The Price We Pay: What Broke American Health Care--and How to Fix It

by Marty Makary

So why do people want to focus on things like lowering central line infections by using the surgery checklist and Safeway model? I think it’s because the real drivers of health care costs are legacy stakeholders, like hospitals, insurance companies, or drug companies, or all the middlemen I’m exposing in this book. There are so many hands taking money out of the system that there’s no silver bullet solution to save money. To lower costs, we must take on the powerful stakeholders. It’s easy to blame bacteria for our health care woes, but infections are not the reason your premiums went up 15% last year.

The evidence doesn’t support the “unbridled enthusiasm” for wellness programs found by the team. They also revealed that certain programs appear to violate the Americans with Disabilities Act, which prohibits employers from conducting medical exams and collecting histories of their employees unless they are voluntary. Some financial incentives don’t give employees a real choice about “volunteering” to share their medical information, the study said.

“Most programs do not work; some raise serious legal concerns. It is time for employers and policymakers to rethink their enthusiasm for the wellness movement.”

The solution isn’t to throw out all workplace wellness programs, but to choose a wellness program that is based on science and results in wiser health care choices.