A slide in the Power Point presentation attached to the e-mail, "Wellness Ambassador 101," warns ominously:

"We have tried carrots so now that leaves the stick!"

Possibilities include:

• Higher premiums and costs for smokers

• Higher premiums and costs for employees that do not get a health screening (finger stick)

• Higher premiums and costs for employees that do not participate in wellness programs like Naturally Slim, etc.

Another slide shouts:

90% of bad health is the result of a decision – you CHOSE that lifestyle!"

"You can CHOOSE to change that lifestyle!!!"

"The city of Tulsa is requiring city employees to subject themselves to a battery of medical tests, before 'qualifying' for medical insurance for the next fiscal year," the employee told WND. "It was indicated that if the medical exam results are negative, that this could impact our insurance premiums."

"Stating that 'you chose to get into this condition' is, in my opinion, degrading and inappropriate. ... My daughter has severe asthma. I spend a lot of money and utilize my insurance to keep her healthy. Will that be taken into consideration when they choose what my premiums will be? Why would I be willing to provide that information even if they asked? It's none of their business!"

The employee also objected to a 15-page set of tables attached to the e-mail that contained detailed information about health-insurance claims incurred and paid, and how many people covered by Tulsa's employee health insurance are using a variety of prescription drugs.

" ... sure enough, my daughter's medicine is listed in the PDF file attached. I'm not very happy about this."

According to the employee, a document posted on Tulsa's intranet "states that HR 'no longer has access to claims information.' And yet just this week they send out a PDF full of claims information about every employee.

"Employees are getting pretty irate over this and I fully expect lawsuits to be filed."

The e-mail was distributed by Christine Fisher, the Tulsa HR department health and wellness coordinator.  Fisher did not respond to WND's requests for comment.

The city is already engaged in aggressive policies to promote health among employees, according to Johnson's email. A Power Point slide lists Tulsa's efforts to date:

What we have tried so far:

Cooking classes, exercise classes, free pedometers, healthy lunch bunches, chair massages, jobsite meetings, lunch meetings, trainer sessions, tobacco cessation, Biggest Loser, discounted Weight Watchers, free biometric screenings, giant Health Fairs, etc.

Another slide announces that the "health and wellness goal" of these policies is:

To provide employees opportunities and resources to make healthy changes to their lifestyles reducing their disease occurrence which in turn will reduce their medical plan utilization and claims.

The Power Point presentation provides information on topics including "annual health cost of diabetes" and the risks posed by "metabolic syndrome," defied as a collection of risk factors that "significantly increase your risk of developing disease," including elevated HDL cholesterol, triglycerides, waist circumference, blood glucose and blood pressure.

People with metabolic syndrome cost nearly double in non-cardiovascular medical expenses, and those with diabetes incur five times the health costs of non-diabetics, according to the slides.

The presentation goes on to compare health indices of 713 Tulsa employees to 15,203 people not covered in the city's employee health plan, using data from Holmes Murphy & Associates, identified as "our benefits consultants." According to the study, 46 percent of Tulsa employees are "obese or morbidly obese," compared to 34 percent of "others." City employees had higher fasting blood glucose, 55 percent, to 25 percent of "others."

The study concludes, "COT [city of Tulsa] was twice as bad as HMA's entire book of business!"

In addition, the presentation encourages Tulsa employees to join "Ambassadors," a voluntary network that "provides a contact person at every City jobsite" to promote and implement health programs.

• Dental
• Pharmaceuticals
• Obamacare
• Medicare - Medical
• Health Care Market Place
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