Health Care’s Brave New World of Compulsory Wellness: Ezra Klein (Bloomberg)

With 40,000 employees, the Cleveland Clinic, recognized nationally as the best cardiac care center in the country, is the second largest employer in Ohio. It is also among the healthiest employers in the country: over the past several years, employee health care costs at the clinic have not escalated at the national average increase of six percent each year. In fact, since initiating an aggressive wellness program seven years ago, the company’s health care costs have slowed and ultimately ceased to grow.

Unlike other employers, who may offer incentives for employees to join fitness or diet programs and to get regular physician check-ups, the clinic imposes penalties on those who don’t play by the rules. Employees caught smoking anywhere on campus are warned for the first offense and fired for the second; others who don’t maintain healthy diet or exercise patterns pay higher health premiums.