Health starts here?
January 25, 2010 4:12 PM   Subscribe

On the heels of Whole Foods’ CEO John Mackey’s op-ed about health care reform (previously, previously) comes the Team Member Healthy Discount Incentive Program, in which the employee discount will be increased from 20% to 30% for those who meet criteria for body mass index (BMI), nicotine use, blood pressure, and cholesterol.

The letter to the team members says that the goals of this program are to make employees healthier and thereby decrease company health care costs.

Much of the criticism of this move is a result of the BMI criteria, in part because the BMI is a highly flawed index of health, and is dependent on genetics.
posted by emilyd22222 (122 comments total) 5 users marked this as a favorite

 
So the solution to employees being fat is to make it harder for them to afford pricier, healthier options? Amazingly done, well thought out, cigars and plo chops all around.
posted by Pope Guilty at 4:14 PM on January 25, 2010 [30 favorites]


It's well known that having children (and getting pregnant) exposes you to all sorts of illnesses. There should be an incentive to remain childless as well or at least have no further children.

I wonder how "Team Member Healthy Discount Incentive Program" translates into Red Chinese?
posted by ennui.bz at 4:17 PM on January 25, 2010 [2 favorites]


Woudn't it make far more sense to give everyone the larger discount on healthy food, and everyone the lower discount (or no discount) on unhealthy food?
posted by twirlypen at 4:17 PM on January 25, 2010 [15 favorites]


Oh John Mackey, how many key demographics are left to offend? Why not just go straight for the jugular and make fun of your shareholders?
posted by mccarty.tim at 4:18 PM on January 25, 2010 [8 favorites]


I heard all about this being "Whole Foods Hates Fatties!" in twitter, but looking at the chart, they are talking some modest discounts for some fairly normal numbers. The blood pressure, cholesterol and BMI numbers aren't that crazy.

The second highest tier puts BMI at 26. Being below 26 on BMI means for me being still about 10-15lbs overweight, being below 24 I'm at a pretty healthy level, but when I read the quips on twitter, I thought the numbers would start at 25 (where overweight starts) at the lowest and skew towards 18 (where underweight begins) given how much people thought it was crazy.

I don't think it's outlandish to encourage employees to be healthy, ride bikes, cut junkfood, etc, and this is probably just one part of many in the company's plans. I don't like the CEO very much, but I don't see why people hate this as much as they seem to.
posted by mathowie at 4:20 PM on January 25, 2010 [12 favorites]


Oh shit, I thought the dystopian Diamond Age was at least another 20 years away. Sigh, does Metafilter have a Phyle yet?
posted by The Whelk at 4:23 PM on January 25, 2010 [5 favorites]


So the solution to employees being fat is to make it harder for them to afford pricier, healthier options?

Hell, they already get 20% off. We're supposed to pile on Mackey for using a carrot approach to employees getting deeper discounts? Is he supposed to give away food to his fat employees now?
posted by 2N2222 at 4:23 PM on January 25, 2010 [7 favorites]


FYI -- a profile of John Mackey in a recent New Yorker: Food Fighter -- "Does Whole Foods’ C.E.O. know what’s best for you?"
posted by ericb at 4:25 PM on January 25, 2010


Also, I didn't want to add this in the FPP for fear of being told to G(my)OB, but I'm extremely wary of programs encouraging people to diet, since dieting is known to trigger disordered eating ">(cite), particularly binge eating(cite for humans, cite for animal models), in those who are genetically predisposed to them. I had an eating disorder that started out as a diet, which was encouraged and maintained by the culture of the place where I was working at the time.
posted by emilyd22222 at 4:26 PM on January 25, 2010 [7 favorites]


Employers changing your health insurance coverage in response to your medical records.

What could go wrong?
posted by Joe Beese at 4:26 PM on January 25, 2010 [23 favorites]


So, you have to disclose your private health information to your boss? No thanks.

A bigger discount for healthier items would make more sense, but those are probaby their lower-margin items anyway.
posted by beepbeepboopboop at 4:27 PM on January 25, 2010 [1 favorite]


dammit, that first cite was this.
posted by emilyd22222 at 4:27 PM on January 25, 2010


Also, having a BMI that's below the "normal" range is just as unhealthy, if not more unhealthy, than having one that's above the "normal" range.
posted by emilyd22222 at 4:29 PM on January 25, 2010 [1 favorite]


I am reminded of those company towns built near the end of the Victorian age, nice bright airy family housing for workers - provided they obeyed all the laws about going to church, not drinking, gambling, etc. Makes you think that a larger organization, say one made from the minor contributions of lots of people, could step in provide these things to all people...

Nah, never work. I mean, who want's to see thier hard-earned money go to help someone else. It's probably they're own damn fault anyway! Why should you reward them for being poor? Besides, want builds character - I wouldn't know about it first hand, but that's what everyone sais.
posted by The Whelk at 4:29 PM on January 25, 2010 [4 favorites]


I don't think it's outlandish to encourage employees to be healthy, ride bikes, cut junkfood, etc, and this is probably just one part of many in the company's plans. I don't like the CEO very much, but I don't see why people hate this as much as they seem to.

Maybe because it's not encouraging people to shape up, it's rewarding people who were skinny/didn't smoke/whatever ALREADY, the day they started working there.

If it rewarded improvement from where you started, that's still obnoxious IMO, but at least seems somewhat fair. As it stands, it's kind of just saying, "fuck you fattie! Pay more for food than than the skinny person."
posted by drjimmy11 at 4:30 PM on January 25, 2010 [6 favorites]


Here's an interesting article on Safeway fail on making workers pay higher premiums if they flunked tests for measures for blood pressure and cholesterol -- contrary to what Safeway CEO told Congress.
posted by bearwife at 4:30 PM on January 25, 2010


Also at 20 *or* 30% off, their bullshit still costs more than Trader Joe's, and tastes worse.
posted by drjimmy11 at 4:31 PM on January 25, 2010 [7 favorites]


I think giving a bigger discount on healthy options is the better way to go. Don't a lot of companies already work with gyms to get some kind of employee discount rate? Why can't they do something like that instead?
posted by MaryDellamorte at 4:34 PM on January 25, 2010


does Metafilter have a Phyle yet?

Really we just need to increase the pace of meetups until, like a leaky faucet dripping faster and becoming a constant stream, there is a permanent, real-world metafilter presence. Eventually we'd have a walled city/fortress, I assume.

On another note, it seems like we're getting all of the crazy, punishing, soul-crushing, apocalyptic stuff from the early Stephenson novels and none of the cool gear.
posted by synaesthetichaze at 4:36 PM on January 25, 2010 [9 favorites]


This food discount is the kind of idea that sounds good to douchebags who think they have the answer for how other people should be living their lives.
posted by Foam Pants at 4:38 PM on January 25, 2010 [11 favorites]


Maybe because it's not encouraging people to shape up, it's rewarding people who were skinny/didn't smoke/whatever ALREADY, the day they started working there.

...it does both. I really don't understand your argument.

This program does the following:

1) encourages unhealthy people to 'shape up' for the better discount
2) rewards people who already take care of themselves

You can argue about the metrics that they use to define 'healthy', but those two aren't mutually exclusive.
posted by ripley_ at 4:39 PM on January 25, 2010


I really hope this ends with Kate Harding owning Whole Foods and John Mackey on my street corner yelling at me to google Ron Paul. Probably not though.
posted by Errant at 4:40 PM on January 25, 2010 [7 favorites]


Maybe because it's not encouraging people to shape up, it's rewarding people who were skinny/didn't smoke/whatever ALREADY, the day they started working there.

If it rewarded improvement from where you started, that's still obnoxious IMO, but at least seems somewhat fair. As it stands, it's kind of just saying, "fuck you fattie! Pay more for food than than the skinny person."


