Page 297 - How America's Best Places to Work Inspire Extra Effort in Extraordinary Times

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historical case studies, she explores the concept of folly. For something
to qualify as folly for her book, Tuchman explains, it must:

: Be clearly contrary to the self-interest of the organization or
group pursuing them
: Be conducted over a period of time, not just in a single burst
of irrational behavior
: Be conducted by a number of individuals, not just one de-
ranged maniac
: Have had people alive at the time who pointed out correctly
why the act in question was folly (no 20-20 hindsight al-
lowed)

Is there no greater folly than the health-care crisis that is before us
today? We know many of the answers, particularly when it comes to
changing the incentives within the health-care system, that promote
disease care and ignore prevention. We know, as we discussed before,
that many of the medical conditions we face are “discretionary”—
brought on by poor lifestyle changes.
One executive we know has started a diabetes prevention program
that is showing great promise. The program bathes the employee in
support: additional nursing care, stress management, and dietary pro-
grams, even payment for using a local gym. Interest in the program is
high, and early results are showing a significant improvement in the
health of program participants. Through efforts like this, our friend
has been able to maintain premium rates at the same level, and there
are not many employers out there making that claim.
As the cost-benefit calculus for this program becomes clearer,
our friend eventually wants to take the program a step further—to
the point that if employees don’t make reasonable lifestyle changes
that are funded and supported by the employer for conditions that
are clearly related to lifestyle (type two diabetes, for example), the
payment for diabetes drugs may fall completely onto the employee.
Bravo, we say.