Getting workers to take better care of their health is getting to be a national obsession. The thinking goes something like this: If we can get employees to stop smoking (or lose weight, exercise more, or get regular health checkups), they will be healthier and happier and use less health care. And, the less health care they use, the more we (the employer) can save on our overall health care costs.

Smoking was the early focus of most “get healthy” workforce campaigns, but now the bull’s-eye is on a more widespread problem—employee obesity. It’s a problem that is seen as the root of a lot of other health care issues, and a story in today’s Houston Chronicle speculated on the possibility of companies charging a “fat surcharge” for overweight workers.

The newspaper talked to Pattie Dale Tye, president of Humana, Houston, who said that “this touchy topic has come up recently during conversations with local employers. “Oh boy, nobody is anxious to go down that path,” she said. Tye said the U.S. hit the tipping point with smoking about five years ago—‘all of a sudden, it was just not accepted’—but she doesn’t believe the country is ready to penalize obesity in the same way. At least not yet.”

Instead, as the Chronicle story points out, companies are more likely to pay workers to lose weight. One Texas employer—Memorial Hermann Healthcare System—has a program called “Leaner Weigh” that “pays $10 for every pound that enrolled employees take off and keep off. Some 3,000 employees sign up each year for the program, and the hospital has paid out $408,000 since the program began five year ago.” Hospital officials say that “records show a 20 percent reduction in medical claims by Leaner Weigh participants.”

And as we have written about here at Workforce Management, some companies use a “calculator” to estimate the cost of employee health care problems. The “Blueprint for Health” “helps us see the cost of medical care and realize why employees’ health is a lot more affordable when you take care of them before they get sick,” says Dr. Steve Goldman, medical director for Peoria, Illinois-based Caterpillar.

Helping employees better manage their health has become an imperative for businesses. Most companies use incentives to do so, but a growing number are taking a more punitive approach. We’ll be exploring these two approaches on April 9 in Chicago at the 2008 Health Care Forum, presented by Crain’s Chicago Business and Workforce Management. The topic is “The Carrot or the Stick: How Employers are Managing Employee Health Care to Reduce Costs.”

If you manage a workforce and are worried about rising health care costs, this is a topic you should be thinking about. With $2 trillion being spent each year by Americans on health care, according to the Centers for Disease Control and Prevention, and half of that being spent to address preventable diseases, it’s a subject you just can’t afford to ignore.