The point isn't to save the country money, it's to save him money. If you give a reward for healthy people to join your workforce, then you will pay less in insurance cost. If you give a reward for people to improve, then unhealthy people will join your hive (because they have room to improve), and cost you a lot.
posted by a robot made out of meat at 4:40 PM on January 25, 2010 [1 favorite]


rewards people who already take care of themselves

You could also argue about that. If I did a lot of coke, ate only a Snickers bar every day, and ran on the treadmill until I passed out, I would meet all of his criteria. The thing is, they're not metrics of health, they're metrics of things that Mackey believes lead to health.
posted by emilyd22222 at 4:42 PM on January 25, 2010 [11 favorites]


Google pays its employees to sit still all day and then feeds them like kings on top of that and they don't seem to have any problems with unhealthy staff or huge insurance premiums.
posted by GuyZero at 4:43 PM on January 25, 2010 [2 favorites]


it seems like we're getting all of the crazy, punishing, soul-crushing, apocalyptic stuff from the early Stephenson novels

You mean his writing style?
posted by adamdschneider at 4:44 PM on January 25, 2010 [4 favorites]


You could also argue about that.

I mentioned that.
posted by ripley_ at 4:44 PM on January 25, 2010


it's rewarding people who were skinny/didn't smoke/whatever ALREADY, the day they started working there.

Looking at the charts, the BMI max for the gold tier is 26 which is considered overweight.
posted by MaryDellamorte at 4:48 PM on January 25, 2010


Also, having a BMI that's below the "normal" range is just as unhealthy, if not more unhealthy, than having one that's above the "normal" range.

There isn't a single mention of BMI below "normal" range anywhere in the Whole Foods flyers.
posted by mathowie at 4:52 PM on January 25, 2010


assWhole foods. amirite?
posted by cazoo at 4:53 PM on January 25, 2010 [1 favorite]


There isn't a single mention of BMI below "normal" range anywhere in the Whole Foods flyers.

Exactly. Since both are unhealthy, one wonders why he's only discouraging being fat, and not also being skinny.
posted by emilyd22222 at 4:57 PM on January 25, 2010


If I worked at Whole Foods I would be POed because while I try to practice a healthy lifestyle I have genetically high blood pressure that would disqualify me for anything above the bronze level. Bogus.
posted by ekroh at 4:57 PM on January 25, 2010 [1 favorite]


The thing is, they're not metrics of health, they're metrics of things that Mackey believes lead to health.

What would your metrics be then? I mean, BMI isn't perfect, and there are various schools of thought on cholesterol and fat levels in healthy diets, but the three criteria here seem very basic and loosely correlated with healthy-ish people. Like I said in my first comment, the BMI numbers start in the obese range, go through most of overweight and end at the beginning of normal.

None of the three criteria seem insane and I'd think people that are still 20-30lbs overweight could qualify for at least one tier.
posted by mathowie at 4:58 PM on January 25, 2010 [1 favorite]


Google pays its employees to sit still all day and then feeds them like kings on top of that and they don't seem to have any problems with unhealthy staff

Don't know about the employee pool as a whole, but I certainly know people who gained weight after joining. Having all that food around does make it harder for me not to overeat, I know that much. The overall workforce is probably fairly healthy, but IMO that has more to do with age (average age has got to be mid to high 20's).
posted by wildcrdj at 4:59 PM on January 25, 2010


One employer offers a voluntary employee discount program, some people think they should tweak one of the metrics used. How is this best of the web?
posted by ripley_ at 5:01 PM on January 25, 2010


I certainly know people who gained weight after joining.

That may or may not be true (I dunno) but I do know that people would have to be rolling in to work before their insurance premiums changed.
posted by GuyZero at 5:01 PM on January 25, 2010


What would your metrics be then?

Perhaps a metric could be doing at least 30 minutes of moderate exercise a day. It's just odd to me that it's not the health behaviors that are being regulated (with the exception of smoking), it's the consequences, and these consequences happen to have more causes than just those health behaviors. I'm not necessarily comfortable with trying to influence employee behavior outside of work either, though. I agree it's tricky- you get into muddy waters when you start this kind of thing.
posted by emilyd22222 at 5:05 PM on January 25, 2010 [2 favorites]


Yeah, I'm not really getting the hate over this program.

The idea of giving deeper discounts as incentive makes some sense. Should fatter people get better discounts on "healthier" food? It seems to me that fat people can (and do) get fat by simply eating too much food in general, not necessarily "unhealthy" food, however you define it. Besides, Whole Foods seems to pride itself on providing healthy foods already. Perhaps if WF wanted to discourage overeating, they should take away discounts for fat employees.

Since both are unhealthy, one wonders why he's only discouraging being fat, and not also being skinny.

Is this the case? The actual press release doesn't really specify only fat people being targeted. The Jezebel article does, conveniently leaving out other things like cholesterol, blood pressure, tobacco use, etc. which sounds much more comprehensive.
posted by 2N2222 at 5:08 PM on January 25, 2010 [2 favorites]


GuyZero, Google pays its employees engineer salaries, probably averaging near the 6 digits (with an equally high mode/median as well). Any insurance premium difference is likely close to a rounding error compared to the total yearly cost per employee (that is about double the salary). They also probably have a top-tier group insurance policy where they just give the insurance company a lot of money in exchange for not being bothered by details.

Whole Foods probably pays close to the minimum wage for most of its staff. In that case, health insurance might be one of their top non-wage employee costs. It also means they have to micro-manage insurance costs, so they probably get premiums fine-tuned for employee health (or at least health statistics for their workforce).
posted by qvantamon at 5:19 PM on January 25, 2010 [2 favorites]


But hey, 30% off is almost down to normal grocery store prices, right? Good deal.
posted by rusty at 5:26 PM on January 25, 2010 [2 favorites]


Perhaps a metric could be doing at least 30 minutes of moderate exercise a day.

That's just a little more difficult and intrusive to measure for thousands of employees.
posted by ripley_ at 5:26 PM on January 25, 2010


(so I'm guessing this askme is related)
posted by scruss at 5:28 PM on January 25, 2010


I think giving a bigger discount on healthy options is the better way to go. Don't a lot of companies already work with gyms to get some kind of employee discount rate? Why can't they do something like that instead?

Well, you see, here's how these tend to work; before you get your wonderful gym discount or exercise equipment reimbursement, you first have to take a Health Risk Assessment (HRA) quiz about your weight, health history, etc. So now you've volunteered more information to your company about your personal health history--maybe that you have trouble with high blood pressure and a family history of heart disease.

And then, let's say your company goes out to bid for a new insurance provider. And that provider looks at their claims history, and says, we COULD offer you a lower rate, but you've got these people with heart problems on staff. So we have to charge you up the yinyang. And your boss maybe thinks about the lower rates they could get if they fired the problem employees. Ta da.
posted by emjaybee at 5:41 PM on January 25, 2010 [12 favorites]


You'd think Jim Mackey would have learned by now to stop putting his foot in his mouth. Whole Paycheck Foods might as well hire Dwight Schrute as a health care consultant.
posted by porn in the woods at 5:49 PM on January 25, 2010 [1 favorite]


emjaybee is dead-on. Your health history is none of your employer's business.
posted by pianoboy at 5:54 PM on January 25, 2010 [2 favorites]


Besides all the obvious other issues other people have already brought up here: If I smoked and I wanted to under their nicotine use line, theoretically I could stop tomorrow. If my blood pressure or cholesterol were bad, I could get that under control with focused meds and other behavior alterations in pretty short order. But medical professionals will tell you it is physically unsafe to lose more than 1-2 pounds a week, unless you are so morbidly obese you require surgical intervention or something of that ferocity. Losing weight, and therefore hitting those BMI metrics, takes a lot of time. Or more specifically: a lot of willpower spread out over a lot of time. I'm currently doing a plan (and quite successfully, thank you very much) at which I will hit my goal weight in about 20 months.

