Biometrified

Stubborn
The tall, slim receptionist took my information and motioned for me to have a seat. “He’ll be with you in a moment,” she murmured sweetly. 

I settled myself into a nearby chair and pulled out my smart phone. Time to catch up on some blog reading. 

At one point I looked up from a post and saw the woman take a bite of a candy bar. She turned to a coworker standing next to her and whispered loudly, “My biometric screening appointment is in two weeks. I have to start my liquid diet tomorrow. I need that discount!” Her coworker mumbled something inaudibe in commiseration as she munched a largish chocolate chip cookie* then said, “There is no way I will ever have the right waist circumference. I just don’t even bother to try anymore.”

Is a liquid diet healthy when the rest of the year you eat like crap and don’t exercise? Apparently her employer thinks so. 

Many employers appear to think so.

I have serious issues with companies who discount insurance plans based on whether or not an employee falls within an assigned range on their blood sugar, cholesterol, BMI, and blood pressure. Does it really improve health? I am skeptical. 

High cholesterol effects, blood pressure issues, diabetes complications… generally are not going to cause an increase in health expenditures until much later, presumably when patients are retired or no longer employed. So why would their employer care now? Between the two of us, it smacks of a way to force employees to pay for more of their own insurance costs. I wonder how much that saves corporate America? 

So sorry, that’ll be an extra $600 in our pocket. Better luck next time!

It isn’t just that I hate taking the time to fill out the forms for patients, though they are tedious. It feels like a terrible invasion of privacy. Why does an employer need to know if your blood sugar is under 100? What difference does a 102 make to whether or not you can do your job? What does a 102 mean for absenteeism, productivity, customer satisfaction, or anything else they want to measure?

“My employer seems to really care about my health. They gave me a free pedometer!”

“Has that made you walk more?”

“Well, no…”

Each program, it seems, has its own unique set of thresholds… some want a blood pressure under 140/90. Some want a blood pressure of 130/70 or less. Some want a BMI of 25 or less. Others want a BMI of under 30 or even 35. Some don’t care about where you fall, they just want you to submit the numbers. Others want you to enroll in an online health class or two. I have never had a patient come in, however, and tell me that they saw the light after one of those classes and have decided to change their ways.

Many companies require employees to go to a screening at HR rather than heading to their own physician. They have a lay person interpreting those results and giving suspect advice to my patients that can take several office visits to undo. Worse, many patients then believe they then don’t need to do a physical with their primary care physician. I lose my one opportunity each year to catch patients up on their PAPs and mammos and colonoscopies, my one opportunity to screen for depression and to talk about healthy lifestyle.

Here’s another thing, though. There are people who have “high” cholesterol who are in great physical condition otherwise and yet, because their LDL is above a certain point, have to pay considerably more for their health insurance. What difference does an LDL of 148 make when the HDL is terrific and there are no other risk factors for cardiovascular disease? I wouldn’t be putting a healthy 24 year old patient on a statin drug because their LDL is 130 simply to get them below 120 for a better insurance rate. And then there is the issue of diabetes. It is a false perception that diabetes is only about diet and lifestyle. It is a genetic predisposition. Is it fair to punish you because your diabetic parents decided to have children? Ultimately it is a form of genetic profiling and I am surprised no one has made a bigger issue of this. 

We have a version of this for employees of the healthcare system I work for. There are tons of invasive questions about my daily habits and diet and exercise routines that I am required to answer and then I have to submit my screening numbers and measurements electronically to HR in order to receive the discount. We don’t have to meet certain criteria on those numbers… yet. I choose to opt out. I have the financial luxury of being able to do that, paying more for my health insurance. Many people, though, don’t have that ability.

So what are your thoughts?

*Please note, I am not saying here that chocolate OR cookies are inherently evil. In fact, they can be part of a healthy diet.

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103 thoughts on “Biometrified

  1. I agree with everything you say. A lot of illnesses or conditions have nothing to do with the way people take care of themselves and it’s a mistake to assume that people who get sick did something to cause it. RA and other illnesses run in my family. I shouldn’t pay higher premiums because of it.

    Liked by 2 people

  2. This is quite thought-provoking (translation: quietly terrifying, as are so many things these days). We have only the illusion of privacy. Sort of makes you wonder what’s at the ends of all those slippery slopes. Thank you for making us aware of these encroachments.

    Liked by 2 people

    • That is my perception, too. I did not do an exhaustive search, mind you, but it is hard to find info on whether or not these invasive programs, requiring specific detailed health info, are really improving patient health in the long run. I think an appropriate approach would be to simply require documentation that a yearly physical was done is the best way to go.

