Financial penalties for the unhealthy? Ethical guidelines for holding employees responsible for their health.
As health care costs continue to rise, an increasing number of self-insured employers are using financial rewards or penalties to promote healthy behavior and control costs. These incentive programs have triggered a backlash from those concerned that holding employees responsible for their health, particularly through the use of penalties, violates individual liberties and discriminates against the unhealthy. This paper offers an ethical analysis of employee health incentive programs and presents an argument for a set of conditions under which penalties can be used in an ethical and responsible way to contain health care costs and encourage healthy behavior among employees.
National Institutes of Health (NIH) Clinical Center Department of Bioethics in Bethesda, Maryland, USA. spearson@icer-review.org
Steven D
SD
Pearson
Sarah R
SR
Lieber
D002755:Choice Behavior; D002908:Chronic Disease / Q000191:economics* / Q000517:prevention & control; D003068:Coercion; D004649:Employee Incentive Plans / Q000191:economics* / Q000941:ethics*; D004992:Ethics, Medical; D005382:Financing, Personal / Q000191:economics* / Q000941:ethics*; D017408:Guidelines as Topic; D015438:Health Behavior; D006264:Health Benefit Plans, Employee / Q000191:economics* / Q000941:ethics*; D017048:Health Care Costs / Q000941:ethics*; D020408:Health Insurance Portability and Accountability Act / Q000191:economics / Q000941:ethics / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D055118:Medication Adherence; D009042:Motivation; D026706:Paternalism; D012941:Social Responsibility; D014481:United States