With problems associated with Obamacare's rollout continuing to grow, the rarely discussed "Safeway Amendment" may well be the next point of contention with the healthcare law.
The amendment gives employers incentives to encourage workers to stay healthy. Helthcare premimums can be set higher for unhealthy employees.
Making the case against the amendment is Boston outcomes-measurement consultant Al Lewis, a registered Democrat who has twice voted for Barack Obama for president.
"I like the concept of Obamacare because it is a step toward a greater number of Americans having healthcare coverage," Lewis said. "And when people know they have that coverage, they are less stressed-out and more civilized. I'll gladly pay extra taxes for that."
But in an exclusive interview with Newsmax, Lewis said, "Obamacare's wellness provision needs a makeover badly. [Lawmakers] need to take a mulligan on this one. They created an incentive for more preventive care when in fact the insured population is drowning in preventive care."
Lewis said the Safeway Amendment — named for the supermarket chain that has a similar program in place — contains incentives and requirements for "workplace wellness," and the record often can contain what he calls "made-up evidence" to support such programs,
As an example, he cited Interactive Health, "which reports in its 2013 white paper a case study in which only 5 percent more people reduced their risks than increased them."
Yet the unidentified client in the study said it "saved the equivalent of $54,000 for each of those reduced-risk participants in 2011 alone. No easy feat when average corporate medical spending is about $6,000 [per employee]."
Lewis founded the Disease Management Purchasing Consortium and established a training and certification program for "critical outcomes report analysis."
In forums ranging from The Wall Street Journal to two best-selling trade books, Lewis has long been critical of the effectiveness of the "workplace wellness" concept and its incentives for weight loss, quitting smoking, and other steps by employees as an alternative to their paying a greater portion of health insurance.
The positive reports of the "wellness industry," says Lewis, "are usually the result of very dubious measurement."
According to Lewis, "Almost every wellness company shows savings by comparing motivated participants in its programs with unmotivated nonparticipants — ignoring, for example, the obvious fact that people who want to quit smoking will quit at higher rates than those who don't, regardless of whether an employer offers a program. Another trick is to count only the people who improve — such as smokers who quit, but not quitters who resume smoking."
This did not stop the Senate Finance Committee from putting the Safeway Amendment in Obamacare when the legislation was being cobbled together in 2010. Co-sponsored by then-Sen. John Ensign, a Nevada Republican, and Democrat Sen. Tom Carper of Delaware, the measure was cited as one of the few cases of genuine bipartisanship in what would become the Affordable Care Act.
Supporters of the amendment frequently cited "Workplace Wellness Programs Can Generate Savings," an academic paper which concluded that workplace provided a 3.27-to-1 return-on-investment.
"And that provided cover for those who wanted wellness provisions in Obamacare," said Lewis, adding that "3.27 has since been the most cited figure in the wellness industry, appearing in articles 187 times and scoring more than 20,000 Google hits. But that figure has never been backed by any other study anywhere."
All those citations came to a screeching halt on July 24, when one of the co-authors of the study — Harvard School of Public Health Professor Katherine Baicker — backed off from the 3.27 claim. Appearing on the American Public Media radio program, "Marketplace," Baicker was asked whether workplace wellness programs save money.
"It's too early to tell," she replied.
"Much to the detriment of the wellness industry," observed Lewis, "Professor Baicker is also honest."
John Gizzi is chief political columnist and White House correspondent for Newsmax.