I agree with what others have said: this is really more a reward for employees who arrive at the job healthy than a goal for those who didn't. I like the plan of scaling discount to how healthy the food in question is.
posted by penduluum at 6:06 PM on January 25, 2010 [2 favorites]


Why not just subsidize fitness center memberships, exercise classes, etc? Why not tie it to health-improving behavior, instead of overall health? The point of targetting overall health is to induce health-improving behavior, right?

This really doesn't sit well with me. The implied message is that you are supposed to have a certain BMI, blood pressure, etc in order to be a fully valued member of the team. Where does this lead? Imagine....

- Whole Foods, on the brink of bankruptcy and determined to drastically cut health care expenses, issues a directive to managers to really push the Healthy Discount Program.
- Some middle-manager starts to include Healthy Discount Program participation rate as a metric by which to assess lower managers in order to boost the overall numbers.
- Some lower manager is told in no uncertain terms to get his numbers up (with an implied "or else")
- That same manager has a position open that he has to hire for. He himself does the interviewing. Two identical candidates make the last round of interviews. One is obviously healthy, the other appears to be slightly overweight; they are otherwise comparable.

Guess what? The potentially overweight person is discriminated against, based on visual appearance alone. Don't tell me it couldn't happen.
posted by PercussivePaul at 6:11 PM on January 25, 2010 [5 favorites]


This really isn't unique to Whole Foods. Lots and lots of companies are starting this kind of health incentive program. It gets them lower insurance rates.
posted by mr_roboto at 6:14 PM on January 25, 2010


Any time you need a blood sample, you've pretty much pegged the intrusive meter.

If they wanted verification my manager could either come with me on a daily bike ride, or we could go over to the sporting good store and pick up some boxing gloves. They say that's good aerobic exercise.

At a little over 300 lbs it should be easy to beat my fat ass.

Evil chuckling? I don't hear any evil chuckling. You should get that checked. Might be a symptom of something.
posted by Kid Charlemagne at 6:18 PM on January 25, 2010


Guess what? The potentially overweight person is discriminated against, based on visual appearance alone. Don't tell me it couldn't happen.

It happens every day anyway, but that's a different FPP.
posted by gnomeloaf at 6:19 PM on January 25, 2010


Didn't fat people used to be jolly?
posted by Gamien Boffenburg at 6:20 PM on January 25, 2010


Oh shit, I thought the dystopian Diamond Age was at least another 20 years away. Sigh, does Metafilter have a Phyle yet?

Dystopian?
posted by grobstein at 6:27 PM on January 25, 2010


You had me until "...because the BMI is a highly flawed index of health."

First off, that linked web site is not one you want to pull references from, especially with a headline like "Pomegranate Oil-Seaweed Mix May Help You Lose 10 Pounds." Additionally, BMI is always seen as a guideline for achieving health. Finally, find another way to quickly measure the health of a population and the research community will be very pleased and you may be on your way to a Nobel prize.
posted by hammerthyme at 6:28 PM on January 25, 2010 [3 favorites]


Let me clarify my distaste. The goal of a program like this is not healthier employees. The goal is lower health care costs, which come about because the employees have lower insurance premiums, which are granted because they have a lower risk of requiring health care. I think it's pretty plain that the health metrics being used here are the same ones being used by insurance companies to set premiums.

The end result of programs like this is discrimination against employees who are (or appear to be) at higher risk of requiring health care, as determined by insurance companies. In some cases this may have little to do with the actual health of the employees. It may lead to age-based discrimination since it's easier for younger adults to stay healthy and fit than older adults. It may make some people virtually unemployable solely because they are (or appear to be) overweight. Hopefully it doesn't need to be said: accepting a system like this is a blow to personal liberty, it is unfair to those who are genetically unlucky, and it penalizes those who cannot afford to maintain their health (perhaps a combination of poverty, time pressure from raising a family, working multiple jobs, etc). Yes, don't forget, a major cause of poor nutrition and obesity is simply poverty.

All this is a negative side effect of tying health insurance to jobs. I know the position of most people here on the topic of health insurance companies controlling the lives of private citizens. Imagine if the same pre-existing condition that denies you private insurance could also deny you employment. I know this program is not quite so drastic -- but this program and others like it are a step backwards, and we should recognize them as such.
posted by PercussivePaul at 6:57 PM on January 25, 2010 [26 favorites]


I don't particularly like this idea for the fact that health isn't as simple as taking a few measurements and plotting them on a chart. The body is a complex system, and while the metrics Mackey has picked do indeed tend to correlate with being healthier, they aren't the final word on the subject.

I'm in the same boat as ekroh in that I have some very unhealthy genes. Bad cholesterol runs on both sides of the family and my maternal relatives have problems with diabetes. Both of my parents have overall cholesterol levels well above 200 - however, that doesn't mean that they're fat and lazy. My mother works out daily, eats well, and is thin as a rail.

My cholesterol is pretty bad, though I have a problem that those metrics don't take into account as my HDL cholesterol (the 'good' cholesterol) is below acceptable levels. For my part, I exercise daily and am doing marathon training. I eat my fruits and vegetables and avoid fast food, soda, etc. I've been taking fish oil capsules for over a year now, and yet my cholesterol level refuses to budge. So, I went to see a lipid specialist.

Over the course of an hour we went through all of the risk factors for heart disease - family history, age, gender, BMI, waist measurements, blood sugar, HDL/LDL and overall cholesterol, triglyceride counts. We talk about the Framingham study which is the most important epidemiological study done on heart health. At the end of the day, taking all of my measurements into account, she tells me that based on these factors and how they relate to the study, my ten year risk of getting heart disease is less than 1% despite my bad cholesterol. That's pretty low.

It's not over yet, though. Next month I'm going through a battery of blood work to measure the density of my cholesterol and some other proteins and stuff that I've never even heard of and that are not generally a part of your routine physical. It's not just the amount of cholesterol, it's the nature of the cholesterol and the interplay between it and other substances in the body that can impact your health. Sure there are medications I can take to help my HDL count, but I'm still pretty young and I'd rather not get on a regimen if it's not necessary.

So yes, blood pressure and BMI et al can be indicators of health risks. However, if you lead a healthy lifestyle they're not necessarily a nail in your coffin or an indication that you're going to drive up insurance costs. You can't just cherry-pick measurements without penalizing people who are indeed healthy, and to me that seems unfair.
posted by Consonants Without Vowels at 6:58 PM on January 25, 2010 [1 favorite]


The incentives would be a nice idea... unless you're someone like me, who has genetically high cholesterol and blood pressure. I fight like hell to control it. I eat well, exercise, take my meds, and yet I still can't keep those numbers knocked down. This is a reason for me to stay out of Whole Foods, whether as an employee or a shopper.
posted by azpenguin at 7:01 PM on January 25, 2010


On the extreme ends BMI does correlate with overall health. As others have pointed out, if you actually look at the measures required for the discount, nobody's being pushed into an unhealthy weight range. As for why they're not giving incentives to underweight people to gain weight...America does not weigh less than most of the western world. It's going to be seen as a less significant problem, no matter how people you know can talk about their bouts with eating disorders.

Gym memberships would be a better idea, sure. They'd also be much more expensive for the employer, and really difficult to monitor what employees are actually exerting themselves. Scales and bloodtests are just easier. This is a quick-and-dirty thing. I don't know why any employee would have the expectation that a new employee benefit program has to work flawlessly in accomplishing its goal.

It is a really intrusive thing to do...except nobody's making anyone do it. I'm really sensitive to arguments about coercion, but this isn't the government coercing through social services. It's not even an employer coercing through standard employment benefits. It's an incremental change in an employee discount program at a luxury grocer. I hear that next he'll offer his employees five dollars off at his brother's Jaguar dealership if you reveal your most embarrassing moment. I understand PercussivePaul's fears about a slippery slope, but until this type of thing even approaches something close to an employee entitlement, it's a lark. After all, he could drop the employee discount program for everyone tomorrow and nobody would have a right to complain.
posted by aswego at 7:02 PM on January 25, 2010 [1 favorite]


or those who meet criteria for body mass index (BMI), nicotine use, blood pressure, and cholesterol.

