celiac, high cholesterol), so not only was a lot of this propaganda overwhelming and unwanted, but it was downright incorrect and harmful.

    just say NO!

  16. You’re all missing a major point: the intrusiveness and coercion are not even the biggest problems. the biggest problem is that this stuff does not work and can even harm employees through overdiagnosis. PSU got horrible advice. I have written extensively on this in the Wall Street Journal, the Health Care Blog, Harvard Business Review, AOL, Health Affairs and elsewhere, with Newsmax and Modern Healthcare coming out this week. I have written two books on this topic (one an award-winner, both insurance industry trade bestsellers). WebMD in particular gives bad advice and I have an example right on my website. Please see the “in the news” section, that links to all these articles. www. dismgmt com

    I’m not anti-Obamacare. I am anti-stupidity and this is a fabulously stupid idea.

  17. To Matthew Woessner, Ph.D.:
    As a health professional involved in workplace wellness I wanted you let to know that not all of us believe in this kind of intrusive, coercive, incentive-laden nonsense – Congrats on standing up to this and sharing this powerful letter with others, who from the responses are obviously feeling the same way. Just wanted you to know there is a growing group of us who are working to turn this craziness around, and that we are meeting with employees from all over the country who are fed up with being forced to be healthy! – thanks again for this – Jon Robison, PhD, MS – Michigan State University

  18. You folks are all missing a major point: NONE of this wellness stuff even “works” — PSU (meaning ultimately you) will lose money on this deal and if you take the advice these programs give, you are more likely to be overdiagnosed than helped. I have written extensively on this topic — The Wall Street Journal, Health Affairs, Harvard Business Review, and also two trade-best-selling books. They can be linked to from my website, www dismgmt com. In particularly see the articles about how wellness can be hazardous to your health. WebMD is singled out in one of those articles.

    Further the vendor often pays the consultants to be “placed” by becoming a “preferred vendor.” I don’t know if that happened here, but if it did you have grounds for a class action suit.

  19. Pingback: A Call for Action and Civil Resistance for Penn State Employees | paaaup – Khanna On Health Blog

  20. I wonder if PSU doesn’t feel conflicted or hypocritical that at the same time they are demanding these biometric screenings to lower health care costs, they operate and profit from the bars, cafes and vending machines selling chips, candy, cookies, doughnuts, soft drinks, pizza, alcohol, etc across campus?

  21. Maybe Penn state should not offer health insurance at all.. how would everyone like that? If they are paying the skyrocketing costs of healthcare associated with poor individual health choices they should have the option to try and control those. Most employee wellness programs are seen as a benefit, they are trying to make it easier for employees to live healthier lifestyles. If you don’t like it try your hand in the individual market…

    • Sorry for leaving so many comments but there is so much misinformation going on here that I feel compelled to. The problem with your comment, Tanya, is that the penalty is $1200 whereas total wellness-sensitive medical events — the avoidable cost of high risk factors — is about $300, of which about $200 is not likely to be controllable, leaving a ton of fuss being made over the possibility that Penn State might save $100 in a perfect world, though quite literally no one has ever saved a nickel.

      Most of the rest of what drives healthcare costs has nothing to do with eating more vegetables.

    • Well Tanya, that might be the case if either of your assumptions were grounded in scientific fact – 1) the skyrocketing healthcare costs have little to do with individual health choices and everything to do with greed and SES – see the extensive recent article in time magazine – and read The Last Well Person by doctor Nortin Hadler or How We Do Harm by Dr. Otis Brawley – and 2) though most wellness programs at the worksite may “be seen” as cost saving there is actually very little evidence that they do much more than cost shift to the poor and disadvantaged. Read Why Nobody believes the numbers by Al Lewis and Crackin Health Costs by Tom Emerick to see why this is so – oh yes – and there are decades/hundreds of studies showing that trying to pressure, coerce, incentivize and shame people into changing behaviors of all kinds and health behaviors specifically not only doesn’t work but ends up causing lots of iatrogenicity – Read Alfie Kohn, Punished By Rewards and Drive by Daniel Pink, and anything by Deci. – Jon

  22. Tanya– you’re either setting up a straw man or you’re genuinely missing the point. No one is saying something doesn’t have to change, but whatever the change it should be intelligent, thoughtful, and ETHICAL. Violating people’s privacy with tactlessly intrusive questions and lab tests that don’t even allow for a stipulation of pregnancy (see my other comment above) is neither intelligent, nor thoughtful, nor ethical.

