Health Affairs

Health Affairs, 28, no. 3 (2009): 845-852 doi: 10.1377/hlthaff.28.3.845 © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Financial Penalties For The Unhealthy? Ethical Guidelines For Holding Employees Responsible For Their Health

Steven D. Pearson and Sarah R. Lieber

As health care costs continue to rise, an increasing number of self-insured employers are using financial rewards or penalties to promote healthy behavior and control costs. These incentive programs have triggered a backlash from those concerned that holding employees responsible for their health, particularly through the use of penalties, violates individual liberties and discriminates against the unhealthy. This paper offers an ethical analysis of employee health incentive programs and presents an argument for a set of conditions under which penalties can be used in an ethical and responsible way to contain health care costs and encourage healthy behavior among employees.

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