TheBakersfieldCalifornian.com

Interesting doings are afoot in the medical benefits world that should have us all peering down the road wondering what's next.

Most recently in the news was Panama-Buena Vista School District's attempt to cut costs by having other employers -- via marriage -- pick up the tab for covering PBV employees.

So, if you worked at PBV and your spouse had benies from, say State Farm, you'd be required to get coverage under State Farm's plan. PBV would reimburse employees for out-of-pocket costs not covered by the other insurance -- such as co-pays and deductibles.

The district got its classified members (about 1,000 school aids, custodians, clerks, etc.) to agree to the plan in their recent contract renewal, but teachers gave it a big thumbs down on Tuesday. (See our news story on page 8.)

Regardless of the vote, PBV's actions ignited a benefits range war among other employers, with at least one firing back.

The County of Kern changed its policies to say that Panama employees would not be eligible for county medical plans if they were denied coverage by the school district.

Though the district told The Californian it researched this "slough off" (what else can you call it?) approach thoroughly and figured it would save $1.6 million a year, I have more than a few doubts about the whole scheme.

First, The Californian's reporting only uncovered one other district in the nation following this approach and it was unclear it had saved that district any money at all.

Second, exactly how legal is it for an employer to dig into a worker's personal life to find out if their spouse has coverage from another employer? Or even if their spouse is employed? And by whom?

And what about other employer health plans that allow coverage for co-habitors or domestic partners? Will PBV require the slough off for them as well? Or just legally recognized marriage partners? Is that discrimination against married people?

Could get kind of sticky.

Yes, health care costs are skyrocketing and school districts are tapped out, but this is just cynical and short-sighted. District officials should do a little more homework and come up with a workable plan that doesn't slough employees, and their own responsibilities, off on others.

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Another upcoming change at one large local employer has me on the fence.

Clinica Sierra Vista, which covers 1,800 people, will introduce a new "wellness program" with its 2012 benefits plan that will prod employees to be more proactive about their health.

Starting next year, employees and covered family members will be assessed for weight, blood pressure, cholesterol and lifestyle choices, such as smoking, among other things.

Clinica is looking at three factors in particular: hypertension, high cholesterol and/or diabetes.

If employees have any one of those factors, they will be moved into the wellness program where they can either participate or pay extra for their benies.

For full time workers with families, who are at the lower end of the salary scale, that could mean an extra $60 a month out of their checks if they chose not to participate.

CEO Stephen Schilling told me there are other incentives built in to encourage participation, such as lower co-pays for doctor visits and prescriptions.

He said he started looking into the wellness program after reviewing claims and seeing they had 160 cases of people with diabetes who weren't treating it.

"And these are health care professionals!" he said.

So, Schilling hired a company to screen employee health assessments.

If someone is above the parameters for cholesterol, for instance, the company will case manage that person. They'll call and talk about the benefits of Lipitor and encourage the person to see the doctor, then check back, etc.

Over time, he hopes the nudging will improve employee health and cut costs for everyone.

"We're self funded," he explained. "We can't keep asking the healthy people to chip in more money for the people who don't take care of themselves, particularly when we're giving them opportunities to get healthy."

At first blush, I can totally get behind this concept. I like to think of myself as fairly health conscious and I don't really want to pay for someone else's bad habits.

That can be a real trap, though, when you extrapolate this out.

Schilling told me that next year case management will extend to smoking, an obviously bad habit.

But what about people who don't floss daily? (Seriously, people, you need to floss!)

Or motorcycle riding? That's a dangerous lifestyle choice that can rack up millions in insurance costs if a ride goes awry.

"I know, I know!" Schilling said as I started listing all the ways wellness programs could encroach on personal liberties. "It runs up against my theories of individualism too. But not when I have to write that check for millions of dollars every year."

"Health care costs are skyrocketing and employers have to do something otherwise everyone's ability to be covered is threatened," Schilling said. "We're all in this together."

Hmmm. Someone forgot to tell Panama Buena-Vista School District.

Opinions expressed in this column are those of Lois Henry, not The Bakersfield Californian. Her column appears Wednesdays and Sundays. Comment at http://www.bakersfield.com, call her at 395-7373 or e-mail lhenry@bakersfield.com Lois Henry