  23. While I agree that they have implemented this poorly, I think everyone is missing the fact that the alternative solution is higher insurance premiums for everyone. Preventative care saves money in the long run. I believe this is Penn State’s way of trying to reduce the amount that employees have to pay for insurance benefits. If they had set it up such that there would be a $100/month reward for filling out this survey, I bet there wouldn’t be so much resistance to the idea. Calm down people.

    • Except that it doesn’t. America’s insured population is drowning in prevention already. This so-called preventive care is (according to the Journal of the American Medical Association) far more likely to lead to overdiagnosis, overtreatment and overprescribing than “find” something. And Penn State will spend a lot more money Typically, HR Departments and their benefits consultants don’t read the literature — this is a perfect example.

      I might recommend the books Overdiagnosed and Overtreated (two different books), as well as that JAMA article and my own book, Cracking Health Costs.

  24. In terms of the $100/month, does anyone know for sure if that’s a penalty or a reward? Has anyone looked at cost of comparable healthy insurance plans at other institutions? I think only after comparison, can we decided what that $100 really is. For example, if our healthy insurance cost is $200/month w/o the $100 deduction, and employers at other institutions pay $200/month as well, then the $100 is really a reward, not a punishment.

  25. Allison, I want to reinforce the reality that the preventive measures like those being foisted on employees at Penn State do not in fact save money. Additionally and more specifically there is no data to support cost savings from the use of differential insurance premiums to drive health behaviors and outcomes (see – Redesigning Employee Health Incentives — Lessons from
    Behavioral Economics. Kevin G. Volpp, M.D., Ph.D., David A. Asch, M.D., M.B.A., Robert Galvin, M.D., M.B.A., and George Loewenstein, Ph.D. N Engl J Med 2011; 365:388-390 August 4, 2011 DOI: 10.1056/NEJMp1105966) – and quite a bit of evidence that the actual result is cost shifting to those who can least afford it (see – Wellness Incentives In The Workplace: Cost Savings Through Cost Shifting To Unhealthy Workers – Health Affairs) which is why organizations like The Prevention Institute oppose their use – that’s right – The Prevention Institute! Finally, people who really understand about health should be aware that the best way to ensure poor health is to increase people’s stress – and coercing them to do stuff they don’t want to do without even giving them a say in the process is a sure guarantee to do just that! – Jon

    • “people who really understand about health should be aware that the best way to ensure poor health is to increase people’s stress – and coercing them to do stuff they don’t want to do without even giving them a say in the process” – Brilliant! My blood pressure went down a tiny bit as I read this.
      But I am still under threat: to pay $1200 or to throw out my very personal data to no-one-knows-where-it-ends-up? This “healthcare” thingy has negatively affected the health and morale of many coworkers I spoke with.

  26. Pingback: Cracking Health Costs » Penn State employees fight back against wellness

  27. Pingback: Penn State to Faculty: We’re Doing This for Your Own Bad | The Health Care Blog

  28. I attended the screening at UP yesterday. When I asked for a copy of their privacy policy, the version provided was in 5-point type. It was illegible to a person of ordinary eyesight. I would encourage those participating in the screening to ensure that they receive a legible version of the privacy policy. I wrote to OHR after the screening and received the following reply: “Thank you for bringing this to our attention. As you mention in your note, the information the privacy policy contains is required by law to be handed out to each participant. The language is similar to the notices provided by physicians and lab offices but it should be easy to read and I agree that what you received needs to be changed in the immediate. After I received your note, I directed ICH to make several legible/larger print copies of the privacy statement available at the registration table for easy reading.”

    • I asked for the info in a larger font and did get it after several minutes. It was not easy for the person to find. I took my copy to read later after skimming it at the site. I was going to read it at home tonight, but I think I should read it at work. After all, this whole thing was PSU’s idea not mine. I have to wonder if everyone else’s productivity is as low as mine these days. By the way, the Teamsters are exempt from this. Duh! We should be organizing before things get even worse.

