When You Feel Like Screaming

It’s early morning, a time when the office is quiet and you can get somework done. And it’s good that you’re alone. Your screams, as you finishrunning the numbers and realize that your company’s health-care benefits arerising at 18 percent a year, would scare your team. Health-care costs aren’tjust nibbling at your company’s profitability. They are eating it like afour-course meal.

    And so, in the moments when you wonder whether the company can survive year after year of hikes like that, you might think the unthinkable:What if you dropped health-care benefits? In this job market, would employeesreally risk quitting?

    But you don’t want to be an Ebenezer Scrooge, a Uriah Heep, or some otherDickensian stereotype, so you won’t do that. People would quit, of course. Andthey’d tell their friends just what a Heep you are. Your company’sreputation would plummet.

    So you’ll do what most employers do. You’ll drive hard bargains with yourproviders. You’ll explain the situation to employees, who will act likegrown-ups and shoulder higher premiums, deductibles, and co-pays. Maybe you’lltake the plunge into consumer-driven health care. And life will go on–challenging,but manageable.

    That’s what happens at lucky companies, and to lucky employees. Aconsumer-advocacy group, Families USA, says that 75 million Americans under age65 lacked health insurance for all or part of a two-year period, 2001-2002.Another revelation: 70 percent of those people had jobs, or were the children ofan employed parent.

    Were their employers Scrooges? Probably not. Nearly two-thirds of the workinguninsured are employed by businesses with fewer than 99 employees. Maybe some ofthose bosses were once able to provide coverage. But as the economy slid and aspremiums climbed, many had to make a fateful choice: the company’s survival orhealth coverage for employees.

    If your organization is a larger one, you have some insulation from such achoice. But maybe not for too much longer. In a recent survey, 48 percent oflarger companies said they are having “significant” problems keeping up withthe cost of health-insurance premiums. And while only 4 percent of the businessleaders said they would drop health-care coverage entirely, companies arestruggling for ways to control costs.

    Some will not replace employees who resign. Others will hold off on plantexpansion, or R&D on a new product. Others will feel they have no choice butto raise premiums for employees one more time. And that will be one time toomany. Some low-wage workers, forced to choose between health-care premiums andrent or a car payment, will go bare.

    Decisions like that add up to fewer jobs, stagnant companies, and arrestedinnovation. The human toll is even more tragic. The worker without coverageskips a colonoscopy–he can’t afford it now. The cancer that would have beendetected and treated grows unchecked. And a father and husband is dead at 45.

    That might make you want to scream. Instead, do this: Visit CoverTheUninsuredWeek.org, and learn how your company can join a coalition thatruns the political gamut from the U.S. Chamber of Commerce to the AFL-CIO. Thecoalition doesn’t endorse one route to solving the problem of the uninsured,but it invites you to join a national discussion that can lead to practicalsolutions. Let’s do it–before it’s too late for our companies and ouremployees.

Workforce, April 2003, p. 10 — Subscribe Now!