Waste watchers

Is the construction industry headed for a diet?

By Jennifer Pfaff

It's the best available job out there.

The interview goes flawlessly, and an offer is made and accepted. Now, all that remains before the first day of work is a trip to a local clinic for a pre-employment drug screen and blood tests.

And then, of course, there's the quick stop to be injected with a health-monitoring microchip.

Is it science fiction? Is it too Orwellian to be real?

Those out to protect privacy rights aren't so sure. And they're concerned despite Wisconsin and federal laws that prevent employers from monitoring employees' behavior outside the workplace.

The rapidly rising cost of health insurance is fueling a noticeable increase in employer concern for workers' well-being. Common measures taken now stay within the realm of encouraging healthier living, but there are those who worry the trend could carry too far, slashing the sometimes thin veil separating public from private life.

"Take smoking," said state Rep. Marlin Schneider, D-Wisconsin Rapids. "Some employers say you have to pay an additional premium if you smoke. I think that's fine.

"But other employers might want to use microchips or other monitoring methods to intrude into private lives."

Schneider is referring to implantable microchips that are banned in Wisconsin but in use elsewhere as identification tools in certain professions. It isn't a big leap to setting those chips to monitor blood pressure or blood sugar, factors that might make an employee unattractive for insurance purposes, he said.

Microchips might not yet be around, but there are still those potato chips to worry about. There are also hamburgers, cheese fries and chili dogs that can leave employers grasping their chests as they deal with increases in health-insurance costs.

And as those employers watch profit margins erode as the cost of doing business keeps getting higher, they begin to see it as a necessity to take a proactive approach to reducing claims, said Dan Ruder, vice president of Aon Consulting Inc.'s Green Bay office. Moreover, encouraging healthy eating, quitting smoking and exercising more can be done in ways that respect employee privacy.

"It is one of the last stands an employer can do to try and control health-care costs, to have employees become healthier employees," Ruder said. "For years, employees considered health insurance as a natural obligation from the employer.

"As the cost escalated, now the employer is saying, 'I can provide a credit card for you to use for health care, but you must now take better care of yourself.'"

And the logic is simple: A healthy employee is less likely to require high-cost medical treatment, and the fewer large claims that are made, the lower the cost of insurance for the employer.

For now, the building trades seem reluctant to follow the healthy living trend, Ruder said. Industry employees, he said, tend to be younger, more physically active and less likely to suffer major illnesses than older, more sedentary people.

Nevertheless, there are those in the trades jumping on board the health craze.

International Brotherhood of Electrical Workers Local 14 in Eau Claire, along with eight other locals, operates a self-funded insurance policy for its members, and the group is encouraging its members to be more health conscious.

"We need to be proactive," said Dean Licht, business manager for Local 14.

And there's a benefit to being proactive. To combat high premiums, insurance providers offer incentives for employees to live healthier. Ruder estimates that every $1 spent promoting wellness brings a $4 to $7 return.

The Green Bay Area Chamber of Commerce is banking on that. More than 130 member businesses formed the Healthy Lifestyles Cooperative last year and negotiated a health insurance package through Destiny Health. Recipients get high-deductible Health Savings Accounts and Health Reimbursement Accounts but must take a health-risk assessment and receive coaching if they have high-risk attributes.

"Destiny is offering us rate-cap incentives if we get a certain percentage of the people in the pool up to a certain vitality level," said Nan Nelson, the chamber's executive vice president and cooperative board member.

Mandatory, health-risk assessments are a growing tool in the insurance business, Ruder said, pointing out that the results are held confidential.

But just how far the corporate push for employee health will go is a matter yet to be determined. Only a generation ago, it was unheard of for an entire community to ban smoking in public. Today Appleton is smoke-free.

That could be a sign that healthy living will be influencing legislation in the future, Ruder said.

"We're going down the road now with the nonsmoking law, but it would be awhile [before employers could mandate certain good-health measures]," he said. "There are gray areas in forcing people. For instance, hereditary issues are at play in regard to things like body-mass index.

"There are some real gray issues when it comes to judging on results. And there is an employee-relations issue."

Madison-based privacy consultant Carole Doeppers is worried those gray issues aren't apparent to everyone.

"I think there is a line - and it's getting dangerously close - where employers are monitoring behaviors," she said.

She pointed to a court case involving a company monitoring an employee's alcohol consumption outside of work. The courts came down against such monitoring.

"When an employee is at work and using equipment that belongs to an employer, they lose a significant amount of privacy," she said. "But outside of work, that's where the line gets crossed. … I do worry about employee discrimination, because it is very hard to prove."

For now, Wisconsin has several laws - most notably the Health Insurance Portability and Accountability Act, which places strict rules on sharing medical information -protecting employees from that type of oversight by employers, Ruder said.

That doesn't stop companies from trying to encourage better health, though.

Some are removing junk food from vending machines or implementing a Twinkie tax and charging more for high-fat, high-calorie items. Others are opening employee gyms and bringing in mobile health screenings.

Although the IBEW's program doesn't require health-risk assessments or a Twinkie tax, it does include a Health Dynamics program that promotes good-health practices, Licht said.

"We're hoping if we show our members positive ways to take care of themselves, it will save us money in the long run, and it will save the individuals money, too," he said.

The message is spread at meetings, in newsletter articles and in one-on-one meetings with new members.

There are occasional grumbles, he admitted. Some members feel the emphasis on personal behavior and practices is an invasion of privacy - or at least opening the door for later invasions.

But times are changing, and most people recognize that, Licht said.

"There isn't the opposition like there used to be," he said. "A large majority understands and goes along with it."