Smart Survelliance and Wellness

I phone watchThe Affordable Care Act now lets employers charge employees different health-insurance rates, based on whether they exercise, eat healthful foods and other “wellness” choices they make outside of work.

Employees (and insured family members) who don’t submit to the screening and participate in wellness programs face steep penalties; they may have to pay up to 30 percent more for their share of health-insurance costs. The law calls this a “reward” for participation. Flip it around and it’s a penalty for not authorizing your employer to manage and monitor how you live outside of work.

Dudley isn’t the only person who has noticed a potential connection between “wellness programs,” the ACA and fitness trackers. For fitness trackers to work most effectively, they will need incentives.  It’s not hard at all to imagine a future in which your employer tells you your healthcare insurance is contingent in participating in a “wellness” program that requires active monitoring.

Of course, healthier lifestyles should be everyone’s goal. But what level of micromanaging are we willing to endure in exchange for insurance security? The prospect of an Internet of Things-enabled insurance future raises all kinds of thorny questions. For example, the Affordable Care Act is supposed to end the practice of healthcare insurers’ discriminating against people with preexisting conditions. But wouldn’t mandatory wellness programs be a kind of discrimination against people with unhealthy lifestyles?

In every realm of insurance, how long will it be before discounts offered for “good” behavior are matched by price hikes that penalize “bad” behavior? Liberals scream bloody murder when conservatives try to make welfare programs contingent on drug-testing. How different will it be when we run the risk of higher health insurance premiums because we ate too many potato chips?

There also obvious class implications. The rich will be able to afford gold-plated insurance plans that come free of prying eyes, while the poor will only be able to afford insurance plans that come equipped with onerous behavior modification shackles.

The connected society is coming. In a best-case scenario, perhaps, as a society, we’ll be able to draw lines between what is acceptable surveillance and what isn’t. But before we can do that, we need to constantly be asking an important question every time we hear about what the Internet of Things will do for us. What’s in it for them?