As a human, I am thinking "holy shit...a dirty-ass company figures out a way to finds out a way to invade their workers' privacy...by giving them $0.30 off the hummus".

As a Human Resources professional, I'm thinking "business as usual".
posted by hal_c_on at 7:03 PM on January 25, 2010 [3 favorites]


Here's what I'm thinking... employees already get 20% off, right?

Employees that don't meet the criteria probably won't apply, so they'll end up with a VERY biased survey of their employees. Mackey will be able to offer up this survey as 'voluntary' disclosures for the 'average' employee... because everyone that applies for it will be 'healthy' (according to the insurance companies), he'll get a great deal on insurance rates.

1.) Create an incentive for healthy people to complete survey
2.) Persuade Insurance companies these people are representative of your employees
3.) ???
4.) Profit!


There is absolutely NO incentive for people who don't meet the criteria to apply for the discount/volunteer their information... if anyone does, they should practice thinking more.
posted by hatsix at 7:11 PM on January 25, 2010 [3 favorites]


Also at 20 *or* 30% off, their bullshit still costs more than Trader Joe's, and tastes worse.

I still can't help feeling like I'm in someone's basement rec room when I'm in one of those, though.
posted by setanor at 7:11 PM on January 25, 2010


According to Wikipedia, BMI is your mass / height^2. It seems like a very coarse metric. Wouldn't it be more informative to directly measure the individual's cholesterol levels, or use a fat caliper, etc? Oh wait, that would cost more money...
posted by polymodus at 7:11 PM on January 25, 2010


When asking about nicotine use, do they rely upon the word of the individual, or is there a specific test that can be used?
posted by Lucinda at 7:12 PM on January 25, 2010


Do HIPAA privacy rules not apply because it's voluntary and in a non-medical setting? Because if you check out and get only the minimum discount, you're broadcasting at least something about your alleged "health" to your coworkers.
posted by uncleozzy at 7:16 PM on January 25, 2010


According to Wikipedia, BMI is your mass / height^2. It seems like a very coarse metric. Wouldn't it be more informative to directly measure the individual's cholesterol levels, or use a fat caliper, etc? Oh wait, that would cost more money...

It would require a greater degree of privacy invasion...and thats WAL-MART MONEY we're talking about, not shitty little "Whole Foods money". You need that money for the in-house consel when you're ass gets sued by everyone and their mama.
posted by hal_c_on at 7:18 PM on January 25, 2010 [1 favorite]


What I find strange is that the vast majority of shoppers at Whole Foods appear to be liberal or somewhat progressive/left leaning, but with every word out of this dude's mouth it appears the company is run by the absolute worst of the hard core right wing.

I would hope that people would wake up and see what a pretty sizable chunk of their money is going to - especially now that corporations can spend money willy-nilly to buy elections.

Is your organic help milk worth having Sarah Palin elected president?

Good, honest, decent companies provide incentives to their employees to be healthy by offering subsidized gym memberships or athletic programs.
posted by Stryke11 at 7:18 PM on January 25, 2010 [2 favorites]


*counsel*...if anyone can change that and delete this...i would appreciate it.
posted by hal_c_on at 7:19 PM on January 25, 2010


That would be "hemp" milk. I can't believe the blue doesn't have an edit function.
posted by Stryke11 at 7:20 PM on January 25, 2010


Every unhealthy worker who has shared confidential medical records with Whole Foods is a potential wrongful termination suit. Beautiful.
posted by mullingitover at 7:22 PM on January 25, 2010


I call Bailey's Irish Cream "Daddy's Little Help Milk."
posted by mccarty.tim at 7:24 PM on January 25, 2010 [2 favorites]


When asking about nicotine use, do they rely upon the word of the individual, or is there a specific test that can be used?

I believe, if it's your employer they have no right to know. If it's your insurer, well, they only know if your doctor tells them. So, if you smoke, A.) Don't smoke at the office or around coworkers, B.) Don't tell your doctor and C.) Hope your doctor doesn't diagnose you with a disease that is linked to smoking and/or puts 2 and 2 together about the whole yellow teeth/stinky breath problem.

Also, it may or may not be insurance fraud to not let your insurance company know up front if you smoke. I'm not exactly sure on this. I just know they charge more if you do and well, I know I'm in for a lot more later on anyways, so I just need to quit smoking to begin with and hope they never catch on to the fact that I smoked in the first place.

Oh, and never admit to smoking publicly like I just did.
posted by robtf3 at 7:26 PM on January 25, 2010


Holy shit I hate this guy. But I've screwed up a little here, too - after his ridonkulous op-ed on health care, I already resolved to never again set foot in a Whole Foods. Now what do I do about this latest outrage? Double-boycott his store?
posted by EatTheWeak at 7:31 PM on January 25, 2010 [1 favorite]


Dystopian?

You know, where humans and dinosaurs live together in peace and harmony.
posted by MikeMc at 7:39 PM on January 25, 2010


Let me clarify my distaste. The goal of a program like this is not healthier employees. The goal is lower health care costs, which come about because the employees have lower insurance premiums, which are granted because they have a lower risk of requiring health care.

The outcomes are not actually important in this calculation, only the premiums. This is what bothers me. Rather than focusing on the healthiness of employees we focus on the cost of health care. If this program just gets you to make one less dr visit or use services a little less because you don't want to be seen as unhealthy or increasing costs then it works from the insurance co and your employeers perspective or at least the spreadsheet view of the business. This is the real unaddressed problem in HCR efforts. We focus on the wrong metric cost, instead of measuring the desired result health. If we focused on health, we might make all kinds of choices from daylighting and mandatory outside time, to lowering vocs and increasing leisure time. Frankly the way we've organized purseves around walmart's lower prices everyday mentality has to stop. It is toxic. We are going to be undone by our pursuit of money we created by fiat instead of value. Not that I'm arguing for a gold standard. We just have to realize that money, gold, etc are imperfect measures of value and worth.
posted by humanfont at 7:41 PM on January 25, 2010 [1 favorite]


I think the thing that a lot of people are missing with regards to privacy is that the additional 10% discount is fully voluntary. To answer an above question: the nicotine test is done with saliva.

From what I know, they have gone to great lengths to ensure that the data used to calculate your additional discount level does not in any way affect your insurance. Even a smoker who has signed up for health insurance as a non-smoker, won't see an additional health insurance charge, nor will the insurance company be notified. But they will not qualify for the highest level discount.
posted by onehalfjunco at 7:41 PM on January 25, 2010


Healthier foods cost more for normal people... this seems to let healthy food be more reasonably accessible to those who LEAST (we all need it, but he is thinking in terms of lifeboat ethics, what we need are smarter ethics... someone who is unhealthy is not a lost cause to be shunned, but someone he should be helping FIRST) need it... rather than those who have the negative physical, emotional, and societal consequences of these health issues.

Positive Incentives (note, not hard and fast RULES; like "if you smoke you are fired", but rather a bonus for quitting...) seem to be more ethical, especially for things that CAN be changed; asmentioned above, genes carry more than just hair and eye colour and also avoid the above mentioned removal of privacy (" did you hear? Jimbo checked out today and only got 15 cents off the hummus... he must be dying of some disease... Probably obesity... better not spend any time with him at break then..." I don't know if this has been debunked or not, but back in 07 there was an obsession with the "obesity is contagious" idea... will this policy lead to more or less discrimination in the workplace?

also, blue doesn't have edit. Stryke(at)11 ;)
posted by infinite intimation at 7:45 PM on January 25, 2010


I work for Whole Foods. When I first heard about this program I was livid, thumping my chest over many of the same points I've seen hit so far in the comments. I certainly agree that the messaging has been horribly mismanaged, like virtually all Whole Foods marketing and ANYTHING that John Mackey has his off-putting hand in (worst. spokesman. ever). After initially viewing the program with anger, disgust, and outrage, my firsthand experience with the rollout of same has more or less completely converted me.

