Why Discovery Health Vitality does not promote a healthy lifestyle

Let’s start off with putting my frustration into context: I have been with Discovery Health for almost 20 years and during that time, I have seen a constant increase in premiums, have hardly ever claimed and have hardly ever seen any benefit from the health-scheme. Granted, one should treat medical aid as insurance and not as a rewards programme, but when a medical insurance such as Discovery Health markets their Vitality programme with

We encourage you to Know your health and Improve your health, then enjoy the rewards. We give you the knowledge, tools personalised wellness programmes and motivation to do well on your journey towards better health.

one would think that Discovery has it all figured out and would be capable of motivating and rewarding their members to stay healthy. After all it is in the interest of health insurance that healthy (non-claiming) people carry the not-so-healthy people. To be clear, when I asked Discovery Health why my premium is the same as my obese, smoking and alcoholic neighbour, I was told that this is legislation and there needs to be a level of “fairness” amongst all members. I personally don’t think it is fair that non-claiming members need to carry the unhealthy life style of other members.

But in any case, the following mail was cause of my recent upset:

Let’s put this into context: In 2013 I arrived at a point, where my lifestyle gave me the only choice to fit into size 44 pants, wear XXL shirts and with 99kg my cholesterol levels peaked and I could barely manage to climb a flight of stairs. In May 2013 I drastically changed my diet, took up running and by August 2013, I was down to 80kg. I continued with a balanced diet and daily running until in November 2013 I hit a plateau where I felt that weekly gym visits will complement my running. So thanks to Discovery Vitality, I signed up with Virgin Active and enjoyed the benefit of discounted gym membership.

My main goal for gym was to compliment and improve my running and mainly tone problem areas – I needed a personal trainer and since December 2013, I have been to Virgin Active 115 times and additionally have run 185 times accumulating 1200km. My 3 weekly sessions at the gym consist of functional training/upper body (Mondays), core and weights (Tuesdays) and leg-day (Thursdays). Each gym session is followed by a 6km run at 4:50min/km pace and during non-gym days I run between 6-10km daily (typically the longer runs on weekends).

So putting my change in lifestyle into context (and it is a daily struggle to stay motivated and avoid falling back to the “old ways” – read “chocolate, beer and lots of carbs”), emails like the one above are highly upsetting – especially so, since Virgin Active sends gym activity to Discovery and those sessions are logged as “Vitality Points”.

And this is where Discovery Health Vitality starts to go wrong – yes, perhaps it might have been a technical glitch and the email was sent out in error, but it allowed me to reflect on Discovery’s statement of “knowing your health” and “improving your health” and to highlight why the Vitality scheme (and similar schemes with other insurers) are just a smoke-screen:

• Discovery Health does not really care. No really, they do not! As a health insurer and a company in the health industry creating jobs, it is difficult to find a balance of healthy and sick people. If there are no sick people, the medical industry will tank as no-one would need it to begin with. If there are no healthy people, there is no-one to subsidise (read: “make profits”) sick people. I think everyone knows, that as part of any viable insurance company, risk analysis is important, and it is really a myth that healthy people subsidise/balance out premiums of sick people. Insurance premiums are structured in such a way to make healthy profits.
• Health assessments are pointless. Well, you do get the points, but if you have ever done a Vitality health assessment, you will find that the nurse/doctor does not really care or provides you with any tangible advise – they merely take your measurements, load everything onto Discovery and you are on your merry way with the points earned. When I did my health assessment, my cholesterol was through the roof and my blood glucose levels were not looking good. The medical professional said “this is bad” but provided no assistance when I asked her what I should do, other than the answer “this is not part of the Vitality assessment and you need to make another appointment – or you can just buy some Rychol without a prescription”. It’s quite shocking that a medical professional will just offer over-the-counter cholesterol-reducing medication based on a 2 minute test.
• The same applies to the Vitality Fitness test. Let’s be clear – I did the fitness test when I was at my worst possible shape, but I managed to complete all tasks on the high ratings of Good and a few at Excellent. The test was not tough, it was mediocre and any unfit person would be able to master the test within the “Good” rating. Similarly, the person conducting the fitness test had no interest other than taking the test and getting the client out the door – it is for the Vitality points after all.
• Do not get me started with the Vitality Nutrition assessment – what an absolute joke. Remember, you make an appointment with a nutritionist whose job it is to understand nutrition and guide their clients. I had all intentions to use a nutritionist to improve my diet, but when you are told “As long as your plate of food contains 1/3 fruit, 1/3 protein, 1/3 dairy and 1/3 fat you do not dramatically adjust your diet”, that’s when I gave up. (Yes I did try to correct her that it is impossible to have four 1/3’s but that went really over her head). Not a train-smash, it’s for the Vitality points after all.
• Fitness points are “capped” and multiple activities per day are not rewarded. There is also an annual threshold and if you are moderately active, you will reach this cap within the first 6 months. Most people will do the bare minimum just to retain the discounted gym membership.