      Liked by 2 people

      • Oh, I know. I’m also implying they have no right to up-charge me for demanding my right to privacy. Charging me more unless I’m willing to surrender my personal boundaries is absofuckinglutely ridiculous.

        In any case, medical care should be affordable by everyone. Pay for a pretty nose job or bigger lips out of your own pocket. You’re 60 and can’t get it up? You buy your own goddamned little blue pill, or every single birth control method, every menstruation product, and every single kind of HRT better be free. Legitimate medical needs should be covered by the government, no matter what. Cancer? They pay for your chemo, or your hospice, or whatever it is you need. Acne? They can pay for Proactiv. Cavities? Glasses? Ulcers? Broken arms, babies, Crohn’s, lupus, WHATEVER — we shouldn’t have our health held hostage by middle men who want to increase profit margins.

        Doctors should be free to learn and practice their craft without worrying about red tape, med school loans defaulting, and fighting with bureaucrats who don’t know anything about medicine and are only concerned with bottom lines.

        No one should have to jump through stupid hoops to receive necessary care.

        Just my two cents, obvs.

        Liked by 1 person

  3. Doesn’t sound like a good way to measure health or present it as a perk to be within certain parameters. Better to simply have a wellness program so everyone would be better educated rather than have some kind of a “cherry” plan (as in cherry picking) on who should be in a discounted tier because their BM is firmer than the next person’s.

    Liked by 1 person

  4. I had no idea employers could do this. I worked for many years under the aegis of a strong union that would have never tolerated such treatment of their members. I guess if you want to be healthy, work in a field where you can join a labor union.

    Liked by 1 person

  5. When my doctor explains results to me in hard numbers (your risk of heart disease is x number because your bloodwork came back with y results) I take him at his word and make an effort to follow his advice.
    When I stop at a big box store to grab dog food and decide at the last second to pick up a package of pasta because I don’t have time to make it myself on the odd occasion I eat it – and find myself having to choose whole wheat pasta because the big box powers that be think it’s healthier for me – I leave the pasta on the shelf.
    I think we are all intelligent enough to know what to do in terms of leading a healthier lifestyle. I can’t imagine my employer dictating how I should eat, what I should weigh, or telling me to track my steps.

    Liked by 1 person

  6. My husband and I both used to have to do this for his employer. Fortunately, they figured out it wasn’t really working. I think it is beyond invasive to a persons privacy. These issues should be ONLY between a patient and their doctor.

    Liked by 1 person

  7. Blargh. I hate corporate ‘merica and this BS. I hate health insurance (and as you know, I’ve worked with it a lot). I don’t care what I weigh or do, I have genetically high blood pressure. It is easily managed with a cheapo drug, and has been for decades, through literally thick and thin. At one point it was a pre-existing condition that screwed me up with insurance. Now, as you say, there’s a good chance if I get another job in a corporate world, it could increase my rates, too. That and my BMI. I don’t get bonus points for not smoking, rarely drinking and meditating. Funny, huh? One of the many reasons I’m trying to look for work in a small, privately owned business, so Big Brother isn’t quite so invasive. Quite. Mantra singlepayersinglepayersinglepayersingle….

    Liked by 1 person

      • Ah, good to know. I also have white coat hypertension, but generally it goes away by the end of the session and we retake it. 🙂 Pre ACA even with the meds it was enough to count as a pre-existing, at least for one company (I forget all the details). Sadly, my BMI can’t be undone by the end of a session.

        Liked by 1 person

  8. 😂 when I went for a job at a public hospital they made me go for a medical exam. Their doctor is pretty crappy but oh well you need to do what you need to do. So they measured BP, took my medical history and asked if my vaccination is up to date . That is all.
    Over here we pay for our own private insurance. I have hospital and extras for the whole family. My oldest is going to be 21 years old soon but she will be covered under our policy as long as she’s a student and still a dependent. Once she start working then she will need to take out her own.

    Liked by 1 person

  9. This is discrimination at its finest.It is culling the employees for information that they have no basis for knowing. We are doing a screening as part of a health fair next month. If we get 50 people, they will report it to the company. They decided not to tell anyone who is getting the screening. You have to register to have it done because we have to bill THEIR insurance. So there is NO privacy here. We also have to do a health assessment every year which includes disclosure of meds your on. Don’t think that being on a $20,500.00 shot will make a difference in who they fire?? Again, discrimination. Mandatory screening is also a way to pinpoint the elderly employees who by course, will have worse numbers and more medications. And how does being over weight impact my job? By the job description, I have to be in my chair at my desk or sitting in meetings or teaching. I am not running any marathons here. I can lift 50 lbs. What business is it of HR or anyone in a company what my BMI is? You have no idea how much this rankles me. We almost went to a discounted insurance for those who were in “perfect health”. I complained about fat discrimination, and ageism of course was “looked at.” We did not do it, but it will be reality someday unless it is stopped.It is supposed to be cost productive but in reality, it is Big Brother at its best.
    You want to make employees healthy? Stop stressing them out.