It's not an invasion of privacy. The testing is voluntary, performed by an external company, confidential (see below) and there is no penalty for not participating -- whether one declines to be tested or doesn't meet the criteria for additional discounts, everyone maintains their 20% employee discount.

Your results have no effect on how management perceives you. The results are confidential, maintained exclusively at the central benefits office (read: people you will never meet, ever). Managers have no access to the data. No one with hiring or firing power has access to the data.

Whole Foods employees are paid very competitively for what they do. My store begins new hires at a minimum of $10/hr, well above industry standard for grocery retail. On top of competitive wages, employees -- even part-time employees -- have access to good health insurance. This is expensive for the company, and I am absolutely in favor of them rolling out a program that could reduce our health care costs. As our health care system deteriorates, we now pay a $10 premium on each paycheck for our good health insurance. This is the first year in Whole Foods histories that full-time employees have had to pay a premium. I am not trying to say that WF has no flaws, but the benefits are fucking fantastic and I would put up with a lot of corporate crap to keep them.

I think it was a mistake to include BMI because of the messaging issues. But, you would be hard-pressed to find a single person whose BMI kept them from receiving an extra discount. The blood pressure & cholesterol categories have very strict standards; I am going to go out on a limb and say that almost everyone who fails to qualify based on BMI result is going to flunk the BP and cholesterol tests.

The number one cause of death in the USA is heart disease. Two of the leading causes of heart disease are hypertension (high blood pressure) and high cholesterol. Giving people a material reason to want to improve their health based on those two metrics can really only be for the good.

So, yes. They fucked up the rollout and messaging on this program, John Mackey is a tool and I have little respect for him, and I can totally understand why people would be upset about this, considering that I was upset about it myself for quite some time. But the greatest possible evil from this program is that someone you don't know at central benefits will laugh at your results and you'll still only get 20% off of your groceries and still have good benefits, and the greatest possible good from this program is that by appealing to your material greed it may inspire you to change your habits to improve your blood pressure & cholesterol and accidentally save your life. Hyperbole? Probably. But I'm still in favor.


Also, many stores do offer discounted gym membership. It's up to store leadership. There's also a company-wide exercise incentive program called "greentrek" that also rewards community service and use of alternative transportation.

posted by kitarra at 8:00 PM on January 25, 2010 [12 favorites]


"If this program just gets you to make one less dr visit or use services a little less because you don't want to be seen as unhealthy or increasing costs then it works from the insurance co and your employeers perspective or at least the spreadsheet view of the business."

humanfont, I understand your distaste and agree that anything that discourages use of necessary health care to be Bad, but this program actually encourages the exact opposite of what you're describing -- for one thing, the company is paying for screening on cholesterol, blood pressure and BMI (and nicotine use but um I think you know that one) for anyone who wants to participate. That's not free for the company. It's an investment they're making. Furthermore, HR would never know whether someone has made a doctor's visit unless that person chooses to disclose that of their own accord. HIPAA works wonders!
posted by kitarra at 8:13 PM on January 25, 2010


Let me clarify my distaste. The goal of a program like this is not healthier employees. The goal is lower health care costs,

Is this a bad thing?

The outcomes are not actually important in this calculation, only the premiums. This is what bothers me. Rather than focusing on the healthiness of employees we focus on the cost of health care.

This seems to be a case where lower insurance costs are likely to reflect better health among it's participants. Even if Mackey's intentions are purely evil allowing him to pinch every penny for his kitten target practice fund, the side result is still reflects healthier employees because they're less likely to need lots of health care resources.

And Stryke11, the absolute worst of the hard core right wing? C'mon...
posted by 2N2222 at 8:15 PM on January 25, 2010 [1 favorite]


Tastes like employment litigation.
posted by Ironmouth at 8:24 PM on January 25, 2010


The Program is incomplete as it stands.
It encourages certain standards for optimum health based on a body of medical knowledge which can never be complete or provide answers which are certain. Thus, while it can save costs based on statistical models, it can never be truly fair.
Crude measures such as BMI or blood pressure can never tell the whole story; there will always be genetic factors, lifestyle and life history intertwined in such a complex web that the only true measure of an individual's insurability is whether or not they get sick.
I hope this Incentive Program is just the first step towards a future in which the socialist nightmare of people contributing towards the common health even when it doesn't benefit them or the stockholders personally can finally be put to bed.
Let's just get it over with and end health insurance once and for all, people.
posted by uosuaq at 8:29 PM on January 25, 2010


Positive Incentives (note, not hard and fast RULES; like "if you smoke you are fired", but rather a bonus for quitting...) seem to be more ethical, especially for things that CAN be changed

I don't think this is a meaningful statement. Positive incentives are exactly the same thing as negative incentives, it's just a matter of perspective.

You can look at this program in two ways:

1) Employees meeting the health requirements are rewarded with an extra 10% discount
2) Employees not meeting the health requirements are punished with a 10% lower discount

Either way it's exactly the same situation.
posted by ripley_ at 8:39 PM on January 25, 2010


Sorry, I should have enhanced; I meant more an overall societal good (rather than an emotional measure to an individual). a net positive. (rather than comparing positively worded vs negatively worded incentives program)
I personally don't see that discount as a massive positive, as checked against the amount of body image consciousness that more medicalized testing as incentive that it has a potential to become (maybe not at whole foods, maybe the "culture there" is really great.. I just don't know, but not every potential employer will have such benevolent leadership.
Is the further Medicalization of bodies in this manner (cost saving) one day going to be seen as having been related to encroaching on exponentially expanding costs of health care?

It seems to have the potential to make everyone involved in our society (even more...) ultra body conscious. As described by the above mentioned eating disorders, which are (while perhaps not always visible) a part of our society, and also people that we want to "do good for", as this claims to be, it is incomplete, and considering the history of opposition to HCR, when applied by less "ethical" corporate persons, will this still have the whole foods sheen?

3 jobs... now aint that uu-niquely American?- 43
In between those three jobs when does the general public have time to get informed about how to find those "healthy choices"... I mean, when the mcdonalds in walmart has healthy choices... are those just as good? Our government "regulates" everything, and monitors Nothing. This is nothing to do with left nor right, but external to those constructs of the 24 hour news cycle, senate holds grand hearings on baseball, they must be now Sabermatricians no? Yet the food guide is pretty much the same as it ever was 50 years ago... "just eat these things... like the cartoon here, it's teh food pyramid, "bread milk eggs... u kno, the good stuff... everybody eats it num num".
This isn't the fault of whole foods, but real health reform for people who are every bit as American as his whole foods employees, are dying for lack of access to Any care, or even basic maintenance checkup services. This is something that Mr. Mackey’ did wholly help derail during a National scale discussion.
posted by infinite intimation at 9:59 PM on January 25, 2010


All I gotta say is I worked for a grocery store for 6 years and the only employee discount I ever got was if we intercepted the day old sandwiches before they hit the dumpster, so screw Whole Foods and screw you.
posted by Uther Bentrazor at 10:08 PM on January 25, 2010


The testing is voluntary, performed by an external company, confidential (see below) and there is no penalty for not participating -- whether one declines to be tested or doesn't meet the criteria for additional discounts, everyone maintains their 20% employee discount.

We're not talking about the 20% employee discounts. We are talking about the 30% employee discounts. Would you consider this a benefit? (Maybe not if you don't like Whole Foods). If so, then it isn't voluntary. You HAVE to participate to get the employee benefit.

BMI is always seen as a guideline for achieving health.--by hammerthyme
What does this statement even mean? BMI is used by many (lazy) doctors, hospitals, and insurance companies as the measure of health. Heck, all you have to do is add a waist measurement to make it vastly more meaningful.

