January 2008


I was working recently with data from the company I work for and began studying the overall profitability of patients diagnosed with a specific disease and it got me to thinking. While to some extent, behavior is a cause of disease, the diseases my company specializes in are primarily life-choice driven. Take diabetes for example. The National Institute of Health has finally anointed obesity (i.e. overeating) as a significant cause of type 2 diabetes. I want to say “Thanks Captain Obvious!”, but I know that scientific research often lags behind anecdotal evidence, and the government moves even slower. I knew that diet and being overweight was a primary cause of type 2 diabetes back in the 1970’s thanks to Dr. Ray C. Wunderlich of St. Petersburg, FL. But this blog post isn’t about why the health care community seems to always be behind the times, I’ll save that for another day.

According to the NDIC, in 2005 the number of people in the United States afflicted with diabetes (type 1 & 2) was 20.7 million people, or about 7% of the population, and the total costs associated with the disease was $132 billion (with a “B”), or about $6,400 per person. Direct costs were $92 billion and indirect costs were $40 billion. The NDIC also states that type 1 diabetes (unpreventable) accounts for 5% to 10% of the diagnosed cases, which means the behavior of 18.6 million people cost $118.8 billion (taking the higher percentage). But what can be done to reverse the trend?

The government could impose a tax on companies and restaurants that produce unhealthy food. Sort of a “fat-tax”, so to speak. Borrowing from my economics education, theoretically that would shift the supply curve up, resulting in a higher price and reduced demand. But I doubt that aggregate demand would drop too much (although I could be wrong). But the politics of getting that tax passed are probably insurmountable, and of limited benefit at best. In my opinion, what is needed is a way to get everyone to understand why it’s in their best interests to eat healthy and remain healthy so as to avoid diabetes and other diseases associated with life-choices. But what would do that?

Maybe what is needed is a version of tough-love. Everyone is complaining about the rising costs of health care, but the continual rise in obesity proves they aren’t changing their lifestyle so as to reverse that trend. But how can the costs associated with bad life-choices be transferred to the person making those choices? I doubt anyone has a workable solution to that question.

So what can we as leaders and managers do, and what can companies do, to make a dent in the situation? If as my previous post says, we as leaders should be concerned about our employees and their personal (as appropriate) and professional lives, then we should come up with ways of promoting better health. After all, an employee who exercises regularly and eats healthy is arguably more productive, so it’s in our best interests to find a way to promote better health for our employees. No, I’m not promoting forced fat-camps or other similar measures, nor am I thinking of the pamphlets all health insurance companies send out on a regular basis. Since none of the current measures are helping, we need new “out of the box” thinking.

“The significant problems we face cannot be solved at the same level of thinking we were at when we created them.” — Albert Einstein.

What if companies were to offer bonus money to those employees who lose a certain percentage of their body weight (as measured by % body fat), and keep it off for at least 6 months. A $1,000 check for dropping 10% of the body weight for 6 or more months would mean the company isn’t at risk of incurring the health care costs related to disease, which can be ~$6,000/person/year, and that company gets a healthier, happier, and more productive employee. And the employees feel more self-confident, happier, and have a little extra money to help pay off debt or buy a new wardrobe.

We could motivate and support the employees through “The Biggest Loser” type contests and campaigns within the company. Done correctly, with open and honest communication, should keep people from feeling pressured or put down for their weight. And after all, a leader who has previously, and continually, shown an interest in a person should be able to approach that person in a non-threatening way about improving their life in a concrete and meaningful way. An added benefit of this is that employees will be more committed to the success of a company, and the manager/leader who helped motivate them, if the company has helped them succeed in losing weight, something most of us fight at least on a cyclical basis.

— National Institute of Health. Type 2 Diabetes Fact Sheet.
http://www.nih.gov/about/researchresultsforthepublic/Type2Diabetes.pdf.

— National Diabetes Information Clearinghouse. (2005). National Diabetes Statistics. http://diabetes.niddk.nih.gov/dm/pubs/statistics/.

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One of my favorite quotes related to leadership is from John Maxwell in his book Be A People Person, ” He who thinketh he leadeth and hath no one following him is only taking a walk” (p. 65). How many of us have known people who were in a leadership position but for one reason or another, no one followed them? How many companies, or departments, today are in a situation like this?

To me, leadership is not about power or control, leadership is about servitude. Leaders serve both the company and the people who work for them. In order to accomplish what needs to get accomplished each day so that the company can succeed, leaders need to have people willing to follow them. And employees will only follow a person who is truly interested in their success. Have you ever worked for someone who you knew was mentoring you and motivating you to rise to a higher level? Wouldn’t you have gone above and beyond the call in order to do for that person? That’s what leadership is all about: focusing on the success of the people in your team or department while also focusing on the success of the projects in your charge and the company as a whole.

When an employee knows that their boss is truly interested in them, both personally and professionally, and in the success of their career, they will follow that leader. But to be truly interested in the success of our employees, we need to be self-confident in our own ability. How many managers are afraid of their own employees showing them up and the company promoting the employee to their position? If a person is in the right job, capable of performing the work, and is accomplishing their job for the company, then any employer who would replace you is probably someone you don’t want to work for anyway. Brave words, I know, but in the end isn’t it better to move on to another company where you can thrive, or languish in a job where not only is your life miserable, but you make other peoples lives miserable also?

–Maxwell, J. C. (2007). Be A People Person. Colorado Springs, CO: David C. Cook.