    Liked by 2 people

  10. A former employer of mine did this including using the measurement of our waist in inches. (What about different body types?) If we didn’t meet *all* of the thresholds then for the discount then we could negate it by logging a certain amount of exersize monthly into a website they would check. It felt like a huge privacy invasion to me at the time, a way to fat-shame as well as cut their own costs. I understand this has become increasingly common but it doesn’t mean it’s right.

    Liked by 1 person

  11. I think it comes down to “predictions” of future cost-but there is always stress , which I think plays a major role in health-and accidents, which are totally unpredictable. While employers should encourage healthy habits-they are sometimes the causes of folks needing cookies to make it through the day! ha!

    Liked by 1 person

  12. Reblogged this on On the Road Cooking and commented:
    I think many are missing just how much privacy we’ve freely given up, despite the empty rantings of some politicians claiming we need our protections again.. These are rights and should have never been made vulnerable.. But yet money and greed, as usual has won out.. Victo has very well summed up the constant invasions on our privacy.. I hate the scam phone calls, the scam emails.. dnc call list is useless and has loopholes.. Email is a bit easier to control.. I hope you enjoy her post and find it empowering and helpful 😊

    Liked by 2 people

  13. Another reason why medical insurance should not come through your employer. And why everyone should have affordable access to regular medical care…(although I just read an article where they interviewed a number of people who felt that medical care was not a right, you needed to “earn” it somehow) (K)

    Liked by 2 people

      • The government is much more inept than a corporation, so they would probably have a harder time doing evil with the information. But there is no “good” answer, only a series of compromises. I’d rather have government armed forces than a bunch of private armies…public schools rather than private schools…public infrastructure rather than private. And I hate gated communities. So I guess I would go with non-profits/public utilities across the board. Equifax and Google already know more about us than we know about ourselves…

        Liked by 1 person

  14. I once had a patient with apparently new onset diabetes. Upon reviewing results of one of these screenings he had done several years previously, I found a seriously elevated blood glucose that he was not aware of. It seems no one had counselled him about it, or told him to follow up with his private doctor. So what could have been a helpful screening was a wasted opportunity to start treating his diabetes years earlier. Fortunately, he had not suffered any diabetic complications due to the delay.

    Liked by 1 person

  15. To me this is just another symptom of the truth that no-one wants to utter … we have never been more watched nor monitored, we have never had less freedom than we do now. There is a book called ‘Eric is Awake’ by Dom Shaw which postulates what happens when Eric Blair (the hero of Orwell’s 1984) finds himself in modern day London. As an observation on where we are as a race and the hellish truth that Orwell was right in his allegorical predictions, it is quite chilling. I recommend it 🙂

    Liked by 3 people

  16. I think the whole concept is crap. I don’t think they should even have to do the yearly physical unless they are in some kind of job that requires physical effort. I also don’t think the employers should have any access to the results unless, again, the job has certain physical requirements. I get the concept for baseball players, firemen, and soldiers, but for the rank and file it seems like a complete invasion of privacy. It also sets up front line supervisors for targets too. “You knew about Craig’s high blood pressure, and yet you yelled at him the day he had his stroke… lawsuit.”

    Liked by 1 person

  17. I have a blog post in my drafts folder about this subject from a patient point of view. The thing that bothers me the most is that, if you read the terms and conditions, you agree to let them share this information with their “partners.” Now you might think that a health insurer or a health insurance broker’s partners would be in the healthcare business. You might want to think again.

    I have been getting reminders all year that I “haven’t yet established your online health profile” and that I haven’t “begun my calorie journal.”

    It hasn’t cost me anything yet, but I would pay more for my privacy on this matter (if I can afford it).

    Liked by 1 person

  18. Personally, I think Biometrics is still a rather soft science and Big Insurance is grasping for anything to charge more or deny coverage. This is clearly a violation of the patient doctor relationship. I’d like to see someone challenge this in court.
    Leslie

    Liked by 1 person

  19. You’ve addressed an issue here which really irks me. I am a former privacy professional and this kind of data collection churns my stomach.
    No corporation, and especially no insurance company, ever collects data on an individual for the benefit of that person. It is always to make money or reduce costs for the company, in spite of how they may frame it in their marketing. Sadly, people are lured into believing they benefit. We innocently give up very personal information thinking that it doesn’t really matter. It does matter.
    With all this biometric data being collected, it is only a matter of time before these same companies develop creative strategies on how to use it … if they haven’t already.

