“Wellness” programs

[mpemburn]

As you may know, the United States suffers under a primitive and costly for-profit healthcare (hellthkare) system. One of the torture devices that has arisen in response to this is “wellness” companies.

Since my wife works for an insurance agency, we get our healthcare plan though her employer, and part of the bargain is to participate in the wellness program they’ve chosen. In service to this, each of us must accumulate 33,000 points per year though logging exercise, good habits, and doctor visits. The reward is several hundred bucks deposited in our Health Savings Account. This provides an offset to the $3,000 deductible, and it’s what pays for most of our out-of-pocket expenses.

I was wondering if your National Health (or equivalent in other countries) requires participation in a program like this?

 

[ianrauk]

Doctor and hospital health care is free in the UK to everyone whatever their status. However we do pay through our wages a percentage of what is called national insurance which contributes to most state benefits. Ie health and pension.

 

[Bonefish Blues]

No, but these types of programmes are often bundled in with employers' private health schemes, presumably as part of keeping claims down.

ETA
Probably over-cynical, even by my standards - TBF employers are taking the 'wellness' (ugh, awful word) of their employees increasingly seriously.

 

[cougie uk]

My last employer offered wellness schemes. Anyone could talk to a counselor and discuss any issues confidentially. No requirement to but I guess if you did have issues then you'd have less of a claim on your employer.

 

[annedonnelly]

We had something through a company health care plan. For a while there were free cinema tickets to be had each week. If you proved that you were a non smoker by having a test at an annual health check you were given a cash payment.

 

[winjim]

The NHS doesn't, or at least shouldn't make moral judgements. Under certain circumstances for certain conditions doctors are supposed to advise lifestyle changes, this is covered by NICE (National Institite for Clinical Excellence) guidelines. But care should be available no matter what.

Our tax system is designed to disincentivise unhealthy habits such as smoking.

 

[winjim]

I would add that 'wellness' is something of a nebulous concept and while there are some good ideas attached to it, such as doing some exercise, eating your greens, self care and looking after your mental health etc, there are also a great many charlatans using it as a front to sell useless pills, potions and such. There is an awful lot of 'wellness' bullshit about.

 

[mpemburn]

The NHS doesn't, or at least shouldn't make moral judgements. Under certain circumstances for certain conditions doctors are supposed to advise lifestyle changes, this is covered by NICE (National Institite for Clinical Excellence) guidelines. But care should be available no matter what.

Our tax system is designed to disincentivise unhealthy habits such as smoking.

"Moral judgement" is a big part of the whole concept of healthcare in the U.S. So much of our political thought is bound up with Calvinist moralism that it has turned to cruelty against anyone unfortunate enough to be unwell. Excuse me for venting, but I'm just disgusted with this.

 

[The Crofted Crest]

Here in the Netherlands there is a mixed system. National insurance contributions are deducted from salary (13.8% on the first tax band, I think) and just about anyone who earns anything has to take out a separate health insurance package.

There are two packages: basic and a bit better than basic. The government decides what goes into each package. Basic, for instance, does not include dentists, anticontraceptive pills were shunted over to a bit better than basic last year (whereas unlimited IVF treatments have been retained), and physiotherapy (as many sessions as needed, at the patient's discretion) was lost just after I stopped needing it. The government also decides on the cost of care, i.e. what doctors and hospitals can charge for their services, and how many care providers there are. Admin is farmed out to private insurance companies who compete against each other on the premiums they charge, they cannot compete on care. Everyone receives the the same care regardless of their insurance company. As far as I know there are no private hospitals in the country.

I pay a premium of about €120 a month (pretty standard) and there is a policy excess/deductible of about €350 a year. To keep the market competitive, the insurance contract lasts one calendar year and then has to be renewed or a new contract taken out with a different insurer.

 

[bitsandbobs]

Here in the Netherlands there is a mixed system. National insurance contributions are deducted from salary (13.8% on the first tax band, I think) and just about anyone who earns anything has to take out a separate health insurance package.

