Moment of venting…

Please allow me a moment to vent. I’m REALLY frustrated at one of the ELCA’s new “wellness” initiatives. The ELCA Board of Pensions is raising the cost of health insurance premiums, as well as co-pays and deductibles, in the new year. This is not surprising, as just about every health insurance company in the nation is doing so. And I don’t really blame the ELCA. But what really is exercising my frustration this morning, is that the ELCA BOP has set in place a “wellness initiative” that comes wrapped up in an incentive plan that supposedly will offset these rising costs.

It works a little bit like those annoying rebate forms you might be familiar with from electronics stores. You log in to a wellness website, managed through the Mayo Clinic (or at least "branded" by them), and then are presented with a series of things you can do. For each task you complete, you are "rewarded" with points, and earning a certain number of points adds up to actual funds deposited in a health savings account that you can use to pay those pesky deductibles.

Ok, so far so good, I suppose. I imagine the ELCA BOP is congratulating themselves on finding a positive way to promote good health, while helping people who are willing to take some action to cover their health care costs.

The problem is that the "tasks" that you are encouraged to take on (read: that you must do if you are going to earn reward points, to get back the funds that offset the increases in the insurance costs) are ALL individual, and assume what Malcolm Gladwell has called a "moral hazard" understanding of health insurance. Gladwell is one of my favorite New Yorker writers, and that piece (although it was printed in 2005) remains one of the clearest articulations I've read of the differences between the US health care industry (which is profit-oriented) and the health care systems of most of the "developed" world, which are health promotion oriented.

So you can get reward points in this ELCA BOP system for signing up for a weight loss program, or a smoking cessation program, or for visiting the website a certain number of times. But there is no incentive for writing to your legislators on behalf of universal health care, or for purchasing locally grown food, or for setting up a lay-led, congregationally-based care system. Indeed, what the reward points do is encourage people who are on the ELCA BOP health insurance plan to minimize the financial risks that the the ELCA BOP incurs.

I suppose, given that the ELCA is a cooperative endeavor, that there is some social good to be gained by minimizing such risks, but on the other hand -- surely our theological commitments drive us towards the common good? Surely what we ought to be doing, at least in terms of social engineering (which is what this kind of incentive system is oriented towards), is promoting health care FOR ALL, and finding ways to attack the root causes of many of our health care problems -- like environmental toxins, a culture of stress and anxiety, racism, etc. etc. etc.?

I'm REALLY frustrated by this whole process, and that doesn't even begin to touch on my concerns about sharing some very private health information in a web-based tool run by the Mayo Clinic (one of the things the ELCA BOP is really pushing each of us to do, is to fill out a "health risk assessment" that includes very specific information you can only get from your doctor).

Ok. Rant done. Thanks for giving me the chance to get this off my chest!