I know this because I have been affected by it. Years ago I added weight lifting to my exercise program. Even though my waist measurement actually got smaller, and my bodyfat % went considerably down, my weight went up until I became borderline overweight by my insurance company. This is just crazy nonsense!
posted by eye of newt at 10:49 PM on January 25, 2010


became/was considered
posted by eye of newt at 10:52 PM on January 25, 2010


BMI is a height/weight chart that neglects to into account ethnicity, general level of fitness, heredity, body shape...

I think it's crap and I shudder every time I hear of it being used in any way related to things like graduating from college or insurance discounts.
posted by Pirate-Bartender-Zombie-Monkey at 11:33 PM on January 25, 2010 [2 favorites]


Eh, I don't really see what's so big of a deal. People who take care of their health should get a discount on their health insurance. Maybe when it comes to BMI super-fit people with excess muscles can get a waver or something.
posted by delmoi at 11:34 PM on January 25, 2010 [1 favorite]


This sounds like the Hershey Plan. I guess it depends whether you trust the BMI less than Met Life's wgt tables. Pretty old news.
posted by klarck at 11:43 PM on January 25, 2010


If "four out of five dentists agree", people find it quite reasonable to take the side of the four dentists.

However, if nine out of ten climate scientists agree that what we are doing will probably KILL MILLIONS... well, Mr. Mackey is with the "scientist" who draws his salary from Exxon.
posted by markkraft at 11:51 PM on January 25, 2010


"Historically, prosperity tends to correlate to warmer temperatures." - John Mackey

Well then...
Go to hell, Mr. Mackey.
posted by markkraft at 11:53 PM on January 25, 2010


I am going to go out on a limb and say that almost everyone who fails to qualify based on BMI result is going to flunk the BP and cholesterol tests.

I think this one comment perfectly illustrates how poorly naturally thin people understand fat people. I'm platinum on BP and cholesterol. Definitely not on BMI, where I'd barely qualify. Wait! My disgusting weight doesn't mean that for my individual physiology my BP and cholesterol are sky high?!? How can this be?

No, one more comment:

Being below 26 on BMI means for me being still about 10-15lbs overweight, being below 24 I'm at a pretty healthy level,

And this means what to my body and my health?

Dear thin people of Metafilter and the world,

My body is not like your body. My body doesn't isn't your body + however many pounds of disgusting fat you believe me to have. I'm not you "letting yourself go" and eating french fries and watching sitcoms till you gain enough weight to equal me. My muscles are bigger than yours, for one. My fat distribution is a lot like my father's, and his grandmother's (she lived back in the olden days when everyone was supposedly thin, but she was still shaped just like me). My body works for me. My doctor is unconcerned.

Using the BMI metric, I'm not in good shape. The BMI — which doesn't know my muscle-to-fat ratio, doesn't know how often I work out, doesn't know how many push-ups or sit-ups I can do or how many miles I can run — suggests I should try to disorder my eating a little bit and lose weight. Me, I don't think that's going to make me healthier. In fact, there's pretty good evidence that yo-yo dieting isn't good for me.

Nonetheless, your national obsession with my weight, and your vague disgust about how, if you weighed as much as I do, you would be a slug, can make me feel bad about myself. I'm embarrassed to have been born with the body I have. There, you win.

I'm going to keep on eating the healthy foods I'm currently eating. I'm going to keep working out. I'm going to keep going to the doctor and getting my cholesterol and blood pressure checked, to make sure that my "metrics" are still good. So, how about I keep maintaining my fat-but-healthy body, and you keep being (naturally) thin?

But for god's sake, the last thing I need at my workplace is a little daily reminder that my metrics don't measure up. Because even though I know I'm doing the right things as far as my health is concerned, you can still hurt my feelings by calling me a fattie.

Thanks,
purpleclover
posted by purpleclover at 12:01 AM on January 26, 2010 [18 favorites]


Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals.

If you don't think so, when this is the (successful) ethic of every other industrialized nation in the world, there's something wrong with you that no amount of rational argument will fix.

I swear to fucking Christ we need to start hanging people.
posted by clarknova at 12:04 AM on January 26, 2010 [1 favorite]


Giving people a material reason to want to improve their health based on those two metrics can really only be for the good.

The perception that overweight people are overweight because they're shiftless bastards who need to be bribed into exercise, dietary changes, and medical intervention never fails to confuse me.
posted by fairytale of los angeles at 12:24 AM on January 26, 2010 [1 favorite]


I eat healthy and ride bikes. I get more exercise than almost everyone I work with. I weigh 330lbs.

So, no, a sensible diet and exercise ain't gonna work for American-style modern obesity. It's a disease, not a poor lifestyle choice. But you can't be treated for the disease, because you have the disease... the company is making medical decisions without a license to practice. Swell.

You know what else is a disease that needs medical treatment instead of a Red Letter of Shame? Addiction.
posted by Slap*Happy at 12:58 AM on January 26, 2010 [1 favorite]


Treadmill to Bucks!
posted by Blazecock Pileon at 2:53 AM on January 26, 2010


Your results have no effect on how management perceives you. The results are confidential, maintained exclusively at the central benefits office (read: people you will never meet, ever). Managers have no access to the data. No one with hiring or firing power has access to the data.

I call "bullshit".

Fine...MAYBE they don't have access to data which says "employee A has an HDL count of X". But they have access to:

1. What employees are utilizing the discount (30% discount means healthier employee...which means less money spent on insurance...which means this employee is more promote-able and a better health insurance risk than the dude who only gets 20%). ie...Drinking the kool-aid makes you a better bet when its time to promote.

2. Aggregate data. It won't just be from the workers who are taking advantage of the plan, its from all applicants. I'm sure they will have no problems using that to come up with insurance plans to the detriment of a majority of the workers there.


Also, to all you people who are making shit up about not being able to test for smoking. You can test for that. Its a blood test, and its a metabolic byproduct of nicotine. Chotinine or something...I can't for the life of me find that...but I read about it while waiting for a blood test a few months ago.
posted by hal_c_on at 3:51 AM on January 26, 2010 [1 favorite]


I could be implied that WFM has an interest not only in cutting costs but also in motivating its team member base to be more healthy so, it could be further implied, they consulted with an expert on health and the one also billing WFM for health: the health care insurer. The health care company said based upon 50% of claims that were made, they involved obesity - thus these criteria were set forth.

You could say that the healthy-ness of it's team members and the savings on health care (in essence, benefiting all who profit from the company) falls right in line with some of the company's core values.

And, lastly: it's voluntary.
posted by lostinsupermarket at 4:37 AM on January 26, 2010


Let's see if I have this right...

All employees, fat or thin, get 20% off purchases. So they have a universal discount so to speak. IF YOU CHOOSE to be tested and are below a certain BMI, you get an extra discount. If you find this whole thing appalling, you ARE FREE to not work there and get no discount at all. You are ALSO FREE to not shop there at all because there are other options available. This is the beauty of our country-- you have a choice and you are free to choose it.

I don't understand the vitriol for this plan but Obamacare is a panacea among many Mefites. Can't you see that Obamacare (and the reason why so many people hate it) would institute these types of incentives/disincentives for you too? Just look at the proposed taxes on soft drinks and the actual taxes on cigarettes. It is simply naive to think the government would not start offering incentives for getting healthier to reduce costs (or, in effect, penalize you for being fat)? Are you going to be pissed off then?

Or how about when you realize that Obamacare doesn't give you the the FREEDOM of CHOICE to go down the road to shop at the competitor for health insurance.
posted by bigwoopdeedoo at 4:38 AM on January 26, 2010 [2 favorites]


I/It
posted by lostinsupermarket at 4:42 AM on January 26, 2010


Dude, did you really just use the word Obamacare, like, multiple times?

