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Let’s face it health delivery in the U.S. is a mess. It is expensive, not very efficiently delivered and for the money we are spending on it the results we are getting are pretty unimpressive. Our infant mortality and morbidity rates and other key measurable are not in line with what we spend per capita. Even the French have way better outcomes at much less cost than we do! - Educate your employees. We have been providing employees with health care for years. In many cases they have little idea about how it works and how much it costs, and don’t care! If I have never had to participate in the costs and have no idea how much or why premiums go up why should I care?
For many small businesses there is almost a feeling of helplessness about what they can do about the escalating costs. If you aren’t a decent size “group” you probably feel like you have little or no impact on your health care costs and premiums. Many smaller employers have had to substantially increase the cost share that their employees are paying to have coverage for themselves or their dependents, or are examining dropping coverage all together. I know employers who are considering it not because they want to, but because they feel they can’t afford to provide coverage.
Some of us may see a “national” plan that we can participate in as a solution, and it may be a solid alternative. I am concerned that many of the “proposals” I see being promoted are about premium alone or dropping coverage for things like mental health, chemical dependency and others. I have heard others including large employers say “we aren’t in the health care business”. Unfortunately in many ways we are. Most people rely on their employer for health care coverage, retirement, and other factors.
The other part of health care we don’t talk about much is managing costs. I agree that the costs of medical technology, advances in treatment, longer life spans, and bluntly just waste effect costs pretty drastically. I am also talking about other costs; the costs of work related stress, poor health management, and other factors.
Jeffrey Pfeffer is an internationally renowned professor of Organizational Behavior at Stanford University. He points out that much of our health care costs are directly related to stress. Employees are stressed out about work, their finances, and a host of other issues. The current economy makes it worse not better, lose your job and lose your benefits. Unemployment insurance is relatively short term as well. Studies by the American Mental Health Association and others estimate we lose $200 billion annually to presenteeism. Presenteeism is where people show up sick, take up work time dealing with personal problems, or just flat miss work, we pay for it!
So great you ask what can I do as a small business person. Here are some my thoughts:
If you had a production or quality issue you would in all likelihood ask your employees for help in fixing it. (If you aren’t you should be). Why not with health care?
A good EAP can help your employees and their dependents address some of these stress, alcohol, substance abuse and other issues much more cost effectively than your insurance provider. In many cases the EAP can act as a “gatekeeper” getting your people to the right intervention. Most are “funded” in such a way that they are incented to do this efficiently. They provide services for a set fee not an open check book.
Many EAPs today also include Wellness programs. These are programs that involve health care screening, exercise and diet, and other lifestyle management interventions that help your employees and their families catch and address problems before they become problems. A gym membership is way cheaper than a bypass surgery!
EAP counselors can also help you identify “hot spots” in your organization. If a disproportionate share of your employees or dependents is using their services you can look for root causes. If a particular supervisor or manager has extremely high turnover or issues the problem may not be the employees.
Look at incentives. It may sound crazy, but incentivizing your employees to utilize things like discounted gym memberships, smoking cessation programs, weight loss, and safety campaigns can save you big bucks. By explaining to employees that health care costs effect the dollars you have available to pay wages, make investments in technology and capital, and pay increases you would be stunned at the difference it makes. They become your partner not your dependent, they realize by helping you they are helping themselves.
- Hire and train good supervisors. I have been practicing human resources professional for thirty years and we have a truism- “people join companies and leave managers”. Poor supervisors and managers cost businesses millions every year in turnover and lost productivity. Make sure that when you hire or promote someone they have the right skill set. This doesn’t have to be horribly expensive. You can either hire these skills or in many cases there is excellent supervisory training available through your local Chamber of Commerce or community college. Executive coaching is great, but most of your employees don’t work for an “executive”. Poor front line supervision is relatively cheap to fix.
- Engage your employees. Engaged employees see themselves as being in partnership with you. They care about your organization, your customers and your goals. They are committed not compliant. Engagement isn’t a big company phenomenon. It requires trust, respect, responsibility, information, rewards, and mutual loyalty.
We are going to see changes in health care, we have to. Most of us running a small business are doing so by choice. The government or Wall St. isn’t going to fix our problem. Let’s protect our own interests and participate in solutions that make sense for us.
Mark F. Herbert is a speaker, author and consultant with over thirty years of experience helping organizations like Honeywell, Spectra Physics, Mobius, Oregon Community Credit Union and others take their organizations from Compliance to Commitment™. He is currently a principal at the consulting firm of New Paradigms LLC. He recently published his book Managing Whole, One Man’s Journey, which is available at amazon.com or his website at www.newparadigmsllc.com. He can be reached at Mark@newparadigmsllc.com.
