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The number of Americans without health insurance coverage grew last year amid a decline in the share of people covered by employment-based health insurance.
Those findings, revealed Tuesday (August 29) in a report from the U.S. Census Bureau, mean businesses spent less than they otherwise would have last year on direct health care benefits. But that’s not necessarily great news for U.S. employers, says Paul Fronstin, director of the health research and education program at the Employee Benefit Research Institute, a Washington, D.C., organization financed by companies and unions.
Fronstin says that the erosion of employer-based care since 2001 may be backfiring in the form of a less healthy, less productive population and higher taxes stemming from the cost of treating uninsured people in public hospitals.
“The fact that we’ve got 46 million people without health insurance really puts pressure on the system,” Fronstin says. “Not only the health care system, but the bottom line of business.”
The Census Bureau reported that the number of people without health insurance coverage rose by 1.3 million to 46.6 million in 2005. The percentage of Americans without coverage climbed from 15.6 percent in 2004 to 15.9 percent last year. The percentage of people covered by employment-based health insurance declined from 59.8 percent to 59.5 percent, according to the government report.
The same report found that real median household income in the United States rose by 1.1 percent from 2004 and 2005, reaching $46,326. But real median earnings of both men and women who worked full time year round declined. The nation’s official poverty rate remained statistically unchanged at 12.6 percent.
One factor behind the higher number of uninsured people is the rising cost of health insurance. A report last year from the Kaiser Family Foundation and the Health Research and Educational Trust found that premiums rose an average of 9.2 percent in 2005, more than three times the growth in workers’ earnings. That report said a drop in the percentage of firms offering health coverage to workers stems almost entirely from fewer small businesses offering health benefits. Nearly all businesses with 200 or more workers offer such benefits, according to the Kaiser Family Foundation study.
Alexander Domaszewicz, a consultant at Mercer Human Resource Consulting, says savvy large companies are looking at health benefits as a way to gain competitive advantage. Plans that foster a healthier workforce can give U.S. employers an edge versus foreign rivals that don’t have much control over the health care of their employees, he suggests.
“If they do it right, they can get an advantage over their international competitors because they improve productivity,” he says.
High health care costs and a large population of uninsured people also have sparked calls for some variety of national health care in the United States.
Fronstin doesn’t expect the latest numbers to trigger a major new effort to create a single-payer health care system. Nor does he see the news as reason to promote health savings accounts, given that HSAs tend not to make health care much more affordable for people. Instead, he expects businesses to offer, and individuals to take on, thinner coverage in the form of higher-deductible plans with limited care options.
“HSAs do not address affordability the way higher-deductible plans do,” he says.
No matter where you are, there’s likely a U.S. Post Office nearby. Until recently, that location probably handled its human resources operations a little differently from any other office.
But now the U.S. Postal Service—an organization with nearly 700,000 employees and annual revenue of $70 billion—is reaching the first milestones in streamlining its HR operations in an initiative called PostalPeople.
So far, USPS has integrated 73 of its 80 districts into a shared services center that can handle benefits, retirement, separation and management hiring.
The second phase of the project involves upgrading its core HR operation, which consists of 70 systems supporting 200 processes in the 80 districts. Part of the computer code is more than 20 years old and is based on essentially extinct computing languages.
The antiquated HR system is being turned off in stages around the country as the Postal Service implements a new system designed by SAP that will allow employees to conduct routine HR transactions at kiosks in the workplace or online from any location at any time.
The system introduction has begun in the New York City area, where it is being used to manage the process of advertising and filling open positions. Three more districts will be added by the end of September, with the national debut slated for January. The shared services center has been established in Greensboro, North Carolina.
PostalPeople, which kicked off in July 2004, is part of the Postal Service Transformation Plan, launched two years earlier with the goal of increasing efficiency. The Postal Service invested more than $103 million in PostalPeople. When completed, savings are expected to total $60 million annually.
The end result will be a self-service HR network that enables employees to do HR transactions electronically, from changing their address to registering for benefits. All of the information will be available in one system serving 37,000 Postal Service locations nationwide.
Supervisors will no longer have to log out of one area and into another to keep track of their employees, fill open positions and evaluate employees.
“It’s one system pulling information onto the screen,” says Deborah Giannoni-Jackson, Postal Service vice president of employee resource management. “It’s pretty incredible.”
The new approach will make the Postal Service more agile and free managers from time-consuming transactional work.
“The first part of being able to manage well is to have the data you need to make decisions,” says Giannoni-Jackson, former HR vice president for international supermarket operator Royal Ahold. “Now they can focus more on succession planning, training and development, or labor relations—issues that are much more strategic for the organization.”
That kind of thinking is becoming more important for the Postal Service, whose operating budget is derived from sales of postage, products and services. It’s a quasi-government agency that’s being run more and more like a private company.
With that in mind, it has worked closely with SAP, bringing the software company almost seamlessly into its operations.
