職場生活: 你胖沒關係, 有老闆爲你買單

Are you a man with a waist measuring 40 inches or more? If you want to work at Michelin North America Inc., that spare tire could cost you.

你的腰圍達到或者超過40英寸了嗎？如果你想在米其林北美公司(Michelin North America Inc.)工作，腰部的這些贅肉可能會讓你付出代價。

Employees at the tire maker who have high blood pressure or certain size waistlines may have to pay as much as $1, 000 more for health-care coverage starting next year.

從明年開始，這家輪胎製造企業裏患有高血壓或腰圍達到一定尺寸的員工也許不得不額外支付多達1,000美元的醫療保險費用。

As they fight rising health-care costs and poor results from voluntary wellness programs, companies across America are penalizing workers for a range of conditions, including high blood pressure and thick waistlines. They are also demanding that employees share personal-health information, such as body-mass index, weight and blood-sugar level, or face higher premiums or deductibles.

就在應對醫保費用不斷上升、自願健康計劃收效甚微的局面的同時，全美各地的企業開始對具有某些身體狀況的員工實施懲戒措施，其中包括高血壓和粗腰圍。他們還要求員工提供體質指數、體重和血糖濃度等個人健康信息，否則員工會面臨更高的保費或自費額度。

Corporate leaders say they can't lower health-care costs without changing workers' habits, and they cite the findings of behavioral economists showing that people respond more effectively to potential losses, such as penalties, than expected gains, such as rewards. With corporate spending on health care expected to reach an average of $12, 136 per employee this year, according to a study by the consulting firm Towers Watson, penalties may soon be the new norm.

公司領導說如果不改變員工的習慣，他們無法降低醫保費用。他們援引了行爲經濟學家的研究成果，認爲相比獎勵這樣的預期收益，人們對罰金這樣的潛在損失會做出更有效的反應。根據韜睿惠悅諮詢公司(Towers Watson)的一項研究，由於美國各公司今年在員工醫療保健方面的花費預計會達到人均12,136美元，處以罰金也許很快會成爲大勢所趨。

Employers may argue that tough-love measures, such as punishing workers who evade health screenings, benefit their staff and lower health-care costs. But such steps also portend a murky future in which a chronic condition, such as hypertension, could cost workers jobs or promotions─or prevent them from being hired in the first place.

老闆們也許會說，諸如處罰逃避體檢的職員這種嚴愛式的措施可以使員工受益，並降低醫療保健費用。不過這些措施對員工而言也預示着一個暗淡的前景，像高血壓這樣的慢性病可能會讓員工失去工作或晉升機會──或者一開始就成爲了妨礙他們被錄用的障礙。

Until recently, Michelin awarded workers automatic $600 credits toward deductibles, along with extra money for completing health-assessment surveys or participating in a nonbinding 'action plan' for wellness. It adopted its stricter policy after its health costs spiked in 2012.

就在不久前，米其林還一直針對自付費用部分向員工提供600美元的自動獎勵金，以及用於健康評估調查或參加非約束性健康“行動計劃”的額外資金。2012年公司的醫療保健開支大幅上升之後米其林才採取了更爲嚴格的政策。

Now, the company will reward only those workers who meet healthy standards for blood pressure, glucose, cholesterol, triglycerides and waist size─under 35 inches for women and 40 inches for men. Employees who hit baseline requirements in three or more categories will receive up to $1, 000 to reduce their annual deductibles. Those who don't qualify must sign up for a health-coaching program in order to earn a smaller credit.

現在，這家公司只對那些在血壓、血糖、膽固醇、甘油三酯和腰圍──女士35英寸以下，男士40英寸以下──方面達到健康標準的員工予以獎勵。有三項及以上指標符合最低要求的員工會得到最高1,000美元的獎勵，這樣可以降低他們的年度自付部分的費用。那些達不到要求的人則必須報名參加一個健康指導項目才能得到額度縮小的獎勵金。

Employee-rights advocates say the penalties are akin to 'legal discrimination.' While companies are calling them wellness incentives, the penalties are essentially salary cuts by a different name, says Lew Maltby, president of Princeton, N.J.-based National Workrights Institute, a nonprofit advocacy group for employee rights in the workplace. 'No one ever calls a bad thing what it really is, ' he says. 'It means millions of people are getting their pay cut for no legitimate reason.'

