If my employer pulled a stunt like this, I’d be looking for another job. Forthwith.

Moreover, I doubt this plan is going to save Clarian money (except for smoking policy – this is probably the only cost saving measure). Even with obesity things are far from clear if you consider possible results of such a policy in real life. Diet conseling will cost money; some people may go on unhealthy crash diets, some will engage in exercise that may be a bit too much – this will increase risk of injury – $$$. Some will take drugs. Not all obese people get diabetes or are sick. So, you still need to consider how much they’ll spend on several people in order to save money on one person. But the plan is bound to cause some otherwise healthy low-risk people to take prescription drugs, and this is going to be expensive.

People often confuse absolute risk reduction with relative risk reduction; it is important to understand the difference. It is also important to understand how many people need to be treated for how many years for one person to benefit when you consider cost (NNT – number needed to treat, I am surprise a health company like Clarian doesn’t understand basic epidemiology). It is easy to say “it is cheaper to give people prescription drugs than to treat a heart attack”, but when you say it you are forgetting that you need to treat many in order to save money on one. There have been many studies showing that except for some very high risk categories such a treatment is not cost-saving. BTW – if you are going to look up such studies keep in mind the differece between cost-effectiveness and cost-saving. A measure is considered cost-effective if the cost of quality-adjusted life year gained is under 50K. While this is worthwhile, it doesn’t mean the measure is cost-saving.