Wednesday, July 30, 2008

Healthy jobs and health insurance

I'm sporting the two badge look this week as it is my first week in my new job and the last week at my old job. I'm going through "oohing" and "ahhing" at all the shiny cool new stuff at my new job and saying good riddance to all my pain points at my old job.
One observation I've noticed is my new client is committed to the health of their employees. Some of the perks are as follows: defibrillators on every floor, on site gym, a martial arts studio, on site massages, and fresh fruit in the break rooms. Additionally, I learned that the company gives people 4 hours of PTO if they use the gym a certain amount of time within a quarter. If they meet a yearly goal they get an extra 8 hours. That's 3 days of vacation for working out. FTEs are permitted to use some of their work time to work out. I'm impressed by the company's commitment to their employees health and well being. I'm also glad they let contractors like me use their facilites. They won't let me bill for it though, bummer.
That's really cool. The people here seem a lot healthier than at my old job.
At my old job, we had at least three people die this year and a lot of people just don't look very healthy.
The company tried to address this by holding a health awareness day where people could get free blood tests and take free mandatory online health surveys. No onsite anything. If you want fruit, go buy some in the cafeteria. What do you think this is a fortune 134 company?
For a health industry company, they also don't do a very good job with health benefits. The company encourages its employees to elect for a consumer 'empowerment' plan. I think my friend Dale Mensch has it right when he opines that when the corporate types use the word empower they really mean disenfranchise.
The empowerment plan scared the hell out of me. Sure, the company gave my family a $2,000 allowance for the year, but once you use that up, you're basically on your own until you hit the catastrophic part of the policy. Colleagues of mine who have had medical emergencies found themselves owing tens of thousands of dollars.
We just don't have room in our finances to handle something like that. Who would?
I think that a consumer driven health plan isn't the perfect solution. It gets sold with the halcion memories of our parents paying cash for our trips to the doctor. Weren't those days great? You didn't have people going into the emergency room for a cold or calling an ambulence for a bee sting or any of the other poor decisions people made when they had no out of pocket expenses for their health care.
Consumer driven care does force people to make choices, what it also does is discourage people from seeking care. There's the 100% preventable coverage part, but it isn't as good as it sounds.
Under a consumer plan I can get a physical free of charge. If I were to mention that my back is bothering me, that's considered treatment and everything relating to my back is not covered under the preventative--a few tests and a big chunk of that $2000 allowance is gone.
A few burns through an allowance and people won't seek care that may improve the quality of their lives. People don't make great decisions when it comes to weighing their health and money. Every time they seek care they have to be wondering whether the trip will devastate their finances.
Life is stressful enough. People shouldn't need to worry about their health and the cost of their health care.


Brian Vaughn said...

Now I can attest that HRA and HSA plans are better than the old PPO plans when it comes to major medical. Having a baby in today's medical world is crazy expensive. Using the HRA plan we paid a lot less out of pocket. I plaid maybe 5 grand of my own money when my son was born under a PPO plan. When my daughter was born I paid maybe 2 grand. It zapped my HRA savings but since I only had to pay 20% for the rest it saved me money.

Where an HRA plan fails is with older people with chronic problems. That 2 grand doesn't go far. Those people are better off using an HSA plan since they can put money into the account tax free. Since is is an interest baring account that money will grow over time if you don't use it. HSA plans also are not tied to a company so if you leave the company you still keep the money. It's more like a 401K plan for health insurance.

There are a lot of things wrong with health care but HRA and HSA plans are something very good. I tend to think having companies provide health insurance for employees is a big mistake. People should be able to shop around for health insurance just like car insurance.

Paul Wiedel said...

Brian, I'm not sure that I'm in the same boat with you just yet. We're in the same harbor though. Health insurance plan types are difficult to compare.
I've had PPOs that were just outstanding, I've had PPOs that were terrible, and I've also had HRAs that were ok. I had an HSA for about four months and it was bad, the company had very limited resources though.
To me, the model that a policy uses is less important than the quality of the coverage.
It's difficult to differentiate the model from the policy when comparing the cost of treatment. This is especially true because employees don't usually see the total cost of coverage.
At its essence, the coverage is what makes a policy. For my money, I want a policy that isn't going to fight every claim and will deliver.
Having fought with a health insurance over coverage, I can attest that being denied for treatment that will improve the quality of your life and seeing your colleagues denied for treatments that would improve the quality of their lives is downright demoralizing.
You raise a very valid point about disconnecting health insurance from employers. I have to admit that one of the primary reasons that I chose to leave my last company and work for my new employer is because the benefits are outstanding.
I also know that people have left and are thinking of leaving my former employer because of the health insurance.
Should one base their choice of employer on his health needs? It's hard to say. I tend to want to work for companies that provide better health insurance. I believe that it is a fair barometer of how much the company values their employees. If a company aggressively cuts the cost of providing health insurance I believe that they are more likely to be the type of company that will continue to cut the cost of employing people, through whatever means they can find. With the mindset that employees are costs that must be minimized, the relationship between the employee and the company is reduced to an impersonal Kafkaesque existence.
I prefer to work with people and for people who value my work.