員工權益維護人士說這樣的懲戒與“法律歧視”沒什麼區別。盧•莫爾特比(Lew Maltby)是總部位於新澤西州普林斯頓(Princeton)的非盈利在職職工維權組織美國工作權利學會(National Workrights Institute)的主席，他說，雖然企業稱之爲健康激勵機制，但是這些措施實質上是在以不同的名義減薪。他說：“對於壞事情沒有人會實話實說。它意味着數以百萬計的人在毫無合法理由的情況下被減了薪。”

Companies may say they have tried softer approaches, but many haven't exhausted their options, like putting healthier food in their cafeterias, building a fitness center or subsidizing gym memberships, he adds. 'At best, these programs are giving employers an enormous amount of control over our private lives.'

他還說，企業也許會說他們已經嘗試了更柔性的手段，但其實很多企業都還沒有傾盡全力，比如在食堂裏提供更健康的食品、建立健身中心或者補貼健身房會員費。“這些計劃充其量是讓老闆大大增加了對我們的私生活的控制。”

Michelin denies any discrimination and says the policy is voluntary. Not participating means employees won't get the incentives. Wayne Culbertson, Michelin's chief human resources officer, says the old incentive programs didn't lead to meaningful change. For example, an employee could pledge to start walking daily, he says, but never have to prove it. 'It was sort of free, you know? You got $600 just for being a good employee.'

米其林否認有任何歧視，聲稱這項政策是自願的。不參加的員工就不會得到獎勵。米其林的首席人力資源長韋恩•卡伯特森(Wayne Culbertson)說，舊的獎勵機制並沒有帶來實際意義的變化。比如，一名職員可以承諾開始每天散步，但從來不用證明自己真的這麼做了。“這有點像免費大餐，你知道嗎？你當好一名員工就可以得到600美元。”

Six in 10 employers say they plan to impose penalties in the next few years on employees who don't take action to improve their health, according to a recent study of 800 mid- to large-size firms by human-resources consultancy Aon Hewitt. A separate study by the National Business Group on Health and Towers Watson found that the share of employers who plan to impose penalties is likely to double to 36% in 2014.

根據人力資源諮詢公司怡安翰威特(Aon Hewitt)最近對800家大中型企業的研究，六成企業的老闆說他們計劃在今後幾年裏對不採取行動改善自身健康狀況的員工實施懲戒。由美國企業員工健康組織(National Business Group on Health)和韜睿惠悅公司開展的另一項研究發現，到2014年，計劃實施懲戒措施的僱主比例很可能會翻番，達到36%。

Current law permits companies to use health-related rewards or penalties as long as the amount doesn't exceed 20% of the cost of the employee's health coverage. John Hancock, a veteran labor and employment attorney at Butzel Long, a Detroit-based law firm, says that while companies can't legally dock a worker's pay for a health issue, they can tie an employee's health-care bill to whether the worker meets or misses health goals. As long as employers offer exemptions for workers with conditions that prevent them from meeting health goals, the firms are in the clear.

當前的法律允許企業實施與健康相關的獎勵或處罰手段，只要數額不超過員工醫療保險費的20%。約翰•漢考克(John Hancock)是總部位於底特律的柏隆律師事務所(Butzel Long)一位勞動用工方面的資深律師，他說雖然企業不能因爲健康問題合法降低員工的工資，但它們可以把員工的醫療保健賬單與員工是否達到健康目標掛鉤。只要企業爲那些身體狀況致其無法達到健康目標的員工提供了免費額度，從法律角度來說就沒有任何問題。

The situation is less clear if, for example, a company ends up singling out obese employees by charging them more for health coverage. If the obesity is linked to an underlying condition, the employer may be liable for discrimination, Mr. Hancock says.

假如一家公司最後單單挑出長得胖的員工收取更多的醫療保險費用，情況就不那麼明朗了。漢考克說，如果員工的肥胖與身體的基本狀況有關係，老闆可能就有歧視之嫌。

Currently, most companies tie between 5% and 10% of employee premium costs to incentives, but that will likely go up, says Charlie Smith, chief medical officer for national accounts at insurer Cigna Corp.

信諾保險集團(Cigna Corp)負責國民賬戶的首席醫療長查理•史密斯(Charlie Smith)說，目前，大多數公司將員工保險費用的5%至10%與獎勵機制掛鉤，但是這個比例很可能要提高。

Pharmacy chain CVS Caremark sparked outrage among employees and workers-rights advocates last month by asking staff members to report personal health metrics, including their body fat, blood sugar, blood pressure and cholesterol levels, to the company's insurer by May or pay a $600 penalty.

