oyees, making it easier to predict, project and estimate savings, which tend to accumulate in later years. As of last July, at least 16 states had created wellness incentive programs for their public employees, according to the NCSL. The list includes Alabama, Arkansas, Delaware, Kansas, Minnesota, Mississippi, Missouri, Montana, New Hampshire, North Dakota, Ohio, Oklahoma, South Dakota, Virginia, Washington and West Virginia. Most offer positive reinforcement as a way to encourage healthy lifestyles. In Arkansas, public employees who complete a health risk assessment, which gauges smoking, alcohol consumption, seatbelt usage, body mass index and weekly physical activity, receive a $10 monthly discount on their health insurance premium. Those found to be low-risk receive an additional $10 discount. Alabama, however, in 2008 gave its 37,527 employees a year to start getting fit. If they don't, they have to pay $25 a month for insurance that is otherwise free. Robert Krzys, an attorney and health care expert for a coalition of Connecticut state employee unions, said the proposed Health Enhancement Program was a concept first suggested by the unions. Krzys, who sits on a health care cost-containment committee, said it's a way to make the state employee population healthier while holding the line on health care spending. Connecticut now spends about $1.3 billion a year on health care for 250,000 active and retired workers and their dependents. Recent figures show that 12 percent of state employees use an existing program that provides workers with disease counseling, such as education about controlling their diabetes. "It doesn't really do us any good if they're not using it," Krzys said. When he pitches the Health Enhancement Program to union members, he mentions that a 57-year-old worker didn't feel well last year, was told to get a colonoscopy and discovered he had stage four-cancer. The man's treatment cost the state $1.3 million and he died shortly afterward. Under this plan, he would have gotten his first colonoscopy at age 50. The plan is voluntary. Those state workers and retirees who decide to participate, including their dependents, must agree to have physicals — annually for those 50 years and older — age-related screenings such as mammograms and cholesterol tests, and cervical and colorectal cancer screenings. The two insurance companies that administer the state's insurance program will inform the state Comptroller if employees are getting their proper screenings and filling their prescriptions. If they're deemed to be noncompliant, they are dropped from the program and allowed to participate in the regular insurance program for state employees, but will pay $100 more a month and a $350 annual deductible, Krzys said. Some state employees already see the initiative as big brother watching to see if people quit smoking or a way to eventually ration their health care. Others have posted concerns on union message boards suggesting there's a political motive behind the plan, which is being promoted by union leaders who support universal health care. Godfrey Fergus