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Frustration with the nation’s health care system has caused a majority of Americans to support a more assertive government role in lowering costs, according to a poll released Friday, December 8, by the Kaiser Family Foundation and the Harvard School of Public Health.

Americans want Congress and 2008 presidential candidates to make health care a priority, the poll states. The survey of 1,867 adults was conducted November 9-19.

Among the most striking findings are that 85 percent want the federal government to do more to expand insurance coverage and 64 percent believe that the president and Congress can “do a lot” to address costs.

“There is more interest in an activist government in slowing health care costs than there has been in a decade,” says Robert Blendon, professor of health policy at Harvard. People “are looking for a government counterbalance to what they see as strong private-sector forces for increasing prices.”

Iraq and the economy. Among independents, health care tied for second (16 percent), behind Iraq (41 percent), as the issue they want the president and Congress to address next year.

It was third (18 percent) for Democrats, with Iraq coming in at 57 percent and the economy at 20 percent. For Republicans, it was fifth (9 percent), ranking behind Iraq (44 percent), immigration, terrorism and the economy.

During the next year, Democrats want Congress and the president to work on expanding coverage for the uninsured (45 percent), while Republicans (38 percent) and independents (30 percent) focus on reducing costs.

Strong majorities favor allowing the government to negotiate with drug companies to lower prices for Medicare prescriptions and back the importation of prescription drugs from Canada.

Poll respondents also strongly support (48 percent) extending insurance coverage to children first if it cannot be provided to everyone who is uninsured. But 57 percent want to see health care proposals from 2008 presidential candidates that focus on expanding coverage, even if it requires a substantial increase in federal spending.

The results don’t necessarily mean Americans favor government-run health care, according to Drew Altman, president and CEO of the Kaiser Family Foundation.

In fact, Democrats (39 percent), Republicans (29 percent) and independents (37 percent) turn to employers as the best means for covering more uninsured Americans. They support requiring companies to offer insurance to all full-time workers.

Employers already are the source of coverage for the majority of those who are insured—and people appreciate their efforts.

“There’s quite a bit of empathy toward employers for covering health care,” says Mollyann Brodie, Kaiser vice president and director of public opinion and media research. “They’re still very thankful that employers are helping them.”

Employees see companies as an equalizer in the health care market. “People like the idea of someone bigger running interference for them,” Altman says.

For a while, at least, companies may be the only source of help. Congress may be cautious on health care policy over the next several months, given that many of the newly elected Democrats came to Washington after campaigns that revolved around Iraq and congressional corruption.

Members of Congress “are going to have to try some proposals out and see how they play,” Blendon says.

—Mark Schoeff Jr.

Workforce management software company Vurv Technology reported Thursday, December 7, that its revenue increased 63 percent in the third quarter. The company attributed the gain to growing demand among large employers for its management software.

The privately held company, which said it has posted revenue gains for 36 straight quarters but would not disclose its numbers, won the business of several large accounts during the most recent quarter, including Amtrak and high-tech firms VeriFone and DoubleClick. Vurv is among the fastest-growing technology companies, ranking 197 on Inc.United States.

The quarterly report came less than a month after workforce management software company Taleo announced a number of new customers in its third-quarter results, which it made public during its quarterly filings November 13. The publicly traded company’s newest clients include the Gallup Organization and MySQL. That new business helped Taleo increase its quarterly revenue to $24.9 million, up 25 percent compared with a year earlier. The increased revenue helped the company narrow its third-quarter net loss to $800,000 in 2006 from $1.6 million in 2005.

—Jeremy Smerd

The much-ballyhooed high-deductible health plans haven’t caught on yet in the American workforce in part because many benefits of those plans have yet to materialize, a new report asserts.

Despite the initial excitement when the plans were introduced in 2004, enrollment has stayed flat, according to a report released Thursday, December 7, by the Employee Benefits Research Institute and the Commonwealth Fund, both of which conduct health care research.

In its second annual look at so-called consumer-driven health plans, EBRI surveyed more than 3,000 adults who were privately insured and found that 1 percent were enrolled in high-deductible health plans with health savings accounts. Using their data, the institute concluded that about 1.3 million people were enrolled in high-deductible plans with health savings accounts, the same number as in 2005.

High-deductible health plans feature deductibles of about $1,500 for individuals paired with a tax-free health savings account, and were introduced fully in 2004. The plans have received a fair amount of media attention and have been embraced by a number of large employers, including Wendy’s, Textron and American Express.

The percentage of employees with a deductible of more than $1,000 but whose employer did not offer a health savings account actually dropped to 7 percent from 9 percent in 2005.

But advocates of consumer driven health care say the report’s numbers are flawed because the sampling is small. Greg Scandlen, a consumer advocate, points to numbers published by the industry newsletter Consumer Driven Market Report, which counted the number of high-deductible enrollees—as reported by health plans—to be 13.4 million, about twice as many as 2005.

Barbara Gniewek, a consultant with Deloitte’s human capital practice, says the numbers do not represent the growth of high-deductible plans among large employers. In an upcoming survey, Deloitte says 30 percent of employers offer a high-deductible plan with a health savings account. By 2008, that number will be 46 percent. Gniewek says employers will begin to consolidate their plan offerings, reducing the number of HMO plans and resulting in more employees migrating to consumer directed plans.