HA HA HA fail.
posted by Civil_Disobedient at 5:34 AM on January 26, 2010 [8 favorites]


Also, why not just give a larger discount to healthy foods (as mentioned already)?

Vitamins & supplements could be 30% off. Pretzels and chips, 10%.

How is that not a more fair system? That way the whole "my body is different than yours!" argument never even comes up.
posted by Civil_Disobedient at 5:36 AM on January 26, 2010 [2 favorites]


I mentioned it in the askme scruss linked to above, but if you want a more nuanced take on employee health incentives, this recent editorial in the New England Journal of Medicine is a good place to start.
posted by TedW at 5:37 AM on January 26, 2010


"Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals."

If you don't think so, when this is the (successful) ethic of every other industrialized nation in the world, there's something wrong with you that no amount of rational argument will fix.


If you talk to ethicists they will tell you that your take on the rest of the industrialized west's approach is wrong. Even among those subscribing to expansive views of human rights.

Many argue that health care is a basic human right, but much fewer argue that it is every citizen's natural right to have health care actually be supplied by his/her own government. Take, for example, a citizen in a poor, insolvent country with no natural resources. It is not at all unethical for that nation's government to prioritize other upper echelon rights over health care.

A closer summary of the (yes, very successful) ethic of every other industrialized nation would be "it is every wealthy society's responsibility to assure health care is provided for its members."
posted by aswego at 5:43 AM on January 26, 2010


I mentioned it in the askme scruss linked to above, but if you want a more nuanced take on employee health incentives, this recent editorial in the New England Journal of Medicine is a good place to start.

The most salient point that NEJM makes, IMO, is this:

But the scenarios above show that voluntariness can become dubious for lower-income employees, if the only way to obtain affordable insurance is to meet the targets.

"Incentive" programs are only voluntary when there exist reasonable alternatives, which the US lacks entirely. At the root of the matter, Mackey's program is one of many that use economic violence to punish lower-income workers who already suffer maltreatment at the hands of an abusive, for-profit healthcare system.

It gets worse when considering privacy and disclosure issues. In the US, weak privacy laws allow insurance companies to require patients to waive HIPAA rights before signing up for care plans, so in reality there exist few, genuine protections of your medical history. These voluntary programs only exacerbate existing privacy weaknesses.
posted by Blazecock Pileon at 6:11 AM on January 26, 2010 [2 favorites]


It's not that unheard of. Other companies are tying health programs to HSAs as well. Participate in the corporate walking program, make progress, get HSA credit dollars.

And 30% off of groceries for Whole Foods is pretty good. At least you're attempting to get healthy and get a discount for your budget.
posted by stormpooper at 6:16 AM on January 26, 2010


Mackey is a smart guy who talks before he thinks. Is it out of the realm of possibility that the BMI/BP/cholesterol thing is a gross mandate and healthy, fit employees with outlier numbers might be able to qualify if their test results are accompanied by a doctor's explanatory note? somebody with a dog in the fight should go ask him.
posted by toodleydoodley at 6:19 AM on January 26, 2010


Managers have no access to the data. No one with hiring or firing power has access to the data.

No, but I bet managers know who has the 30% discount. The rest are either a drain on their insurance premiums or not Team Players.
posted by dirigibleman at 6:29 AM on January 26, 2010 [1 favorite]


I'm guessing it's been said already given the 106 comments but... This is a great example of why health care is such a thorny topic.

Living healthier lives will lower the cost of our care. Good luck finding ways to encourage it without roiling the masses!

Smoke break anyone?
posted by MeatLightning at 6:39 AM on January 26, 2010


> And 30% off of groceries for Whole Foods is pretty good. At least you're attempting to get healthy and get a discount for your budget.

But don't you see the logical failure here? The people who would -- at least by Mackey's metric -- should be "attempting to get healthy" and therefore need healthy food the most, e.g. the obese and otherwise physically unfit*, are the ones who benefit least from the additional discount.

It's sort of like offering a free copy of Mavis Beacon to folks once they take a test and prove they can type 70 wpm.

* parroting Mackey's rationale here, not my own. I think, as many have explained far better than I could here, that "fitness" is a much more difficult state of being to pin down, and relying so heavily (heh) on BMI is just damned lazy.
posted by shiu mai baby at 6:42 AM on January 26, 2010


So this is what happens pommefrits., Slowly and surely all these services become free market and with all these horrible little qualifiers (Free health are for all church members, just don't ever get an abortion or vasectomy! We're building God's army!) at around the same time genetic engineering starts to deliver on its promises - you can;t build Supermen but you can influence metabolism, heart disease, more fast twitch muscle fiber etc. Soon the upper classes are clamoring tor the newer, better babies (there was a brief, regrettable fad for naturally hot pink hair) while at the same time lobbying that such "Pre-natal health services" should not be available to anyone else cause they would be "wasted". Who needs more efficient lungs when you sit behind a screen all day? The divine between the classes grows until it's a lteral biological divine and you've got GATTACA with Morlocks.
posted by The Whelk at 6:51 AM on January 26, 2010 [1 favorite]


Blazecock Pileon: Luckily, in this instance, we are talking about people earning decent pay who already have better health insurance than most people in the US.

No one is being punished for not meeting the new criteria -- nobody's discount is going down. Nobody's medical benefits are changing, not even the people who participate and pass. The only incentive is an additional employee discount, on top of the 20% that no one was complaining about being stingy in the first place.

If the people up top had a lick of sense, they would leave BMI off their criteria. Purpleclover is a perfect example of why. BMI is not a reliable tool and it sends a negative message. But I believe on balance this system existing is an improvement over it not existing. I am certainly motivated to improve my BP and cholesterol before the 6 mos voluntary retesting, and if I can change my habits and improve those results I will live longer. I think that's pretty cool.

toodleydoodley - I disagree with your assessment of Mackey's abitity to think before acting. The rollout on this was horribly botched, with a ton of wailing and rending of cloth (guilty!) in a vacuum of knowledge. I think they were rushing it through to coincide with the companywide rollout of a new Health Starts Here marketing/merchandising campaign. But, we have been told that there is a forthcoming FAQ on things like "What about pregnant women's BMIs?" and "What about genetically high cholesterol?"
posted by kitarra at 6:57 AM on January 26, 2010 [1 favorite]


I think the inherent assumption that buying more food at Whole Foods means your diet is healthier will eventually result in the irony of someone knocking him- or herself out of the 30% discount range by eating all that discounted food. A delicious irony indeed.
posted by mikeh at 7:33 AM on January 26, 2010 [1 favorite]


I don't understand the vitriol for this plan but Obamacare is a panacea among many Mefites. Can't you see that Obamacare (and the reason why so many people hate it) would institute these types of incentives/disincentives for you too? Just look at the proposed taxes on soft drinks and the actual taxes on cigarettes. It is simply naive to think the government would not start offering incentives for getting healthier to reduce costs (or, in effect, penalize you for being fat)? Are you going to be pissed off then?

Or how about when you realize that Obamacare doesn't give you the the FREEDOM of CHOICE to go down the road to shop at the competitor for health insurance.


Well, that took longer than expected. Who had 26 minutes in the pool?

Do you actually need me to sit down and sketch out for you why vice taxes are structurally different than private health insurance imposing de facto surcharges on unhealthy people? Because I have all this math-y stuff about how if you offer a small discount at your own stores that costs you less than the discount that the insurance company gives you in exchange for requiring your employees to surrender private health care information that your insurance company will soon use to further raise your premiums (at the expense of your employees and not you, natch), your insurance company will make more money both short- and long-term, you'll make more money, your employees will get bent over a fence post, and you'll be able to get your insane and exploitative libertarian-ideals-masquerading-as-an-earnest-attempt-at-health-care-reform published in vaguely-reputable right-leaning publications.