There are two packages: basic and a bit better than basic. The government decides what goes into each package. Basic, for instance, does not include dentists, anticontraceptive pills were shunted over to a bit better than basic last year (whereas unlimited IVF treatments have been retained), and physiotherapy (as many sessions as needed, at the patient's discretion) was lost just after I stopped needing it. The government also decides on the cost of care, i.e. what doctors and hospitals can charge for their services, and how many care providers there are. Admin is farmed out to private insurance companies who compete against each other on the premiums they charge, they cannot compete on care. Everyone receives the the same care regardless of their insurance company. As far as I know there are no private hospitals in the country.

I pay a premium of about €120 a month (pretty standard) and there is a policy excess/deductible of about €350 a year. To keep the market competitive, the insurance contract lasts one calendar year and then has to be renewed or a new contract taken out with a different insurer.

Formally, most hospitals are private in the sense they are run by private organizations (albeit non-profit organizations). Same for many schools.

However, I don't think there are "private" hospitals in the sense that you can pay to get treated outside the regular healthcare system. The best way to do that is probably to go get treated in Belgium and persuade your insurer to cover the costs.

 

[a.twiddler]

Another factor is that once you reach State Pension age in the UK you do not pay National Insurance. This applies even if you choose to continue to work past that age. Your State Pension counts towards your tax allowance, however, whether you are employed or not.
If you have long term conditions such as Diabetes you do not pay prescription charges. After the age of 60 in England prescription charges are free, Scotland and Wales have different rules.

 

[CanucksTraveller]

I'm a UK citizen working for a US company so I see both sides of it. I can use the NHS largely free of charge, or I can use private services provided by the insurance company (AXA Health) who my employer contracts with in the UK.

My private health care plan is a little different to that of my US colleagues, like you they can earn credits for doing wellness bits, fitness challenges at work, being vaccinated etc, so it sounds like yours. I can't do that, my policy is more simplistic, i.e. I'm either covered for treatment or I'm not, it's not dependent on me taking part in a wellness programme.

Having said that, my employer also provides a seperate wellness service to UK and EU employees (via another 3rd party) where you can get general lifestyle support and advice, counselling if you're generally suffering from poorer mental health, worries, and that kind of thing. That began when covid hit, I'm not sure what it's like as I've not needed to use it.

 

[Kingfisher101]

The G.P practises here in the U.K used to do check up type visits for over 40s, where periodically they weigh you and you do a questionnaire etc about smoking, exercise, healthy eating etc.They can also do a blood test to make sure your not a diabetic etc. All this is usually done by the practise nurse.I don't know if they are still doing these ATM, god knows? Everything is still quite up in the air due to Covid and the G.P surgeries have been just doing everything over the phone etc.
If you are a diabetic or nearly one you can go on special courses run by the NHS for a few weeks looking at again things like healthy eating and your weight etc.
You don't get any deductions though on your Ni contributions or anything for attending these.
In the U.K the NHS is free at point of contact, not totally free because people have to pay out of their NI contributions. It has become increasingly common though for people to pay for medical care privately if they can afford it. That's because the NHS is absolutely rubbish and that's putting it very politely.

 

[annedonnelly]

That's because the NHS is absolutely rubbish and that's putting it very politely.

I imagine that your experience of the NHS has been very different to mine and that of people I know. As far as I'm concerned they are fantastic. Perhaps we're just fortunate to have a number of excellent hospitals in this part of the country.

 

[cyberknight]

The G.P practises here in the U.K used to do check up type visits for over 40s, where periodically they weigh you and you do a questionnaire etc about smoking, exercise, healthy eating etc.They can also do a blood test to make sure your not a diabetic etc. All this is usually done by the practise nurse.I don't know if they are still doing these ATM, god knows? Everything is still quite up in the air due to Covid and the G.P surgeries have been just doing everything over the phone etc.
If you are a diabetic or nearly one you can go on special courses run by the NHS for a few weeks looking at again things like healthy eating and your weight etc.
You don't get any deductions though on your Ni contributions or anything for attending these.
In the U.K the NHS is free at point of contact, not totally free because people have to pay out of their NI contributions. It has become increasingly common though for people to pay for medical care privately if they can afford it. That's because the NHS is absolutely rubbish and that's putting it very politely.

if it wasn't overburdened by fat cat mangers and had the resources it needed then i think it would be a different story , although im not going to get into a political debate about it i would just say the doctors and nurses are doing the best they can with what they have to work .