  29. Did you know that after completing the survey, HealthAmerica will not only give WebMD all your medical history (doctor visits, prescriptions, etc), but they will also give them any psychological visits as well! Why does WebMD need to know if I saw a counselor??? It was only to discuss my marriage and to get some advice and they put it down as depression!

  30. Cmon, why would you expect anything else from a university administration that spent years covering up the systematic molestation of young boys from one of their own? Also, they have to pay the monetary penalties and one way to do that is to find a way to extort it from the rank and file.

  31. Pingback: Penn State Wellness: Fear and Loathing in Happy Valley, PA | In tEWn

  32. Pingback: Hyper Obedience, Malicious Compliance and NYC Cycling | A Disorder of Things

  33. This information is private and not the concern of Penn State University. I seldom go to a doctor unless I am sick, even for wellness checkups. Tests are just a way to get you in and claim you need to come in for more tests or to find something wrong with you that you don’t have. It is a money making thing for the doctors and labs. My file is so thin, one substitute doctor thought I was a new patient one time. Last year though, I hurt my arm and was off for 7 weeks and finally have recovered from a dislocated shoulder injury.. If a person is already well and does not cause high medical bills, that person has no need to be subject to any type of penalty. There is a wellness incentive at my job that gives an employee $250 in cash I believe for going for wellness tests. I am already well so I see no need to go for that incentive and it is not worth getting a free $250 cash. What I weigh, my blood count levels, etc is my business only. The people who not take care of their health, eat badly or ignore organic food, don’t exercise, etc—they bring the price of medical care up by their own conduct. A healthy person then has to pay extra because they have to cover the ones that don’t take care of themselves. If I have high medical claims, maybe single me out if you must, yet if I am healthy, leave me the heck alone. CVS Pharmacy is doing similar to their employees this coming year. I have boycotted their store with my money, though it does me no good. At least my money doesn’t go to them. However, if Penn State goes forward with this invasion of privacy here for their employees, I hope they lose all their football games and lose all their major donors as well. Allow the survey if must and if they fill it out, then give then a deduction on their insurance premium as a motivation factor, yet do not punish them for wanting to provide data that is not of any importance to the university bosses. Anything can be hacked. Screw the survey–give silly answers. I am not going to pay a doctor visit and freely let them stab my fingers for blood to satisfy some dumb survey that has no value to the Penn State bosses. Employees, keep up the fight on this. Money talks. Penn State donors, undonate your funds to this university and maybe it will hit home. If you do undonate, do not give it back to them if Penn State complies and does away with the survey and penalties as Penn State would do it again. Otherwise, it will be in your back door next with government requiring it in order to get Medicare or Medicaid benefits, etc. I am an Okie yet the wellness programs show that they really don’t work. One can force someone to be healthy and make proper decisions. Next thing, they will tell you how to breathe, what to eat, etc. Penn State boss–you’re totally wrong on this. Down with PEnn State.

  34. Pingback: Preventive Health Science Gets Expelled from Wossamotta U | In tEWn

  35. Pingback: Technophoria: On Campus, a Faculty Uprising Over Personal Data | Technology in America

  36. Pingback: Technophoria: On Campus, a Faculty Uprising Over Personal Data | HEALTH OF PEOPLE

  37. Pingback: Technophoria: On Campus, a Faculty Uprising Over Personal Data | Health Of US

  38. Pingback: 2013 09 16 NYT On Campus, a Faculty Uprising Over Personal Data – NYTimes.com | AIRSTRIP ONE USA

  39. Pingback: Privacy Lives » Blog Archive » New York Times: On Campus, a Faculty Uprising Over Personal Data

  40. Pingback: On Campus, a Faculty Uprising Over Personal Data | Vaniceseasonal's Blog

  41. Pingback: NYT: On Campus, a Faculty Uprising Over Personal Data | Take Back Our Health Care

  42. Pingback: Is Penn State’s new health assessment legal? | The Incidental Economist

  43. Pingback: On Campus, a Faculty Uprising Over Personal Data – NYTimes.com

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s