员工因肥胖而被老板罚款，真的吗？

    温科勒指出，机构内部文化和信任度是健康方案最重要的元素。公司在实施与健康行为有关的奖励或惩罚措施时必须提供相关的信息、干预和方案，使员工有可能实现健康目标。依据员工个性、健康风险和其他因素所制定的个性化方案获得成功的可能性更大，但是也更难以管理。

    推高医保成本并导致疾病风险主要有八种风险，它们包括吸烟、静态生活方式、不健康饮食、过量饮酒、缺乏预防性检查、病人不遵医嘱、睡眠不足和不良的压力管理。温科勒说，公司应评估员工的最大风险和成本，并从此处着手，而不是同时应付这八种风险。

    然而，不要以为公司会用花花绿绿的手册和人事讲座这种老套的手法来推出新的方案。美国大公司在这方面各显其能。温科勒表示：“那些成功促使雇员改变行为方式的公司所采用的是营销策略，而不是传统的人事福利沟通。”

    越来越多的公司采用竞赛和游戏等有趣的方式来鼓励员工实现健康目标。翰威特的研究发现，在接受调查的公司中，22%的企业愿意将健康方案与游戏理念进行结合。

    博斯沃思称，Keas公司认为惩罚难以改变个人的行为。该公司找到了一种成功的模式，它将有趣的、基于社会性奖励的方式与游戏、可实现的目标、健康习惯培养以及支持健康目标的小型同事团队相结合。Keas在佛罗里达州一家医院开展的一项案例研究显示，46%的参与者增加了新鲜农产品的摄入量，并加大了运动量；16%的员工降低了压力水平；30%的员工减掉了一定的体重。

    全球企业挑战赛同样超越了金钱奖惩的范畴。在这项赛事中，各公司员工组成的团队在虚拟环境中进行环球竞走比赛。比赛从5月23日开始，前16周是启动阶段，接下来是9个月的后续赛程。挑战赛总裁兼创始人格兰•莱斯利表示，“奖金并不能激发人们的责任感，实际上还会产生不利作用。”

    在前几年的挑战赛结束时，参赛者的体重平均下降了9.9磅；66%的人表示压力得到了缓解；在血压偏高的参赛者中，54%的人把血压降到了不那么危险的水平。挑战赛网站上的信息显示，参与这项赛事的公司包括培生集团（Pearson）、华纳兄弟（Warner Brothers）和劳斯莱斯（Rolls Royce）。

    怡安翰威特的调查显示，绝大部分美国公司（83%）已通过激励政策来鼓励员工参与健康计划。与健康行为有关的奖惩制度预计会越来越多，而且最终会以具体指标为依据。

    考利说：“很多人都会觉得这样做有点不近人情。而真正不公平的是现在的体制，目前所有参与医保的人都在承担不正常肥胖所带来的医疗保健成本。”（财富中文网）

    译者：翔

    Culture and level of trust within an organization are the most important elements of a wellness program, according to Winkler. Rewards or penalties around healthy behavior must be give in the context of information, interventions, and programs that make it possible for employees to reach their health goals. Programs that are personalized to the workers' personalities, health risks, and other variables are more likely to be successful -- but are also harder to administer.

    Eight primary risks can drive up health care costs and lead to diseases: smoking, sedentary lifestyle, unhealthy diet, excessive alcohol use, lack of preventive screenings, patient non-compliance, inadequate sleep, and poor stress management. Rather than tackle all eight at once, an employer should assess where the greatest risks and costs exist among their employees and go from there, Winkler says.

    But don't expect the same old glossy brochures and HR-speak as new programs roll out. Organizations are getting creative. "Employers that have had success in connecting with people to change behavior have used marketing tactics as opposed to traditional HR benefits communications," notes Winkler.

    Rather than simply threatening or bribing employees, a growing number of employers are launching competitions and gaming applications that encourage achieving health goals in a fun way. The Hewitt study found that 22% of employers surveyed are interested in incorporating gaming concepts into their wellness programs.

    Keas believes that penalties don't work in changing individuals' behavior, says Bosworth. Rather, the company has found success through a fun and social rewards-based approach that combines games, achievable goals, healthy habit building, and small coworker teams that support health goals. A case study Keas conducted at a Florida hospital found that 46% of employee participants improved their fresh produce intake and exercise, 16% improved their stress level, and 30% lost a modest amount of weight.

    Also going beyond monetary rewards or penalties is the Global Corporate Challenge, in which teams of employees compete in their virtual progress walking around the world, with a 16-week jump-start period beginning May 23 and another nine months of follow-up. "Payment doesn't encourage personal responsibility; it actually compromises it," argues GCC president and founder Glenn Riseley.

    At the end of previous years' challenges, participants lost an average of 9.9 pounds; 66% reported decreased stress; and of those with high-risk blood pressure, 54% had reached low-risk levels. Past participants include Pearson, Warner Brothers, and Rolls Royce, according to the GCC web site.

    The vast majority of American companies, 83% according to Hewitt's survey, already offer incentives for participating in wellness programs. Expect more to expand those rewards and penalties to cover healthy behaviors and eventually to rest on specific results.

    "A lot of people will feel that it's somehow mean to do this," says Cawley. "What's not fair is the current system where everybody else in the health insurance pool is subsidizing the health care costs of the morbidly obese."