Most U.S. employers and insurers offer financial rewards (and/or penalties) to encourage employees and insureds to make healthy choices like losing weight and quitting smoking. These wellness incentive programs will soon become ubiquitous because the Affordable Care Act endorses them and opens the door for bigger rewards. Trouble is most existing programs are poorly designed and inefficient, achieving too little reward for each dollar spent and often offending employees and insureds with a forceful “Big Brother” pathos that alienates the well-intentioned financier of the program. Many wellness incentive programs include higher healthcare premiums to directly penalize employees who make decisions that are costly and bad for their health—e.g. smoking or maintaining an unhealthy weight. Far from being positive and rewarding, for a typical worker already struggling to be healthier on her own accord, these programs behave like a credit card debt that never seems to go away. These programs occupy the same channel of anxiety that sometimes stimulates...
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