You Go Mayor!

Courtesy of the Chicago Sun-Times

City employees who smoke, weigh too much, have high blood pressure or high cholesterol will soon face the same pressure to shape up as their counterparts in private industry.

After releasing a public health agenda for Chicago that identifies a dozen major priorities, Mayor Rahm Emanuel on Tuesday said he’s prepared to drop the other shoe: a wellness plan for city employees that uses incentives to drive down costs by as much as $240 million over four years.

At a news conference at the teen fitness center at the Humboldt Park Field House, Emanuel referred to a Chicago Sun-Times story about the growing number of private sector companies now forcing their out-of-shape and unhealthy employees to pay higher health insurance premiums, deductibles and out-of-pocket expenses.

“There’s a reason the private sector has embraced this whole hog. And there’s a reason we’re gonna embrace it whole hog. It’s a good public health strategy,” the mayor said.

“We cannot afford the standard we’re on. And we can’t afford to do pilots anymore. ... Six to 8 percent of the city’s employees drive almost two-thirds of the health care costs around five chronic illnesses that are all manageable. ... We are going to be the first city to ... implement a citywide wellness plan for our employees because health care costs are being driven [up] 10 ten percent a year and we’re not seeing revenue growing that way.”

Emanuel said the city’s wellness plan would use a healthy mix of “carrots and sticks” to change employee behavior. He refused to identify the incentives and penalties.

“I’m not gonna get ahead of it. That’s a partnership you develop [with employee unions]. It’s a carrot-and-stick approach. It’s not just one approach,” he said.

“You don’t put your thumb on one side of the scale. You make the incentives clear enough that the individual realizes that good health care is the right road for them. It’s not one tactic. It’s a multi-pronged approach.”

Chicago taxpayers spend $500 million a year to provide health care for city employees, nearly 10 percent of the city’s annual budget.

Emanuel campaigned on a promise to reduce those annual costs by as much as $60 million in each of the next four years by implementing an incentive-laden health and wellness plan mirrored after the one pioneered by such private sector companies as Safeway and Johnson & Johnson.

Johnson & Johnson managed to reduce employee smoking by two-thirds, cut high-blood pressure in half and get $3 of savings for every $1 invested in incentives.

The city has tried over the years to make inroads on wellness, using preventive screening programs. But Emanuel has argued that participation has fallen short, in part, because lucrative incentives are missing.

His wellness plan would begin by offering all participants in the city’s health plan an enhanced screening to establish benchmarks and long-term goals, including weight loss, medication, exercise and kicking the smoking habit.

City employees would get wellness training. Coaches would ride herd over them on a weekly or bi-monthly basis to make certain they’re following their prescribed nutritional, medical and physical fitness regimens.