Firms Use Carrot, Stick to Encourage Healthy Habits Firms are cracking down on the health of employees. Clarian Health recently revised plans to penalize workers for smoking, high blood pressure, or a body mass index over a certain limit. Monitoring workers' health is a growing trend; it costs more to insure smokers and overweight people.
NPR logo

Firms Use Carrot, Stick to Encourage Healthy Habits

  • Download
  • <iframe src="" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript
Firms Use Carrot, Stick to Encourage Healthy Habits

Firms Use Carrot, Stick to Encourage Healthy Habits

  • Download
  • <iframe src="" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript


On Wednesdays we talk about the workplace. And today we'll explore what your employer has to say about your health and your weight. IBM recently said that starting next year it will pay employees $150 if they sign up their kids for a program to fight childhood obesity. Clarian Health, a hospital chain in Indianapolis with 13,000 employees, recently attempted something even more dramatic.

We've brought in Liz Ryan, Business Week columnist, and becoming a regular guest on this program, to talk about what happened. Liz Ryan, what did Clarian try to do?

Ms. LIZ RYAN (Columnist, Business Week): Well, the original thought process there, Steve, was to fine the employees of Clarian Health if their health metrics - I'm talking about BMI...

INSKEEP: Body mass index.

Ms. RYAN: Exactly - and other sorts of numeric measurements, didn't reach certain goals, people would actually be sort of entered into this program where they'd be measured according to certain guidelines and targets, and if they fell short or went over, for example, in the case of BMI, they'd be fined, they'd lose money out of their paycheck.

INSKEEP: You'd be docked in pay if you stepped on the scale and it was a few pounds too high?

Ms. RYAN: You'd be docked in pay.

INSKEEP: So what happened?

Ms. RYAN: Well, they made this announcement. It made some level of national news. There was a pretty strong reaction among the workplace commentator population, and evidently Clarian backed off. They're going more now to an incentive-based program like many, many employers across the country. I think that's fantastic.

But I think what they learned in the process was just really what are the limits of what people will tolerate in terms of employers' intrusion into their personal lives.

INSKEEP: Is it illegal for a company to say they're going to dock your pay if you weigh too much or if you smoke?

Ms. RYAN: No, it's not in general. There are some places where employment discrimination on the basis of weight, okay, are illegal, like Santa Cruz, California and the state of Michigan and a few other spots. But for the most part, that is not illegal. And it's not illegal to discriminate in employment situations against smokers.

INSKEEP: Well, now, let's talk about this from the employer's perspective for a moment. If you're a company like Clarian, you're a hospital chain, you're obviously focused on health care.

Ms. RYAN: Yes.

INSKEEP: You probably have health care costs for your employees just like everybody else that keep on going up. Why wouldn't you take drastic measures if you could to make sure that employees are living in a more healthy way?

Ms. RYAN: Great question, and of course you should take aggressive measures, absolutely, around wellness education and intervention to make it easier for people to exercise during the workday or after or before, to have great nutritional choices, to learn about all sorts of positive health interventions.

The place where Clarian sort of when out of bounds was in this Big Brother approach. If you don't achieve arbitrary goals that we've set, we're actually going to take money out of your paycheck. And I think that's where people really pushed back.

INSKEEP: Pushed back because why?

Ms. RYAN: Because this is the United States. It's not Romania under Ceausescu. We don't require people as a condition of having a job to get on a scale and to be measured and to have it written down. It's a very bad way to manage people.

INSKEEP: So we've mentioned two companies here in particular: one that had the stick of a punishment to loss and pay, the other that offered a carrot of an actual payment for a change in healthy practices, actually for people's families, for their kids. Would you say that that's where the line should be drawn between what's appropriate and what's not?

Ms. RYAN: I absolutely would, Steve. I think all of those forward-looking proactive, voluntary - that's a key - voluntary wellness interventions at work are fantastic things. One of the ironies about workplace health education is that the workplace tends to be the place, in many cases, where our health suffers.

We sit, we're sedentary, we have a high level of stress very often, way too much stress. So you know, it is only right that our employers should begin to intervene in the opposite direction.

INSKEEP: Liz Ryan writes about workplace issues for Business Week and also for

Copyright © 2007 NPR. All rights reserved. Visit our website terms of use and permissions pages at for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.