    Liked by 1 person

  20. I think it’s simple. It’s all about money. If they can establish health standards that no one (or very few) can actually achieve, then they can start putting more and more people on more and medications. Ka-Ching!

    Since many will simply ignore the standards and take their chances (not wishing to spend their dwindling paychecks on more and more expensive “health care”), convincing empoyers to strong-arm their employees into supporting the sustem seems like a logical tactic. Want your job? One way or another, you’ll have to buy into our corrupted systems! Ka-Ching, ka-Ching!

    While the care-givers (doctors, nurses, etc.) may have the best interests of the patients at heart, the administrators and policy makers certainly don’t. Unfortunately, for them it seems to be all about status, rising to the top of their chosen hierarchy, and making money.

    Love Always,

    Stargazer

    Liked by 1 person

  21. I completely agree with you. Companies would save much more money if they just provided ways for their employees to be healthier. Good canteens, gyms, low stress environment, decent vacation time and decent wages. I look as healthy as anyone could which is entirely untrue and my blood results are usually perfect.

    Liked by 2 people

  22. Whoever keeps calling on behalf of my husband’s corporate healthcare program is so annoying. I’ve been “encouraged” to reconsider whether I need my mental health meds and “make a plan” (presumably to stop taking them, I guess). None of it seems like it should be their business, let alone something as delicate as that.

    Liked by 1 person

  23. I’m not sure any individual measurements paint the true picture. My BP, heart rate and cholesterol are all good, close-on perfect. It’s just that when I step on the scales or have a tape measure wrapped around me, the numbers are a bit alarming. My recent health check had me as low-risk for all the nasties because the calculations focus more on BP, heart rate and cholesterol than the fact I’m carrying more weight than I should, and being a strange hourglass shape skews the figures even further. So I’m down as healthy despite not feeling it. How does that help anyone?

    I’ve also tried liquid diets, once or twice losing a lot very quickly, but the minute I eat (just healthy stuff) the kilos pile back on and bring extra kilo-friends, as if they need power in numbers for next time.

    Liked by 1 person

    • The problem with that kind of dieting is the fact that it causes starvation. The starvation studies during WWII showed rapid weight loss with a plateau (no further weight loss despite continued low calories) followed by rapid weight gain beyond the original weight once caloric intake normalizes. Your body is programmed to do that! There are much better ways to be “healthy” than focusing on weight. 🙂

      Liked by 1 person

  24. A friend of mine participates in something like this. She receives discounts on shoes and gym membership, in addition to everything you’ve mentioned. I thought it was kind of silly, mainly because I work out at least four times a week, but my BMI is higher than the chart and so is my weight, but all of my other numbers are great. I just think it perpetuates the concept that there’s an ideal weight, health, etc.

    Liked by 1 person

  25. I love reading your thoughts on this.

    My employer offers a health program. It offers perks for “good” behavior instead of disincentives for “bad” behavior. (For reasons I believe you can appreciate, I reject a lot of these good/bad designations as, for starters, based on science substitute.)

    You get a shot at gifts like, oh, Fitbits for taking part in health challenges. This, like so many things in the world (U.S.?) these days, puts a happy face on something much more ominous, diverting attention from troubling facets (like data privacy and corporate dominion over even government) to upbeat ones (free item for 1/100 participants!).

    I dig my job, but I will not opt in to that.

    Liked by 1 person

  26. This is abit foreign since Canada’s public health care system is quite different than the U.S. Incentives to be healthier should not be financially based. I would rather be told…you don’t need a physical exam every year if you’re so healthy…which is what I was told. But I know, if I get sick I can go without financial penalty.

    Works for folks up to approx. 60 yrs.

    Liked by 1 person

  27. Pingback: Writing Links…10/2/17 – Where Genres Collide

  28. It’s beyond refreshing to hear a doctor express skepticism about these practices. It bothers me, too. I’m overweight or more considered morbidly obese; however I have low blood pressure (so low I faint easily), no diabetes, and my health problems started when I was exercising 6-7 times a week. Right now there isn’t much I can do in the way of exercise (due to said health problems), but numbers wise I *should* be healthy. I’m not saying the numbers can’t pinpoint a particular risk, but it’s not fair to punish people for genetic predispositions.

    Liked by 1 person

  29. I do not see how a company can be allowed to access an employee’s medical record.
    In France that is not only illegal, it’s unthinkable. On the other hand in Mexico, the blue chip
    companies who were my clients made their top executives (my clients) pass a “drug” test once a year.
    That should be illegal.
    Sometimes your posts, my dear “Vicky” frighten me. We’re not getting close to Big Brother. We’re already in it. Then the medical records will be cross-analyzed with your google habits, your Waze circulating… And the employee/exec who falls out of range will be fired…
    God bless – not just America – the world…

    Liked by 1 person

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