But I rather suspect that would be wasted effort.
posted by Mayor West at 8:12 AM on January 26, 2010 [3 favorites]


I am going to go out on a limb and say that almost everyone who fails to qualify based on BMI result is going to flunk the BP and cholesterol tests.
Yeah, no. Like purpleclover, I also have stellar, perfect BP and cholesterol yet my BMI is currently in the 27ish range. Guess what? I also smoke. Clearly I am far from an ideal employee and probably will not be deemed worthy of health care eventually. Still, I sort of feel that my health information should be between my doctor and me, period, full stop.

Can't you see that Obamacare (and the reason why so many people hate it) would institute these types of incentives/disincentives for you too? Just look at the proposed taxes on soft drinks and the actual taxes on cigarettes.
Here's the difference - although your use of the ridiculous term Obamacare makes me think I'm wasting my time, here - those taxes don't require blood tests. Institute a vice tax and blammo: I'm paying more for cigarettes while my health information stays confidential. I don't have a problem with my bad habit costing me more money (well, I do, frankly, but only in a whine about it in private sort of way that acknowledges that I don't really have an ethical or logical leg to stand on and still allows me some room for self pity.)

Yes, I'm a smoker and I think higher cigarette taxes are perfectly fair. They're working. They're finally getting even me to walk slowly towards the quitting line. I don't drink sodas for the most part but if I did and I wanted a giant daily dose of HFCS I wouldn't have a problem paying extra taxes for that either. Let's look at the difference here, shall we? Under current and proposed vice taxes, every time I walk into my local convenience store to buy a 6 pack and a pack of smokes and a 2 liter bottle of soda and perhaps a giant chocolate bar, part of my hefty bill is going to the government, where, presumably, it will eventually go into a pool that will include health insurance of some kind even for hideous, fat, drunken, smoky me. Fine. However, if we adapt the Whole Foods model that you are erroneously attributing to "Obamacare" then every time I walked into that store I would be met by a phlebotomist wielding a giant needle to check my cholesterol and my final bill would depend on that, as well as on the BMI being measured by yet another government employee with a tape, not to mention the blood pressure taker. That would make my shopping experience rather dismal and end up costing everyone a whole lot more money, because those government measuring drones don't come cheap.
posted by mygothlaundry at 8:37 AM on January 26, 2010 [2 favorites]


It is simply naive to think the government would not start offering incentives for getting healthier to reduce costs (or, in effect, penalize you for being fat)? Are you going to be pissed off then?

Let me reiterate what has been said in a couple different places - opponents of US healthcare reform always pretend like no one has ever tried a single-payer system before, ever. And they make up all sorts of SCARY arguments about how bad it will be.

No Canadian province denies health care to a resident (not even citizens! Mere residents!) because they made choices that lead to poor health. My aunt smoked her whole life and still got treatment for lung cancer. Overweight people get treated the same as normal weight people. Even people who routinely exceed the posted speed limit in their vehicles get treated when they injure themselves or others. The same is true in Germany, the UK, France - I mean, jeez, you think any of them are going to give up their diet of red wine and foie gras? Unlikely.

Your crazy straw man is both crazy and a straw man.
posted by GuyZero at 9:58 AM on January 26, 2010 [6 favorites]


No Canadian province denies health care to a resident (not even citizens! Mere residents!) because they made choices that lead to poor health. My aunt smoked her whole life and still got treatment for lung cancer. Overweight people get treated the same as normal weight people.

It remains to be seen what the nationalized health care systems are going to do when they are resource constrained going forward. The last 50 years for the western world have been simply an incredible anomaly from the point of view of history.

This is a real issue; perhaps they will deal with end of life and rationing sensibly. There is no such acceptance in the US and a strong reluctance to honestly deal with the problem that medicare will become as our population ages.

The opposition to national health care in the US is not _entirely_ irrational teabaggers and loons. The Canadian government does not appear to play games with everything it can to win votes; at least this is how it appears to the outsider. The US political parties constantly game with medicare and social security, progressively more with each election. It should be no surprise that the US citizens have a sort of wonky feeling about putting something else into the political arena.

Look at the proposed bill as an example of how US politics can readily go off the deep end and insane.

(note: totally, 100% in favor of US HCR, single payer, etc.)
posted by rr at 11:02 AM on January 26, 2010


To be fair...

It remains to be seen what the nationalized health care systems are going to do when they are resource constrained going forward.

Unequal access to cancer drugs creates 'postal-code lottery' - apparently they allocate certain cancer drugs regionally so more populated regions get proportionally less of the drugs and more patents are forced into second-tier treatment, at least for chronic lymphocytic leukemia. Also, we make people wait.

But it's not like everyone in the US with leukemia gets treated for it either.
posted by GuyZero at 11:13 AM on January 26, 2010


Unequal access to cancer drugs creates 'postal-code lottery' - apparently they allocate certain cancer drugs regionally so more populated regions get proportionally less of the drugs and more patents are forced into second-tier treatment, at least for chronic lymphocytic leukemia. Also, we make people wait.

This is a time of plenty. There is very little that will improve over the next thirty years in terms of the overall health needs of the aging population.

Europe is going to get there first, it will be quite interesting what happens.
posted by rr at 6:57 PM on January 26, 2010


I like how people pretend that the Baby Boom generation wasn't larger than all generations since and that the number of people requiring Medicare and Social Security is only going to get larger. It's incredibly stupid, and incredibly widespread.
posted by Pope Guilty at 7:20 PM on January 26, 2010


I'm unsure whether that's a for or an against health care reform, PG. Old people are going to get Medicare under the status quo in the US and they're going to get what they always got in civilized nations while governments pop a vein trying to figure out how to pay for it.
posted by GuyZero at 8:50 PM on January 26, 2010


Oh, shit, I meant to make a better comment for my #5000. Anyway, there it is world. Enjoy.
posted by GuyZero at 8:50 PM on January 26, 2010


"Mackey is a smart guy who talks before he thinks."

"We sell all kinds of candy. We sell a bunch of junk."


"I don’t believe that business primarily exists to make a profit."

“While (Economist Milton) Friedman believes that taking care of customers, employees, and business philanthropy are means to the end of increasing investor profits, I take the exact opposite view: Making high profits is the means to the end of fulfilling Whole Foods’ core business mission."

"Whole Foods management doesn't manage the business in terms of the short-term stock price. I doubt they even look at it more than once a month or so." - posted by Mackey to the Yahoo! Finance forums, using an alias. He was investigated by the SEC for attempting to manipulate WFM's short-term stock price.

"Would Whole Foods buy OATS? Almost surely not at current prices. What would they gain?"

"The writing is on the wall. The end game is now underway for OATS. ... Whole Foods is systematically destroying their viability as a business — market by market, city by city."

"I like Mackey's haircut. I think he looks cute!"

"If (Whole Foods') stock trades down then it only becomes a more compelling value for long-term investors."

"The union is like having herpes. It doesn't kill you, but it's unpleasant and inconvenient and it stops a lot of people from becoming your lover."

"In light of this significant change of circumstances, we have decided the best way to respect the wishes of our Madison team members is to withdraw recognition from the union, and we have done so effective yesterday."

"I don’t like authoritarian managers."

"You only love animal fat because you’re used to it. You’re addicted."

"We’ve been making it up as we’ve gone along. I never took any business classes or worked for other companies."

"'Happiness is often seen today as self-indulgent and narcissistic . . . Why should I have so much when others have so little?' What many of us have yet to learn, however, is that the key to creating happiness and abundance throughout the world is to first experience it within ourselves."


So, basically, he's a vain, shallow, dishonest, two-faced, self-serving, manipulative, greedy authoritarian f*ck who couches his faux-green image in phony, new-age rhetoric, routinely saying things that upset and alarm both his customers and his shareholders.

(Just in case that wasn't abundantly clear yet.)
posted by markkraft at 5:22 AM on January 27, 2010 [2 favorites]


« Older Tishman Speyer Properties is defaulting on its $5....  |  Two free EPs from the cerebral... Newer »


This thread has been archived and is closed to new comments