上個月，藥品連鎖企業CVS Caremark要求員工5月之前向公司的保險承保人報告包括自己的脂肪比率、血糖、血壓和膽固醇值在內的個人健康指標，否則將面臨600美元的罰金，此事在員工和員工權益維護人士中引起衆怒。

Few workers can afford to refuse, but some aren't happy. 'It opens a Pandora's box, ' says a full-time CVS employee who works at a distribution center in Florida. 'It's none of their business.' While the 26-year-old describes himself as healthy, he says he is worried about disclosing health information that could be shared without his knowledge. He says he plans to cancel his health plan, which also covers his wife and child, and will start looking for work elsewhere.

沒有幾名員工拒絕這項要求，但是一些人很不開心。在佛羅里達一個配送中心工作的一名CVS全職職員說：“這開啓了潘多拉的盒子。健康指標與他們毫不相干。”雖然這名26歲的年輕人表示自己很健康，但他說他擔心自己的健康信息有可能在自己不知情的情況下被泄露。他說他打算終止自己現有的醫保計劃（該方案把他妻子和孩子也納入了保險），然後到別處另找工作。

CVS, which maintains that the change is intended to make workers aware of their health risks, says it doesn't have access to workers' screening results.

CVS堅持認爲改變政策的目的是讓員工注意自己的健康風險，該公司說它無法獲得員工的篩查結果。

Mohawk Industries, a Calhoun, Ga.-based flooring company, says participation in its company's health-risk assessment process shot up to 97% after the company imposed a $100 monthly penalty on nonparticipants. The company had previously offered rewards for participating in the assessment, but enrollment rates were low, says Phil Brown, senior vice president of human resources.

總部設在佐治亞州卡爾霍恩(Calhoun)的地面材料生產商莫霍克工業公司(Mohawk Industries)說，公司對不參加健康風險評估程序的員工硬性實施每月100美元的罰金之後，參加者的人數飆升至97%。該公司負責人力資源的高級副總裁菲爾•布朗(Phil Brown)說，公司以前對參加評估的人提供獎勵，但是報名率很低。

Honeywell International Inc. recently introduced a $1, 000 penalty─deducted from health-savings accounts─for workers who elect to get certain procedures such as knee and hip replacement and back surgery without seeking more input. The company had offered $500 for participating in a program that provides access to data and additional opinions for workers considering surgery, but less than 20% of the staff joined up. Since it flipped the incentive to a penalty, the company says, enrollment has been above 90%.

霍尼韋爾國際公司(Honeywell International Inc.)最近出臺了對未尋求更多健康投入就選擇接受膝關節和髖關節更換以及背部手術等療法的員工處以1,000美元罰金的政策──從醫保儲蓄賬戶中扣除。該公司過去曾爲員工提供500美元的資金，讓考慮做手術的員工參加一個可以提供相關資料和其他意見的項目，但是不到20%的員工參加了那個項目。自從公司將鼓勵的政策變成處罰之後，該公司稱，報名該項目的人數超過了90%。

There are no new data on surgeries, but the change is projected to save at least $3 million annually, says Brian Marcotte, Honeywell's vice president of compensation and benefits, who presented the plan at the Conference Board's Employee Health Care Conference last month.

霍尼韋爾公司負責薪資與福利的副總裁布賴恩•馬科特(Brian Marcotte)說，目前還沒有關於手術的新數據，但是政策的改變預計每年可以節省至少300萬美元的資金。他上個月在世界大企業聯合會(Conference Board)的員工醫療保健會議(Employee Health Care Conference)上提出了這個方案。

Typically, 20% of a company's workforce drives 80% of health-care costs, according to Cigna's Mr. Smith, and roughly 70% of health-care costs are related to chronic conditions brought on by lifestyle choices, such as overeating or sedentary behavior. But when employers target those conditions, employees themselves may feel targeted, especially when it comes to their weight. While companies can't say it outright, many of their measures─such as high cholesterol and high blood pressure─are proxies for obesity.

信諾保險集團的史密斯稱，一家企業裏往往是20%的員工動用了80%的醫療費用，而大約70%的醫療費用都跟生活方式所引起的慢性疾病有關，比如過量飲食或久坐行爲。但是當僱主針對這些情況採取措施時，員工可能感覺到自己成爲了被針對的對象，尤其是涉及到他們的體重時。雖然公司不能明示，但是它們的很多衡量尺度──比如高膽固醇和高血壓──在肥胖者中都是非常普遍的。

A 2011 Gallup survey estimated obese or overweight full-time U.S. workers miss an additional 450 million days of work each year, compared with healthy workers, resulting in more than $153 billion in lost productivity.

2011年的一項蓋洛普(Gallup)調查估計，與健康的職工相比，美國肥胖或體重過重的全職職工每年額外誤工的天數達到了4.5億個工作日，造成的生產力損失超過了1,530億美元。