A Big Problem: Obesity and Employee Rights
For employers and employees, this truism holds: its not over until the Equal Employment Opporunity Comission (EEOC) or the Court rules on it.
Is obesity a disability? Isn’t fat just that—fat—someone who eats a few (okay many) nacho’s while lounging on the couch while watching TV, night after night? Or is it a complicated medical condition?
It’s Not Over ‘til the Horizontally Challenged Woman Sings
Research shows that the majority of Americans who want to reduce their weight fail. Why? Sixty-eight percent of America can’t be that lazy, and as for the 1/3 of those that fall within the definition of obese, maybe it is more than just too many trips through the fast food window. Looking at this epidemic, which is what obesity is called in America, from both sides might provoke discussion, and this month that is what I am striving to do.
Studies show that obesity counts for 17% of direct health care cost in this country. Obese patients have medical costs 42% higher than their thinner counter parts. This epidemic hits us financially when 12.9 percent of private payer costs are related to obesity.
This does’t mean that someone who is obese is being treated for obesity. These costs are the co-morbidity costs of health conditions that are linked to weight problems, such as type II non-insulin dependent diabetes, heart disease, high blood pressure, and sleep apnea, to name just a few. Prescription costs alone are on average $600 a month more for the obese than for a person who fails within weight guidelines.
People don’t understand the challenges of obesity. Ignorance is prevalent in peoples’ thinking. Comedians routinely make fat jokes, and people tell fat jokes in front of fat people—fat people are jolly, after all, aren’t they?
I have been told by obese individuals:
I would rather be an alcoholic than obese, I could stop drinking and never do it again—but I have to eat every day.
Obese people hear the comments, “Look how fat she is, she doesn’t need those French fries,” and see the distain in the eyes and voices of those around them, living with the bias and discrimination. It may not be illegal (not all of it), but it is discrimination.
Applicants speak of attending job interviews and having interviewers shift their bodies away from them, cutting short an in-person interview with a candidate who they said “clearly has the experience we are looking for” during a phone interview. Obese applicants and obese employees are obese—not stupid, not lazy, nor naïve.
Morbidly obese women earn 24.1% less than their standard weight counterparts. One study showed that obese employees were treated worst in discharge decisions than ex-felons (not that I am advocating poor treatment for felons based solely on their convictions).
Twenty-six percent of study participants reported being denied health insurance or other benefits because of weight, and 16% felt pressured to leave their jobs because of their weight. These are the statistics that obese employees face, and they need employers who understand the complexity of the condition, looking to wellness programs, health care coverage, and specialized doctors to assist them when necessary.
Who do we think is paying for the cost of higher premiums for health care due to usage by the morbidly obese or obese employee? The employer and society (Medicare and Medicaid) must step in if other guidelines are satisfied. Employers contain these costs through a variety of methods: increasing co-payments, plan design, and the introduction of wellness programs.
Weight issues are more complicated than increasing or exposing the employee to higher premiums—it’s a legitimately serious health condition. The prevailing concept is to promote employee participation and utilization in wellness programs through discounts on premiums and coverage. Yet, this is not enough for the employees at the highest risk of weight-related health problems.
Many employer’s policies exclude bariatric surgery (gastric bypass, gastric banding, etc.) because it’s too expensive, and obese patients already encountering bias may not have the resources to pay for the surgery themselves. However, and yes it’s a big HOWEVER, studies are showing carriers see surgery paying for itself in less than 2 years, which is not a significant amount of time when an employee’s health and ability to perform their job is concerned.
Carriers have voiced concerns about safety, quality issues, and the experience of the surgeons, but the risk of death has dropped to less than 1 percent, and centers of excellence have evolved for patients. The medical community is responding. Omaha has a variety of seasoned physicians who have developed expertise in this field.
Finding Balance on a Weighty Issue
This is an issue that will continue to be debated, and I forecast a new arena of litigation as employees fight literally for their lives. They will participate in wellness programs, but they aren’t the answer for all employees. Telling a morbidly obese employee to participate in wellness options when they can’t even walk the length of the hall is like telling some who is engaged in high risk behavior they can reduce their risk of STD’s by just becoming abstinent. Ludicrous, definitely, but the analogy works even if we don’t want to admit it yet.
We need to approach obesity with common sense and compassion—it is a complex condition—and while its effect is visible in the extra weight, many of its causes may not be so clearly seen. We have to look beyond traditional solutions and agree to focus on obesity as a health condition that requires treatment.