Dr. Roman Kownacki knows the cost of health care. As specialist in Occupational Medicine and Preventative medicine at Kaiser Permanente since 1999, he has seen not only costs, but health care usage skyrocket. Dr. Kownacki states, “Employers are unable to absorb the increase in health care costs and compete in the global market.” On March 14, Dr. Kownacki’s presentation gave employers and safety professionals useful takeaways to promote the value of workplace wellness programs.

He brought up the question, “Why wellness and safety?” His statistics told the story. 18.2 million Americans have diabetes and two-thirds of them don’t know they have it. 64% are obese and 31 million have asthma. 40% of deaths are due to heart attack or stroke. Early deaths are linked to behaviors. Behaviors overlay industrial accidents and illnesses.

The challenge is selling wellness to management. Taken from the viewpoint of direct and indirect costs, the full cost of an employee in poor health is as follows:

	Medical treatment and pharmacy (direct costs)	$ 3,376
	Health related productivity (indirect costs)	$10,128
	(absenteeism & presenteeism)
	Total	$13,504

Presenteeism is the practice of coming to work in spite of illness. Presenteeism can have catastrophic effects on a company’s output since the employee may operate at a fraction of his normal capacity requir- ing the same expenditure in wages and benefts as an employee operating at 100%. Although cancer is the top condition as far as direct costs with expenditures of almost $200,000 per person; back and neck pain, and depression are the leading conditions for indirect costs at just over $500,000 and $400,000 respectively.

Dr. Kownacki demonstrated that integrated management of health risk reduction is an overall process. Management must assess the impact of poor health, implement intervention and measure the outcomes on return on investment. He suggests getting aggregate data so programs can be targeted. Demand pro- grams such as teaching employees how to access healthcare wisely using the nurse advice line not the emergency room, reduce medical costs. Awareness programs can involve just talking about issues such as HIV, which mitigates them. Help employees understand the value. Those with risk factors participate less – be sure to get this population involved.

Dr. Kownacki reported that he has never seen a wellness study that has not had a positive result on return-on-investment. In a business climate where management is trying to stretch every dollar, wellness is a step in the right direction.

March 14, 2008
Cathy Hastings