The side effects of 'wellbeing': from the welfare state to the wellness state
What happens when the state is concerned with how we feel and how healthy we are? André Spicer (Cass Business School) and Carl Cederström (Stockholm Business School) argue that with many governments now employing behavioural scientists to help shape policy, state interference in our private lives is increasing.
They also explain that this obsession with wellness can burden businesses with an expectation to constantly improve their employees’ health and happiness, even though research shows it’s not easy to change people’s habits. This article originally appeared on the LSE policy blog.
Today we face a puzzling situation. Welfare states around the world are being wound back. In the UK, about half of public spending is now contracted out to private companies. There is hope that by shrinking the welfare state, it is possible to not just harness the power of the private sector, but also to give citizens more freedom to choose.
While the welfare state is receding, state interference in our private lives seems to be increasing. Not only are we banned from smoking in our own car, we are also told how many fruit and vegetables we should eat, how many steps we ought to walk in a day, and how to make ourselves feel happy.
Clearly, the state has not been dismantled quite as fundamentally as many free marketers may have hoped. Rather, it seems the state has been resurrected, dressed in a yoga outfit. In its new form, the state is less concerned with welfare. The focus, instead, is on wellbeing. Rather than providing people with basic services such as health, education and a basic income, the state is now focused on helping citizens make the right choices to maximise their health and happiness.
Proponents may claim that paying attention to wellbeing is a way to treat people holistically. It acknowledges the interconnectedness between people’s health, emotions and lifestyle choices. Wellbeing is said to drill deeper. It goes beyond the surface level and taps straight into the root causes. Sure, the ultimate responsibility falls onto the individual, but that is not a problem as long as the individual is equipped with the best possible directions for maintaining their wellbeing. This is great news, we are informed. When individuals address the root causes of their problems, we no longer need to rely on armies of costly professionals. Why empty the public purse when citizens can maximise their own wellness themselves?
Yet we know from existing research that it is notoriously difficult to encourage people to change their behaviour. Take obesity, for example. Research shows that among those who go on diets, about 95% fail to maintain their new weight, and a significant number of dieters actually end up gaining weight instead. That aside, as the wellbeing state intervenes into people’s lives, more and more people begin to feel ill at ease. Being told how often to exercise, what to eat, and how much to drink can make people feel that their private lives are violated. What’s more, wellness interventions may end up costing money rather than saving it. A study conducted a few years ago found that the lifetime health-care costs for healthy non-obese, non-smokers are higher, since they are expected to live longer.
As well as creating unforeseen problems for the state, our newfound obsession with wellbeing has a big impact on the private sector. A key part of the move from the welfare state to the wellness state is the transfer of responsibility of a person’s health and happiness away from the state. The idea is that as the state steps back, the private sector will step in. This could mean that businesses find themselves saddled with the expectation of constantly improving their employees’ wellbeing. As a result, they will not just have to offer health insurance and gym memberships, but even more elaborate schemes which reach deep into the physical, mental, emotional and even spiritual lives of their employees. This could burden companies with significant costs and distract from focus on their core activities. But it could also give rise to an even more disturbing trend: the move from the nanny state to the nanny corporation.
Sometimes, the nanny corporation can be kind. For instance, last year IKEA in the US gave all its employees wearable devices which allowed them to track their patterns of activity during the day. But increasingly, this kind of kindly behaviour has taken on a more punitive tone. One water company in Sweden offers higher wages if employees visit the company gym weekly. A hedge fund in London introduced a device which tracks what employees eat, how much they sleep and what they drink. This bio-data is relayed to a central system and is then compared with their trading patterns.
Perhaps a more profound concern is what happens when the nanny corporation decides to stop caring. Unlike the welfare state, the caring corporation always has the option of firing you. When this happens, the difficult and costly cases are likely to be dumped onto an increasingly stretched state system. The wealthy will start asking why they should support the sick poor who frequent public hospitals. They may start to think the great mass of unwell have brought their fate upon themselves through hapless lifestyle choices. Perhaps it should come as no surprise that one of the functions which the state plays with increasing zeal is to tell the population, like you would tell a child, what to eat, what to drink, how much to walk each day, and how to make yourself happy.