“The Postal Service treats us not as a software vendor, but as a partner to them in building their business,” says Rand Blazer, president of the SAP public sector business unit.
Despite rumors that it was considering selling off its HRO division, Hewitt Associates says it’s staying in the business.
Rumors peaked after a number of executive departures. In June, CEO Dale Gifford announced he was retiring, while Bryan Doyle, president of the HRO business, and Michael Salvino, co-leader of HR outsourcing sales and accounts group, left the firm.
Then on August 3, Hewitt announced that it was delaying filing its third-quarter financial results to August 14 from August 9 “to allow for completion of the previously announced review of its human resources business process outsourcing contract portfolio.”
But on August 14, the company sent out a notice assuring analysts that it was staying in the HRO business.
“Our board of directors and our leadership remain firmly committed to our direction,” the company said in its statement.
The assurance came on the same day that the Lincolnshire, Illinois-based company posted its third-quarter earnings, which included a $249 million noncash charge related to the company’s HRO business. A $70 million loss provision based on the expectation that one-third of its 2005 contracts and two earlier contracts would lose money was part of the $249 million charge.
“It is clear with the benefit of 20/20 hindsight that we underestimated the complexity and therefore the cost of taking on multiple contracts,” Gifford said on the earnings call.
Gifford and CFO John Park attributed Hewitt’s troubles largely to taking on too much too quickly. Specifically, they cited payroll and recruiting as two areas where Hewitt was facing significant challenges.
All of the major HRO providers are struggling with offering recruiting services because they require an in-depth knowledge of the buyer’s needs, says Mark Azzarello, director of HR operations at International Paper in Memphis, Tennessee, which is in the fifth year of a 10-year HRO contract with Hewitt.
Hewitt’s assurances that it is staying in the business came as a relief to him. Gifford and Jim Konieczny, the head of Hewitt’s HR business process outsourcing division, had met with Azzarello in June and delivered similar assurances then, he says.
“They made it clear that [the rumors] were unfounded … and that they have every desire to stay in the business,” Azzarello says.
But things may change in the next few months. On September 5, Russ Fradin, former president and CEO of the Bisys Group, starts as Hewitt’s new CEO, and analysts expect that he will do his own due diligence of the business.
“I for one don’t see how they avoid at least considering a breakup or sale as a whole,” HRO consultant Naomi Bloom says. “They lost a lot of talent when they failed to elevate the very capable people they acquired with Exult.”
Edward Kelley
CEO, Edward W Kelley & Partners
Edward Kelley has held a variety of high-profile positions during his 30 years in consulting and the executive search industry, including president and board member of Korn/Ferry International’s European operations. Earlier this year, Kelley spearheaded the management buyback of A.T. Kearney Executive Recruitment from Texas-based Electronic Data Systems, from which emerged a new company: Edward W Kelley & Partners. As CEO, Kelley has traveled the globe, opening offices in Boston; Calgary, Alberta; Sydney and Melbourne, Australia; Moscow; and Vienna, Austria, to help clients meet staffing needs. Kelley recently spoke to Workforce Management staff writer Gina Ruiz.
Workforce Management: Where is the demand for executive recruitment most pronounced?
Edward Kelley: The global economy is growing at a healthy pace. This bodes well for business in general. But the markets where the demand is outstripping the talent by far is in the emerging world—China, India, Russia and Eastern Europe.
WM: Have the executive recruitment needs of employers changed over the years?
Kelley: The needs of clients are not changing tremendously. But the time given to a candidate to prove himself has shortened dramatically. Before, the time frame was a matter of a year or two. But now it can be a question of quarters or even months. This raises the stakes when it comes to selecting the most suitable candidate.
WM: Do the needs of clients vary from region to region?
Kelley: They vary drastically. Take China, for example. That country has a tremendous need for indigenous middle- and top-level people. In markets where economic growth is moderate, like North America, employers generally look for executives that have something unique to contribute to the company. They are looking for somebody who can make a strategic difference.
WM: Are there any new technology tools that allow recruiters to meet the needs of employers more effectively?
Kelley: There are all kinds of tools one can use. Certainly the ability to identify candidates within companies is much greater than it was before. The use of research, extensive databases, outside research centers like the ones in India or other parts of the world have made it a lot easier to get information on individuals than it was 10 years ago. There are also a whole series of personality tests.
WM: Will recruitment activity be affected by unfolding events in today’s global political/economic climate?
Kelley: It depends on the type of challenge that is out there. The situations in Lebanon, Iraq, the price of oil and interest rates may eventually force companies to look differently at where they make their investments and carry out staffing efforts. Some parts of recruitment are more insulated than others. For example, if you are working in the field of higher education, you are less susceptible. There is always a need for deans of schools and presidents of universities. That doesn’t change. But demand for heads of companies, marketing directors, finance directors in major Fortune 500 companies—yeah, that changes.
