The recently leaked internal Wal-Mart memo regarding cutting benefit costs throws a kleig light onto the insanity of the American health care system and the various incentives it enshrines, and it also shows clearly how little loyalty management feels toward labor even as they exploit them. The bottom line drawn in the memo is that it is far more expensive because of seniority pay and obligatory raises and the growing expense of health care for older people to have an employee who has worked for the company for five years than one who has worked there for five months, so ideally the company's employment policy would do whatever it could to encourage people to quit as soon as they were in line for a wage hike. So the more you toe the line as an "associate" at Wal-Mart and do what you can to stay employed, the more the management secretly despises you.
Of course Wal-Mart plans to shift to the bogus health-savings-account-type model for health insurance, which has the primary purpose of discouraging people from seeking medical attention and puts the onus on individual patients (rather than doctors) to decide whether or not they can afford to be sick, can afford that medication, can afford that MRI or CT scan. This plan is always sold as being beneficial to younger workers, but that is only because they are less likely to need medical attention -- if they do, they are just as screwed as everyone else, if not more so, because they ahve a longer life to live with the burden of medical-bill debt on their backs.
Wal-Mart also intends to change the jobs to make them less desirable to those they perceive to be unhealthy and those more likely to incur expensive medical costs. This is supposed to "encourage healthy behavior in the workforce" but has the effect of culling the workforce of its weaker members and encouraging the workforce to ramp up the deceit they must employ in dealing with management. If smokers are surcharged, then smoking must be concealed. On your next smoke break, there could be someone there taking names to be put on the first-to-be-laid-off list. If a skiier is more likely to be injured off the job, then you better not let anyone know you ski. What you do on your off-hours can keep you from being hired if your potential employer sees it as likely to lead to health complications. So it would be prudent to be as tight-lipped and vague as a Supreme Court nominee at your next interview when asked what you like to do -- sitting on the couch in a healthy posture may be the only correct answer.