????最近,，美國CVS Caremark（CVS）公司登上了報(bào)紙頭條，原因是該公司規(guī)定，那些在年度體檢中未向公司匯報(bào)體重,、體脂,、血糖和膽固醇等健康數(shù)據(jù)的員工將被罰款600美元。這一備受爭議的舉措只是該公司實(shí)施新一輪職場健康計(jì)劃的前奏,，目的是通過定向激勵(lì)措施來鼓勵(lì)員工追求更加健康的生活方式,。

????人力資源咨詢公司怡安翰威特（Aon Hewitt）首席創(chuàng)新官吉姆?溫科勒說，“人們將看到,，在未來3至5年內(nèi),，很多公司會獎(jiǎng)勵(lì)那些成功降低自身健康風(fēng)險(xiǎn)的員工?！?怡安翰威特通過對約800家公司的調(diào)查發(fā)現(xiàn),，58%的公司打算對那些不采取適當(dāng)措施來改善自身健康狀況的員工予以罰款。

????面對不斷攀升的醫(yī)療保險(xiǎn)成本,，企業(yè)正擴(kuò)大健康計(jì)劃的外延,。怡安翰威特的數(shù)據(jù)顯示，2013年,，人均醫(yī)保成本預(yù)計(jì)將達(dá)到11,188美元（69813.12元人民幣）,，而2007年為7,874美元（49133.76元人民幣）。很多公司已將單一的獎(jiǎng)勵(lì)健康生活調(diào)整為獎(jiǎng)勵(lì)與處罰并舉,。在線健康咨詢公司KEAs聯(lián)合創(chuàng)始人,、谷歌健康（Google Health）前任主管亞當(dāng)?博斯沃思表示，美國公司每年要在醫(yī)保上花費(fèi)2.7萬億美元（16.848萬億元人民幣）,，其中約50%-60%的資金都用在了那些可以通過飲食調(diào)整,、運(yùn)動(dòng)和緩解壓力來治療的疾病上。

????最近通過的美國平價(jià)醫(yī)保法（Affordable Care Act）明確指出,，企業(yè)可以對員工的不健康生活方式進(jìn)行經(jīng)濟(jì)處罰,。該法案將罰款或獎(jiǎng)金占醫(yī)保費(fèi)用的比例從20%上調(diào)至30%。聯(lián)邦醫(yī)保改革一攬子方案還對獎(jiǎng)金或罰款能否有效影響員工的行為進(jìn)行了探討——不管企業(yè)更看重的是懲罰還是獎(jiǎng)勵(lì),。

????《唐尼肥胖報(bào)告》（The Downey Obesity Report）編輯,、出版商摩根?唐尼說：“對于肥胖和體重管理來說，這些方案并不是很奏效,。所有的研究都顯示,，員工在12個(gè)月內(nèi)減掉的體重微乎其微。世界上最好的科學(xué)家和醫(yī)學(xué)家都對控制這些問題感到頭疼,，我們?yōu)槭裁匆竿肆Y源部門能做到這一點(diǎn)呢,？” 《唐尼肥胖報(bào)告》主要報(bào)道與肥胖有關(guān)的科學(xué)和公共政策。

????唐尼說,，與抽煙,、高血壓和血糖控制（醫(yī)師可以通過很多方法來治療和控制這些癥狀）不同的是,，目前沒有有效的臨床藥物或治療方案來解決肥胖問題。此外,，醫(yī)保改革中提到的聯(lián)邦法規(guī)也探討過是否實(shí)施此類措施,，即公司要求所有員工的體質(zhì)指數(shù)達(dá)到27，并對那些無法達(dá)到這一標(biāo)準(zhǔn)的員工或難以取得持續(xù)進(jìn)步的員工處以罰款,。

????大部分美國成年人都超重或患有肥胖癥,。研究發(fā)現(xiàn)，大部分人的減肥努力都以失敗告終,，而且大多數(shù)成功減肥的人也都在5年內(nèi)恢復(fù)了基準(zhǔn)體重,。康乃爾大學(xué)（Cornell University）經(jīng)濟(jì)學(xué)家約翰?考利表示：“大多數(shù)美國女性隨時(shí)隨刻都在節(jié)食,。人們其實(shí)也意識到了這個(gè)問題,，他們也曾努力過。但是要改掉這些頑固的習(xí)慣談何容易,?！?/p>

????考利最近對獎(jiǎng)勵(lì)減肥的職場政策開展了一項(xiàng)研究，對象涉及2,635名員工,。該研究發(fā)現(xiàn),，員工的減肥效果很一般，而且中途退出的比例很高,?？祭c德州大學(xué)阿靈頓分校（University of Texas at Arlington）的喬舒華?普萊斯共同發(fā)表了這篇研究報(bào)告?？祭f：“我們試圖找到設(shè)計(jì)這些激勵(lì)方案的最佳方法,，目前我們還處于起步階段?！?/p>

????CVS Caremark (CVS) recently made headlines for rolling out a $600 penalty on workers who fail to report biometric data such as weight, body fat, blood sugar, and cholesterol in an annual screening. The controversial move is likely just the start of a new wave of workplace programs that aim to encourage healthier employee behavior through targeted incentives.

????"You're going to see over the next three to five years lots of employers rewarding employees for successfully improving their health risk," says Jim Winkler, chief innovation officer for HR consultancy AON Hewitt, which found that 58% of the nearly 800 employers it surveyed plan to penalize workers who fail to take appropriate actions to improve their health.

????Companies are expanding their wellness programs in the face of climbing health insurance costs, which in 2013 are expected to reach an average of $11,188 per employee, up from $7,874 in 2007, according to AON Hewitt. And many are switching from solely offering carrots -- rewards for making healthy choices -- to include sticks.

????Of the $2.7 trillion spent each year on health care, about 50% to 60% relates to conditions that could be improved through changes in diet, exercise, and stress management, says Adam Bosworth, co-founder of online wellness company Keas and former head of Google Health.

????The recently passed Affordable Care Act clarified employers' ability to financially penalize employees for unhealthy behavior. The act raised the allowed penalty, or reward, to 30% of health care premiums, from 20%. The federal health care reform package also cast a spotlight on the effectiveness of using payments and fines to influence employees' behavior -- regardless of whether they are weighted more on punishment or rewards.

????"These programs, when it comes to obesity and weight management, are simply not very effective. All the studies have shown a very marginal weight loss over 12 months," says Morgan Downey, editor and publisher of The Downey Obesity Report, which covers science and public policy on obesity. "The best scientists and clinicians in the world have trouble getting these conditions under control. Why do we think HR can do it?"

????Unlike smoking, high blood pressure, and glycemic control -- issues that physicians have a range of options to treat and control -- there are no clinically proven pharmaceutical or treatment protocols for obesity, says Downey. Moreover, the federal regulations proposed under health care reform contemplate such possibilities as an employer requiring its entire workforce to achieve a body mass index of 27, and fining those who cannot meet the standard or make consistent progress toward it.

????A majority of adult Americans are overweight or obese. Most fail in their attempts to lose weight, researchers find, but the majority of those who succeed return to baseline weights within five years. "The majority of American women are on a diet at a given time," says John Cawley, a Cornell University economist and public policy professor. "It's not that people don't know, and it's not that they aren't trying. It's that these are really hard behaviors to change."

????A recent study of a workplace program that offered financial incentives for losing weight to 2,635 workers found only modest weight loss and a high dropout rate, according to Cawley, who published this study with Joshua Price of the University of Texas at Arlington. "We're at an early stage with figuring out how to optimally design these incentive schemes," says Cawley.