Whose problem
Some recent trends have convinced me that wherever the burden of health care may fall, we would be better served if employers were not the best place to get it.
The first trend is toward corporate streamlining. My company has been doing this pell-mell for the last four years, partially to catch up and consolidate with the larger company that had just purchased it when this trend had begun and partially because the larger company has itself continued to slim down. To slim down, the company has outsourced several business functions (AP, Payroll/HR and IT are the most prominent.) This saves the company money, but in order for the vendors who now perform these services to maintain their margins, they have to hire people who are utterly incompetent. So when I transferred to a new location this past summer and had to choose a new health plan, somehow my choice was not correctly executed. Frustratingly, when I pointed this out to my HR department, they told me there was nothing they could do. (Seriously, what do we pay you for?) I had to call an 800 number. And wait on hold. And eventually, even though I spoke to someone, when they made the change, they made it to a different but still incorrect choice.
The end result of this was that for about a two week period, although I think I was technically covered by health insurance, I didn’t have insurance cards for myself or my wife, nor did I really have access to, say, print them out. That was a little uncomfortable. (This story is nothing compared to the Payroll nightmare. That group has had a hell of time just getting me paid the correct amount–they’ve screwed up four different times–but not only that, they’ve overstated my income on my W-2 by nearly over 10,000 dollars and despite the fact that I pointed this out nearly two months ago, still haven’t corrected it.)
The bottom line is that it sucks that my company has found such incompetent people and that we as employees must suffer. (To say nothing about our small vendors who depend on our timely payment not only to feed their families but the families of everyone that works for them.) But it’s even worse that our health care could be subject to the capricious errors of an incompetent contractor.
But now that they’ve outsourced and outsourced and there isn’t anything left to give to incompetent contractors, my company is struggling to find new ways to keep margins high. And one thing they’ve noticed, that lots of companies have noticed, is that health care costs are really high. This is a tough problem–a good opportunity. What my company (and others) have decided is that they now have a vested interest in the health of their employees. To what extent this is true is debatable…as we discussed two years ago, rising health care costs are going…somewhere. But is it really to help unhealthy people?
Not that it matters. My company has gone gung-ho into a program called “Health Works.” (Guess what? This program is outsourced, to a company called WellCorp.) First off, they are enticing (not coercing, yet,) employees to fill out an involved medical questionnaire. After that, it gets creepy. From the slickly-produced pamphlet mailed to my house (which features an abundance of beautiful, healthy people):
Why are strangers calling me at home and asking me about my health status? How did they get my health information?
The health professionals who are calling will give you the opportunity to enroll in a lifestyle management program to help you make lifestyle changes or manage chronic conditions. The health information was provided to the callers by our health care administrators. [Our company] has no knowledge of your personal health information and will not receive any information resulting from these calls.
Ok. This, to me, is over the top. This is beyond soft paternalism. I appreciate companies giving us benefits and offering programs to make us healthier. But lifestyle choices are choices. If health care costs hurt employer’s bottom lines to the point where they feel the need to pressure employees into a pre-selected routine then it’s time for the health care dollars to come from somewhere else. And that somewhere else may be totally elective, totally government-paid (i.e., “universal” health care,) or somewhere in the middle. But although I’d favor a system perhaps more on the universal side, I think it’s important that any financial disincentive toward an “unhealthy” lifestyle be born in such a way that the choice is preserved.
I enjoyed the story in Business Week on this subject which takes a balanced look at some of the tough choices facing large companies in the realm of health care costs.
