The "Wellness" Program at Penn State: The View From the Bottom Up

I have been considering how (1) the American infatuation with eugenics, (2) the nation's culture of permitting the private sector a vast area of unchecked discretion that affects the individual human dignity of employees, and (3) the natural goals of U.S. enterprises (both for profit and non-profit) to maximize income and minimize expense, have contributed to the move toward the current interest in "wellness" programs being embraced by American industry.  Usually, employees, the object and ostensible beneficiaries of all of these programs, are rarely or adequately consulted.  And the relationship between employee welfare and enterprise cost cutting is less fully addressed than it might be.   It might be useful, though, for enterprises to have a sense of the reaction from the "bottom" as they develop, implement and operate such programs.

(Pix (c) Larry Catá Backer 2013)

I have also suggested the way these enterprise programs to make a "better" employee--one whose maintenance is "cheaper" and whose availability for greater work at lower unit cost with flat or declining salary--has found a home in the American university.  Penn State's recently announced version of this "wellness" program movement provides one of the more interesting examples of the operationalization of this tendency in the American workplace. This post seeks to provide a small window on some of the reactions from the "bottom" at Penn State. Please feel free to include your own comments, even if they are anonymous.  It may help those who have authority over this plan to think through additional issues of implementation and reform. 

These reactions may suggest the way that what to some may appear to be primarily cost reduction driven programs may be received in the absence of substantial outreach before, during and after conception, drafting and implementation.  It also may suggest the particular sensitivity with which an administration might want to approach programs that, at least in the view of some, have a potentially detrimental effect on the fundamental human dignity of employees. Lastly, it also evidences the increasing importance of meaningful transparency (at the formulation state), engagement and effective consultation.  Included are some links from prior posts that considered other bottom up reactions.

1. The most communal reaction has been public, a petition posted by Brian Curran of State College on Change.org and is directed especially to the structuring of the pricing structures of the program: Brian Curran, Penn State President Rodney A. Erickson, Benefits Office, and Trustees : Stop the New Penn State "Wellness" Program and its Surcharges, Changer.org. The peititon is available for signature by "Concerned Employees, Alumni, and Friends of Penn State University."  To the date of this post, the website reports 750 signatures (UPDATE: as of August 8th the petition had received at least 1000 signatures). Here is the description from the site:

Penn State's new Health Care policies, which have been rolled out quietly in the middle of the summer, include punitive surcharges directed against employees with spouses covered by the plan, as well as an intrusive "Wellness" initiative. The latter consists an excessively intrusive questionnaire, as well as mandated blood tests and a "biometric screening," both of these to be conducted by a third party contractee. Participation in this "initiative" is being punitively enforced by another substantial surcharge. While the university claims that the data collected from the questionnaire will not be shared with any university officials, as required by law, the Vice-President for Human Resources has stated publicly that data from the questionnaire will be used to impose yet another surcharge, on employees who smoke. Whether this was a mistake or not, it exemplifies the confusion that has attended the roll-out of this program. We ask that implementation be stopped, or at the very least delayed, so that further consultation with the employees and their representatives can begin.

The posting includes the text of the petition itself. Also worth reading for gauging reactions from the bottom are the comments posted to this petition website.  These may be accessed here.  Together, and putting aside intemperate responses and inappropriate argumentum ad hominem, these suggest the range and tenor of the concerns raised.

2. Some comments suggested a range of issues touching on the program and its coherence with the real situations of employees.  There is a sense among some that the plan was made for the convenience of the employer, but touted as one for the welfare of employees.

I am glad that the faculty are raising this issue on everyone’s behalf because staff members do not have quite this much freedom to speak out. I am annoyed by the unnecessary medical tests and the invasiveness of this plan. I am also feeling the pinch on the $100 charge for spouses who are eligible for insurance elsewhere but who elect to stay on PSU’s policy. My husband’s employer offers insurance…in a way. The deductible is six thousand dollars, which would be about two months of my take-home salary. So this is quite the one-two punch. I cannot avoid the $1,200 charge for my husband’s insurance. And my husband and I must submit to unnecessary, invasive medical tests to avoid another $1,200 punch.  I do question whether the powers that be have any grasp on how much the average employee is being squeezed by everything—child care costs that increase more than our salaries, the presence of “cost sharing” in our health plan over the last year, and now this. I remember reading somewhere that the average Penn State staff salary is about 40K per year. I tried to find that on the PSU news site and couldn’t locate it. At the very least, it would be nice if they could distribute this “fee” in a way that takes salary band into account. Surely a hundred dollars a month impacts a staff assistant at the lower end of the salary spectrum more so than the higher earners. 

 3. The issue of privacy was raised.  Especially concerning was the power given to the records administrator to batch and sell employee information without either employee consent or compensation. It was not clear that the university owned this information nor that it could unilaterally enter into an agreement by which it might derive a benefit from the exploitation thereof.

 "It looks like they can give your health information to “3^rd party vendors”, for example, pharmacies, who can then send marketing information to you, and also to our “plan,” I’m guessing that’s Highmark, and I don’t think it excludes the university.  Are pharmacies barred from further selling the information by HIPPA – they are pretty far down the line of parties?  You can opt out from this disclosure, the policy says, but, of course we can’t opt out unless we want to pay the $1200 penalty.  But wait, you say, they won’t tell the university your personal medical information – but then how are they going to charge the smokers the additional benefit unless WebMD discloses answers to the survey?  I shouldn’t be surprised, but ….  I started to read up on the policy after I got a nice email sending me to my personal page that lists not only my answers to the questionnaire but apparently mined insurance records since it includes doctor visits I didn’t list.  Is this thing going through?  Surely the university could have created a wellness plan that doesn’t include giving all my medical information for sale to the nearest 3^rd party. "

4. Human dignity and its relationship to perceptions of  abuse of power (understood as administrative imposition with limited consultation and disclosure beyond information sharing after the fact) was sometimes stressed.  The idea here was not that the university lacked power or that it could coerce employees to conform, but that such an assertion of power might adversely affect morale and the sense of the relationship of employees to the university (and of course, to the strength of shares governance). 

. . . coercive, invasive, and punitive health insurance policies created by PSU (while studies have shown that such programs do not save money, since additional medical testing leads to additional use of expensive prescription drugs and medical treatments that people would not otherwise utilize).

5.  Some comments expressed confusion; if it’s the “member’s personal choice” and not mandatory, why is the initiative a requirement that may cost each of us $1200?

5.  Another point raised focused on transparency and information dissemination by OHR. ,

6. A public and very thoughtful reaction was delivered by the faculty governance organization of the Brandywine Campus at Penn State.  These raise some of the issues most troublesome to faculty and staff and may reflect an emerging bottom up consensus about the parameters and scope of concern.   More on Penn State's "Wellnees" Program: Letter to the Faculty Senate From the Faculty Executive Committee at Penn State Brandywine

7. Another very public response, and one that generated substantial media coverage:   A Call to 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.

8.  University Faculty Senate leadership, from the time of the announcement until the date of this post, has chosen to remain publicly silent.  It is not clear, what, if anything, that group is doing.  But what is clear is that there is an appearance that they may be adopting an older style of leadership, one which rations its communications to its members, and which may be more comfortable with a model of centralized decision making within a small group of elected and unelected officials, the decisions of which may be vetted and approved by university officials before communication to the people who elected them and to whom they might be especially accountable.