Wellness Capitalism: Employee Health, The Benefits Maze, and Worker Control

This primer presents a brief history and critical analysis of employee health and wellness programs in the United States. These programs come in many varieties, from “employee assistance programs” that address conditions such as alcoholism, to “employee wellness programs” that provide incentives for employees to work toward aspirational forms of “wellness.” Both types of program have surged in popularity over the past half-century, in part because of their powerful win-win narrative. Proponents of these programs argue that everyone wins when employers pay for wellness benefits—workers are told they will be healthier, and employers are told they will save money. Lawmakers have embraced this narrative, and continue to show increasing support for these initiatives, allowing companies to offer a higher percentage of total benefits through such wellness programs.

The result is what we call “wellness capitalism,” a model of public health involving the state, employers, and a wellness industry in which worker behaviors are monitored to improve society’s health. There are real problems with this model. There has been inconsistent evidence as to whether wellness programs improve health outcomes (or save money). In addition, government support for these programs has outpaced their regulation. Companies in the benefits industry often sidestep traditional health privacy regulations like the Health Insurance Portability and Accountability Act (HIPAA). Today, this industry is a conglomeration of third-party providers, a benefits maze that can collect, exploit, and transmit worker data in mysterious ways. In order to truly benefit workers, we need to disassemble the promises of wellness capitalism’s win-win narrative and question the value of increasingly invasive data collection from workers in the name of wellness.