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Tess Vigeland: Obviously, a lot has changed since those days. In fact, health insurance is morphing as we speak. And as I mentioned at the top of the show, those changes are showing up in open enrollment season. Unhealthy workers cost companies more money. So bosses are looking for ways get employees to give up their bad habits -- sometimes by carrot, sometimes by stick.
From the Health Desk at WHYY, Taunya English reports.
Taunya English: At Campbell's, the company's cooked up a friendly competition. It pits factory workers in Texas against tomato processors in California and the folks at headquarters in Camden, N.J.
The contest is over which site can get the most workers to take an online health-risk assessment. If enough people fill out the survey about their health habits and lifestyle, everyone in the group gets a $50 gift card. Some lucky winners will get a year of free health insurance. And then, there's bragging rights.
Jan Kelly: Not only will they get a trophy, which is actually a very coveted award, it's kind of like the Stanley Cup of annual enrollment, we pass it from plant to plant each year.
That's Jan Kelly, her team creates incentive programs. At Campbell's, the nudging never stops. There are prizes for working out and stickers point to the healthiest choices in the vending machine.
At the company cafeteria, apples and oranges are stacked up beside the cash register. If you skip the French fries in favor of a small salad, you'll save a dollar.
Health fair worker: Right now, what I'm going to do is measure your waist. What I need you to do is hold this right here in the middle for me, I'm going to go around you, O.K.?
I caught up with John Faulkner at one of Campbell's morning health fairs. The 52-year-old was getting his middle measured and his cholesterol checked. Last year, he was told his body fat was too high. He dropped more than 30 pounds.
John Faulkner: Candidly, my wife started hitting me over the side of the head, and said, 'We've got to go after this,' and it was a real team effort. She makes eggbeaters in the morning for me and was sending me in with a salad for lunch.
At Campbell's sleek new fitness center, Amanda Hershon hits the treadmill right after work. Hershon, a communications specialist, started exercising and eating better two years ago.
Amanda Hershon: I was just at a size 12; I just was trying to make the decision as to whether or not I was going to leave my pants open when I was sitting down, the button, the fly. It was really bad, I didn't want to keep buying new clothes.
Now Hershon's a bit of a fitness celebrity. She was written up in the company newsletter and won $500 in cash.
Campbell's health strategy isn't all carrots. There are also sticks. Again, benefits administrator Jan Kelly.
Kelly: If you are a tobacco user, there is a $20 per month surcharge that you will pay for participating in the medical plan.
But the fee is waived if you complete a smoke-enders class.
Not all the payoffs require sweating or counting calories. Employees considering an elective operation, like a knee replacement or weight loss surgery, can earn a $200 gift card simply by discussing their treatment options with a nurse or counselor. The program is voluntary and it's run by an independent medical information company. Kelly says about 25 percent of people decide not to have the operation or opt for less invasive, less costly treatment after discussing their alternatives.
Medical ethicist Art Caplan says workers do need better information about which doctors and hospitals have the best track record. Still he's wary.
Art Caplan: The last person I want to trust for my advice about those things is the person who's going to pay most of the bill. So, there is an inherent conflict of interest if the sole source of information coming in workplace-based programs are the people who are trying to tamp the cost down.
Caplan leads the Center for Bioethics at the University of Pennsylvania. He says he also worries about how those health assessments get used. Kelly says Campbell's is strict about keeping worker information private.
With all Campbell's nudging, are any of the incentives working? The experts aren't sure, and Amanda Hershon says, for her, the promise of a gift card didn't make much of an impression.
Hershon: You know maybe there was a raffle, I'm not really sure. If there was one, that's not motivated me in the least bit.
It may be that keeping your wife off your case or wanting to fit into your favorite jeans works about as well as anything your company is doing.
I'm Taunya English for Marketplace Money.