EVERY SPRING IT’S the same ritual, and every spring it makes me the same kind of crazy. It’s the annual crisis of conscience called the Healthy Incentives survey.
If you don’t work for King County as my husband does, you may not know about this maddening public sacrament. People insured through King County spend the first six months of the year in rabid pursuit of the coveted Gold Status, which so reduces one’s out-of-pocket health insurance expenses that it’s worth the rabid pursuit. So reduced that some 90 percent of employees sign up.
The program consists of two parts: First, a Self Assessment, where participants submit their weight, drinks per week, cholesterol levels, body mass index, and other conversation killers. The program shoots back a verdict (“You’ve earned Silver Status on your insurance rates!”) along with a menu of personal improvement regimens to fulfill in order to qualify for Gold Status. Choose a 10-week regimen—working out, eating healthier, destressing, the usual suspects—and this becomes the second part: the Personal Action Plan. Complete the plan; snag the lower-priced Gold Status.
One records one’s statistics and progress on the honor system—and therein lies the rub. Four years ago when King County became one of the nation’s pioneers of Healthy Incentives, the new paperwork and new deadlines took my husband and me so by surprise that we madly logged all 40 days’ worth of exercise entries the night before it was due. Let’s see…what day was that beach run? Was that before or after the long bike-ride day? Sure we were missing the day-by-day value of the program—but just getting the worksheets completed without a second to spare felt practically aerobic.
The next year we were more prepared—and shrewder. The night before the deadline found us horizontal on the couch, Kahlua milk shakes lubricating the “memories” effortlessly. “Let’s see…if I ran 10 miles on April 11, I wouldn’t be likely to run for a couple more days,” my husband mused. “We’ll make April 12 an easy gym day, shall we?” Slurp. Belch.
Don’t get me wrong—it’s not like we…lied. We both work out, enough to fulfill the spirit of the action plan, if not exactly the letter. “It’s just like this,” my husband blurted to a colleague over beers a few weeks later. “When the plan is so easy to bluff your way through—I gotta admit, it’s difficult to take it seriously enough to tell the truth, let alone change my behavior for.”
The colleague, an alum of the department that managed the plans, burst out laughing. “You think we don’t know people lie?” he said. “We know people lie!” Even former County Executive Ron Sims lied on his wellness assessment, famously admitting to his staff that he knew it was time to commit to a fitness regime when he fudged several pounds off his weight and the thing still pronounced him fat.
“The thing about this plan,” my husband’s coworker concluded, “is that it works anyway.”
Since King County became one of the first employers in the country to link out-of-pocket expenses with participation—in other words, one of the first to reward employees for merely logging attempts to live healthier—those employees have in fact become healthier, in 12 out of 14 areas. This the authorities determine by comparing insurance claims data (anonymous, of course) with wellness assessment responses.