Monday, August 8, 2016

The Trouble With Insurance Wellness Programs

I've noticed a trend in health insurance developing over the past several years - wellness programs. The insurer hubby and I use has one of these programs and they are constantly pestering me. I get phone calls and letters in the mail informing me that they can help me manage my condition better. All I have to do is call their nurses at such and such number. I've also been seeing more and more commercials for insurance providers who are touting their wellness programs as a selling point.

As wonderful as wellness sounds I can't help but have some mixed feelings about insurance company programs. So here are my thoughts:

On the up-side
Everyone benefits from preventative care and a focus on wellness instead of just illness. It's always cheaper and better to prevent problems instead of trying to treat or solve problems. That's true for everything, not just in matters of healthcare. There's even a saying - an ounce of prevention is worth more than a pound of cure.

A wellness program that can help educate people about eating well, exercising, cutting back on alcohol, quitting smoking and managing any conditions is a great idea in theory. Some people really do need help with education, follow through and encouragement.

On the down-side
A wellness program administered by a health insurance company doesn't likely have what it takes to make a real difference in wellness for 2 simple reasons. First, there is no physical location or in-person contact with the nurses who run these programs. Change is extremely hard, way too hard to manage with some random voice over the phone. Second, it's not realistic to think that these nurses can actually help. They don't have access to your medical or social history (thankfully!) and they don't have the medical training to really help with the wide range of complex medical conditions people are experiencing. For example, me. I know more about my conditions than both my PCP and my OB/GYN. I certainly know more than any nurse working for the insurance company.

I suspect these nurses are intended to help the insurance company save money by helping people manage common expensive conditions like diabetes, weight management, high blood pressure and the like. They certainly are not prepared for people like me, which doesn't stop them from trying to shove me into one of their programs to make themselves feel better.

In addition to the ineffective nature of insurance wellness programs, I have a difficult time trusting them with my private health information. In general I believe personal information needs to be carefully guarded and only given out on a need to know basis. The fear with insurance companies is that at some point in the future that information could be used against me. Right now laws might be in place about pre-existing conditions and such but republicans have continually tried to overturn this law since the moment it became a law. It's entirely possible that they might succeed some day.

I think wellness programs are a fantastic idea and I would love to see all people be able to access them as a right. Wellness ought to be valued and prioritized much more than it is today. It ought to start in preschool and be provided through high school - that will also require an overhaul of the school lunch programs, which consider pizza to be a vegetable. It should be available for adults in the community who need continued support. But it also needs to include access to food, quality medical care and mental health care. We need to eliminate food deserts and ensure that nobody goes hungry. We need to have a livable minimum wage and support for people who are unable to work.

Okay, I'm getting off topic here - my point is, insurance wellness programs feels to me like putting a bandaid on a severed limb. Plus, I'm pretty sick and tired of being harassed by them because I'm not participating.

1 comment:

  1. I like that BCBS has the wellness survey at the start of the year because I get $50 loaded to my BCBS card to use on prescriptions. They also have coaching online for things like exercise, losing weight, mental health, etc. I did try their "helpful" program that meant I was on the phone for about 2 hours explaining to someone everything I have going on. They wanted to schedule a follow-up and I declined because the first call was exhausting enough. I called the nurse's line one time and it was a waste of time for the very reasons you state: they aren't knowledgeable enough to handle calls from people with multiple chronic illnesses. I go to CVS Minute Clinic when it's something like a sinus-related illness, but otherwise, I see my family doctor or the internal medicine doctor I have to oversee all that's going on with me.