Surveillance State University, Inc

Penn State has joined a host of other colleges and universities, together with corporations and businesses across the country, in advocating for healthy living among its employees. This is a positive trend in America, where prevention had long ago fallen prey to the monopoly over life acquired by the hospitals, medical profession and pharmaceutical companies at (as well described by Ivan Illich in Tools for Conviviality (free copy here). People will live longer, healthier and thus more-fulfilling lives and the overall cost of healthcare should go down in the long run (in fact, studies show that medical costs fall by $3.27 for every dollar spent on prevention). While I can already hear the right-wing cries of nanny-state whistling through the Fox News airwaves, a deeper concern lies in the method Penn State has chosen to incentivize their employees (Inside Higher Education).  

The new policy involves a $100 surcharge each month for those staff and faculty that refuse to complete an online wellness profile and a physical exam that includes biometric screening (a full lipid profile, glucose, body mass index and waist circumference measurement). Against the most basic findings in effective incentive modeling, they have decided instead to take a punitive approach – just as NCLB did a decade ago, to little positive effect. This is not surprising at a research one university, where expertise in teaching is considered on par in importance with the athletic prowess of the faculty (until now), but hard to argue is the most effective way to push the program. How about incentives for those who complete the survey and exam? How about making the screening, which occur on campus, somehow part of a larger celebration?

Actually, it is not surprising that the punitive approach was taken given the increasingly combative relationship that has emerged in the wake of new neoliberal models, which are really based on reducing labor costs to increase corporate profits after the dramatic declines that occurred in the 70s. This included a multi-pronged approach including reducing job security, attacking unions in both the legal and political arena, transforming employer-funded pensions (defined benefit) to portable, largely employee-funded 401(k) plans (defined contribution), reducing government power and oversight, attacking progressive taxation (to give elites a larger share of the pie and increased political power), building a lobbying state that dominated DC, outsourcing jobs and manufacturing in general and weakening employee protections. The universities and colleges across America were slower to follow these reforms, though the reduced federal and state funding pushed them to slowly reduce the ranks of tenured faculty in lieu of cheaper part-time faculty. The shift from the 70s to now has been dramatic and has led to two distinct and oppositional parties within many universities – the leaders of the school who often have business backgrounds and look at the bottom line like corporation execs and the faculty and staff who are actually interested in the old mission of schools – educating students and advancing knowledge in a relatively autonomous milieu. Thus “be healthy or else” appears to be right in line with the new employer-employee relationship at many institutions of higher learning.

One final concern, of course, is the notion that this data is only being collected for the employees benefits. All of the data out there today on every one of us – from the websites we visit, to everything we do on Facebook, to the web forms we complete, forms we fill out for jobs, dating sites, to buy a book and the like to the medical records themselves – leaves us at the disposal of anyone who wants to use that information. Corporations have been the biggest crunchers of this data so far, capitalizing on these online profiles to target us with things that fit our consumer profiles. Recently we have learned that the government is also quite interested in this data, with the NSA using it to find the next terrorists among us. And now there is compulsory medical testing, together with many people choosing to learn their genetic makeup. With the failure to pass comprehensive healthcare reform that really altered the current system, the real fear is that insurance companies will start refusing coverage, or charging risk-associated premiums to those with predilections (or higher probabilities) of getting sick. While most people are worried about Big Brother, and maybe rightfully so, the real concern for me is the corporations and their power to  make us little more than commodified numbers in their pursuit of maximum profits.