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Straining to contain costs and looking ahead to worse as the workforce ages, employers are beginning to introduce wellness programs with teeth. Feel-good corporate self-interest is taking a back seat to employee accountability, with heftier rewards for those who toe the line—or painful bites taken from paychecks of workers who don't. And instead of simply urging workers to exercise and engage in other health-promoting activities, companies are focusing on specific benchmarks for weight, blood pressure, and cholesterol, for example, that they expect employees to meet to get the lowest-priced healthcare coverage.

This bottom-line focus on "workplace wellness" stands to benefit workers as well as employers, of course, and could go some distance toward brightening the nation's overall health picture, too. A study released by the Milken Institute in early October concluded that reorienting our health system toward preventing rather than treating disease could stave off 40 million cases of cancer, heart disease, and other chronic illnesses during the next 15 years. That would shrink the cost of medical care and lost productivity by $1.1 trillion, an amount equal to half of all healthcare spending in the United States in 2005.

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