Whether the Supreme Court upholds the health care law or not won’t change the fact that employee health costs have become the third-largest expense in business today. A report from the Milken Institute found direct medical costs combined with ill health-induced absenteeism and presenteeism—employees show up for work but are less productive—costs American businesses more than $1.3 trillion per year. Holding everyone accountable for their own health could be the solution employers are looking for. A 2010 study by Harvard health economist Katherine Baicker found that for every dollar spent on wellness, “medical costs fall by about $3.27 … and absenteeism costs fall by about $2.73.”

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