Workforce Management, August 28, 2006, p. 9 — Subscribe Now!
Employees in the United States may value vacations in theory—planning for them, negotiating for extra days when they’re hired—but in actual practice do the unthinkable: They forfeit paid time off.
Workers here already earn shorter vacations compared with those in other Western countries—14 days annually versus 24 in Great Britain, 27 in Germany and 39 in France. Now comes this surprising finding: On average last year, U.S. workers gave back three days, compared with one or two days in other Western countries. This year, entitled to two additional days, they’re expected to leave four unused, according to a survey conducted by Harris Interactive and Ipsos Reid for Expedia, the online travel agency.
The survey noted that workers in Western states spend the most time on the job: 41 percent don’t take all their vacation, compared with 33 percent nationally. Those workers give up an average of seven days. Overall, 574 million days of unused vacation will total an estimated $75.7 billion in wages this year. Expedia calls the trend toward “overworked, vacation-deprived” workers unsustainable.
Shortened vacations diminish revenue because overwrought employees lose productivity, says Gregg Lemley, a labor and employment attorney. “Vacation is a two-way street. It’s a benefit to employees to recharge their batteries. But it’s also a benefit to employers. They want employees well rested, ready to do their jobs mentally and physically.”
Lemley, who’s in the St. Louis office of international law firm Bryan Cave, doesn’t believe employers fuel the trend. “What we have is a generation of people who believe that work is paramount to the point it’s not healthy.”
Simple fear may also play a role. “American workers are overloaded and afraid that if they don’t give back some vacation, they might lose their jobs or promotions,” says D. Quinn Mills, professor of business administration at Harvard Business School and author of Having It All … And Making It Work: Six Steps for Putting Both Your Career and Your Family First.
Among the reasons workers relinquish vacation days are the need to schedule them in advance (14 percent), workload (11 percent) and the prospect of being paid for unused days (10 percent), though expectations of a payout may be misguided. States often regulate vacation policies, and while some have use-it-or-lose-it laws, most do not, Lemley says.
Occasionally, even in states that allow it, companies without well-drafted vacation policies can wind up paying almost a year’s salary upon an employee’s termination or retirement, Lemley says. Well-drafted policies are those that clearly state vacations must be taken in the year they’re accrued.
The survey didn’t ask respondents where they worked, but Lemley sees a growing number of industries, especially in emerging fields like technology, advocating vacations. “The reality of the situation is that you’re ultimately going to get more production and better work,” he says.
One challenge remains, however: Employees need to actually relax on vacation. Twenty-three percent check business voice mail or e-mail during that time, and 65 percent say they experience work-related stress—even though they’re off the clock.
The latest effort to make more information about pharmacy benefit managers available to employers began July 25 when a committee of industry participants and observers began work on a set of standards that PBMs must meet in order to receive an industrywide seal of approval.
The meeting came a day after 10 PBMs—including two of the largest, Medco Health Solutions and Caremark Rx—agreed to pass on their rebates and follow a set of standards detailed by a 56-employer purchasing coalition created by the HR Policy Association. Members of the group include Caterpillar and IBM.
During the past five years, however, PBMs have come under attack for not acting in the best interests of their clients, particularly for not disclosing sweetheart deals with pharmaceutical companies and not passing savings from rebates on to their clients.
Despite fierce resistance from PBMs, insurance companies and chambers of commerce, laws governing the industry have been passed in several states and proposed in 24 others, much to the delight of doctors, drugstore chains and pharmacists.
Supporters say both the certification and accreditation will allow the marketplace to police itself.
“Mandates simply drive up the cost of doing business with PBMs for everyone,” says Marianne Fazen, who is part of the National Business Coalition on Health and a board member of URAC, the organization that will manage the accreditation program.
Some provisions in state laws could find their way into the accreditation process, says Debra Friedman, senior vice president at URAC. One of the more comprehensive laws passed in 2003 in Maine addresses the issue of transparency by requiring all PBMs to pass discounts on to customers.
That provision would not likely become an accreditation standard because “it would be too prescriptive,” Friedman says, though it is a part of the 56-employer coalition standards for certification.
Fazen says receiving rebates is “not the issue.” She would like to see standards that detail how PBM services are calculated. “The issue is, where is the money coming from and where is it going?” she says.
At the core of the Maine law is a provision requiring PBMs to act in the best economic interest of their customers, says one of its architects, Sharon Treat, a former Maine state legislator who is now executive director of the National Legislative Association on Prescription Drug Prices, a nonpartisan group working to reduce prescription drug prices.
Employers would like to see the concept of the fiduciary duty of PBMs adopted as part of an accreditation requirement, Fazen says.
PBMs, for their part, have a lukewarm attitude toward accreditation. Medco says it would support accreditation that “would highlight industry best practices,” but could not commit to participating in creating the standards. Once the standards are detailed this fall, the public will have a chance to comment.