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Employers, which have long been nickel and diming workers to lower their costs, now have a new tactic to combat these growing costs. They call it “wellness.” It involves growing surveillance, in­cluding lots of data pouring in from the Internet of Things — the Fitbits, Apple Watches, and other sensors that relay updates on how our bodies are functioning.

The idea, as we’ve seen so many times, springs from good inten­tions. In fact, it is encouraged by the government. The Affordable Care Act, or Obamacare, invites companies to engage workers in wellness programs, and even to “incentivize” health.

By law, employers can now offer rewards and assess penalties reaching as high as 50 percent of the cost of coverage. Now, according to a study by the Rand Corporation, more than half of all organiza­tions employing fifty people or more have wellness programs up and running, and more are joining the trend every week.

There’s plenty of justification for wellness programs. If they work — and that’s a big “if” — the biggest beneficiary is the worker and his or her family. Yet if wellness programs help workers avoid heart disease or diabetes, employers gain as well. The fewer emergency room trips made by a company’s employ­ees, the less risky the entire pool of workers looks to the insurance company, which in turn brings premiums down. So if we can just look past the intrusions, wellness may appear to be win-win.

Trouble is, the intrusions cannot be ignored or wished away. Nor can the coercion. Take the case of Aaron Abrams. He’s a math professor at Washington and Lee University in Virginia. He is covered by Anthem Insurance, which administers a well­ness program. To comply with the program, he must accrue 3,250 “HealthPoints.” He gets one point for each “daily log-in” and 1,000 points each for an annual doctor’s visit and an on-campus health screening. He also gets points for filling out a “Health Survey” in which he assigns himself monthly goals, getting more points if he achieves them. If he chooses not to participate in the program, Abrams must pay an extra $50 per month toward his premium.

Abrams was hired to teach math. And now, like millions of other Americans, part of his job is to follow a host of health dictates and to share that data not only with his employer but also with the third-party company that administers the program.

He resents it, and he foresees the day when the college will be able to extend its surveillance. “It is beyond creepy,” he says, “to think of anyone re­constructing my daily movements based on my own ‘self-tracking’ of my walking.”

My fear goes a step further. Once companies amass troves of data on employees’ health, what will stop them from developing health scores and wielding them to sift through job candidates? Much of the proxy data collected, whether step counts or sleeping patterns, is not protected by law, so it would theoretically be per­fectly legal. And it would make sense. As we’ve seen, they routinely reject applicants on the basis of credit scores and personality tests. Health scores represent a natural — and frightening — next step.

Already, companies are establishing ambitious health standards for workers and penalizing them if they come up short. Michelin, the tire company, sets its employees goals for metrics ranging from blood pressure to glucose, cholesterol, triglycerides, and waist size. Those who don’t reach the targets in three categories have to pay an extra $1,000 a year toward their health insurance. The national drugstore chain CVS announced in 2013 that it would require employees to report their levels of body fat, blood sugar, blood pressure, and cholesterol — or pay $600 a year.

The CVS move prompted this angry response from Alissa Fleck, a columnist at Bitch Media: “Attention everyone, every­where. If you’ve been struggling for years to get in shape, whatever that means to you, you can just quit whatever it is you’re doing right now because CVS has got it all figured out. It turns out what­ever silliness you were attempting, you just didn’t have the proper incentive.

Except, as it happens, this regimen already exists and it’s called humiliation and fat-shaming. Have someone tell you you’re
overweight, or pay a major fine.”

All of this is done in the name of health.

Adapted from Weapons of Math Destruction: How Big Data Increases Inequality and Threatens Democracy.

Cathy O’Neil/Backchannel

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