[mostlyjason]

People don’t work at jobs for life any more. It’s common for younger people to switch jobs every 2-3 years. In this environment, it makes more business sense to work employees hard because the company doesn’t need to consider long term health. This creates a kind of prisoner’s dilemma where’s its only advantageous to invest in employee’s long term health if other companies do so as well.

[lazerpants]

I know the former CEO of one of the big U.S. health insurers. He has mentioned that on one side, as a doctor, he wanted to do good for patients long term, but, with shareholders on the other side, it can be very difficult to align incentives for long term health when most plan members will only be plan members for an average of 5-10 years.