Pretty much every programme offered by Discovery Vitality to know or improve your health is pointless (well, not quite, you get the points, but Discovery and their suppliers in the health-network do not really care too much if your health improves). Most points collected can be achieved by cheating or faking it:

• People swipe their gym cards and leave the gym within a minute – the purpose is to record the gym visit to retain the discounted gym membership fee and obviously earn 150 points per visit. It is very easy for the gym and for Discovery to establish if someone goes to gym or not. The gyms are equally at fault, as they should monitor gym access and report fraudulent activities of that sort (well in the end, the Vitality member cheats on himself by not doing a workout). It is not uncommon that the “clever” people give their card to another member (gyms let people “double-swipe”) or in some rare cases, people go to the gym to pick up a smoothie, surf the web or read a book/listen to music.
• People lie about sports events – they will genuinely enter races and log them at Discovery to claim points without actually having participated in the event. Some go as far as letting other people participate for them (I saw this during a Parkrun, where a highly obese lady handed her barcode to her kid)
• People send healthy friends/colleagues for fitness- or medical tests.

TL;DR :

• In my 20 year membership with Discovery, the medical insurance at no point in time made a sincere and honest attempt to understand if they should or could improve my health.
• No medical aid has any interest in keeping healthy members, and rewards schemes hardly ever incentivise the health members
• A medical insurance is “forced” to collect the same premium for healthy and sickly members. My point is, that if you are a smoker and your medical insurance offers you a substantial discount on premiums, you will more likely quit and stay a non-smoker. The same can be said if you maintain a certain weight, BMI / bodyfat or maintain a certain level of fitness.
• Perhaps keeping check on members is too difficult and time-intensive and costly (my thought is that if you do not check up on members abusing your scheme and rewards, you would have to “load” premiums to absorb that risk)
• There is always the notion of “We can not discriminate” sick/unhealthy members as it would be unfair. I think this is just an excuse, as one can very well say “We will reward you financially/discount your premium if you do XYZ”. As in a work-environment, medical insurers should reward performers and assist/help non-performers.
• Vitality partners have no incentive to do a proper job, as they will receive revenue for just having a Discovery member participate. Nutritionists and biokineticists make more money from Vitality assessments than client consultations and I am not sure why Discovery does not look at this properly.

Update 2014-09-18: September I received a call from a C-level Discovery executive, who said that he read my complaint and wanted to arrange a meeting with a “Vitality expert” to explain to me how Vitality works. Strangely, the C-level executive did not get my point about gym points not reflecting for almost one year – humble pie right there.

Update 2014-09-19: Problem was resolved and communicated via email – short and sweet “We have confirmed your Virgin Active visits with the gym, you may now view your workouts on the online points monitor.”

Update 2014-09-25: Bribe incoming? I just declined a delivery from Discovery which looked like some fruit&nut health platter. A pity that our membership money is wasted by sending Discovery staff dropping of healthy snacks, only to have them returned. The content of the platter looked too carb rich (nuts, dried fruit) and I honestly prefer my own dietary selection. I would have much more preferred a communication from Discovery along the lines of “We have made some adjustments on how we onboard and monitor our members gym activity and a problem like you had experienced will not occur again – XoXoXo”