“I think that consumerism is a critical component of bringing health care costs down,” Gniewek says.

High-deductible plans have been championed as a way to make health care consumers more sensitive to price. Employers buckling under the burden of high health care costs have looked at these plans as a way to change the purchasing behavior of employees.

In response to critics who have said high deductibles would keep sick people from getting necessary treatment, the legislation that created health savings accounts allowed health plans to cover preventive treatment. The EBRI study, however, suggests that many of the criticisms may be valid.

Half of the individuals enrolled in high-deductible health plans did not have their preventive care covered. And those enrolled in the high-deductible plans were more likely to delay or avoid necessary care than were those in low-deductible plans, the study notes.

Though the plans make individuals sensitive to price, those surveyed said their health plans did not provide adequate information on the cost and quality of doctors and hospitals.

Health insurance companies were quick to respond to the report. How a plan is designed will determine its use by enrollees, says Karen Atwood, a senior vice president for Blue Cross and Blue Shield of Illinois.

Scandlen says a third of the care people receive is wasteful, and therefore sees a drop in treatment as a sign that consumers are making decisions not to seek help they don’t wish to pay for. He agreed that information on cost and quality lagged.

“Patient support information services is a real problem,” Scandlen says. “We’re hearing that a lot in the market.

“That is where a lot of innovation and energy is happening right now. Information technology systems are growing as fast as the Internet did 10 years ago.”

Cost was another issue, especially the high deductible. Federal law determines that a high deductible must be at least $1,000 for an individual or $2,000 for a family to qualify for a health savings account. The survey reports that many people have much higher deductibles. Less than half of individuals had a deductible under $2,000; 42 percent had deductibles of between $2,000 and $5,000. For family plans, 29 percent had a deductible of $5,000 or more.

James Bentley, a senior vice president with the American Hospital Association, says high deductibles are causing people to go into debt, either because they don’t have a health savings account or they don’t have enough money in the account at the moment when they need medical services.

“Many of the people lacking a savings account to accompany it people are not prepared to pay the deductible to whomever they owe it in a timely way, leading to bad debt,” he says.

As a result of the high costs and other issues presented in the report, the survey’s authors write: “As in 2005, individuals in CDHPs and HDHPs continue to be less satisfied than individuals with comprehensive health insurance with various aspects of their health plan, are less satisfied overall with their health plan, and are less likely to recommend the plan to a friend or work colleague.”

—Jeremy Smerd

A new report about how typical Americans think about the economy has lessons for liberals, conservatives and corporations.

The report, released Tuesday, December 5, by the Economic Policy Institute research group, says everyday Americans are at once more hopeful yet more concerned about the economy than many pundits portray them. It also finds evidence that corporations or corporate executives often are blamed for difficult economic circumstances.

During a conference call Tuesday, Stan Greenberg, a pollster and contributor to the study, suggested employers view the research as motivation to get on employees’ good side.

“Being part of the solution, rather than a part of the problem, is the message,” Greenberg said.

Greenberg did not elaborate on how companies can do that. But there’s evidence firms are increasingly eager to win over employees. The number of companies that apply each year for Fortune magazine’s list of the 100 best American employers has climbed from about 300 in 2001 to more than 450 this year.

During the past several years, conflicting information has emerged about the state of the U.S. economy and its impact on American workers.

The economy has been growing, jobs have been created, and the official unemployment rate has fallen. But gains have been skewed to those at the top, while typical workers have treaded water financially. A recent U.S. Census Bureau study found that real median household income in the United States rose by 1.1 percent from 2004 to 2005, reaching $46,326. But real median earnings of both men and women who worked full time and year round declined.

Meanwhile, workers face the possibility of their jobs being offshored, and are witnessing the erosion of health and retirement benefits.

Typical Americans tend not to see themselves as victims, but they aren’t happy with the direction the economy is taking, according to the new report, titled “Talking Past Each Other: What Everyday Americans Really Think (and Elites Don’t Get) About the Economy.”

In one poll cited by the report, respondents by a 2-to-1 margin chose to describe the economy overall as characterized by increasing uncertainty and inequality rather than as one in which “the American dream is very much alive.” But of the group that said increasing uncertainty distinguished the economy, 63 percent still thought they would achieve the American dream.

“Americans don’t just think one single thing about the economy,” EPI president Lawrence Mishel said during the conference call. “They think several things.”

EPI is considered a liberal-leaning think tank. Its new report adds to a national debate about increasing economic insecurity in the United States. There has been concern that business leaders have not played a forceful role in discussions about how to reshape the social contract around work in an era of greater globalization.

On Tuesday, another report indicated international trade could have a destabilizing effect on many American employers and workers. From 1997 to 2005, more than 100 major U.S.-based manufacturing industries lost significant chunks of their home U.S. market to imports, according to the study.

The report published by the U.S. Business and Industry Council, a group that lobbies on behalf of family-owned and closely held American firms. The council favors a new approach to international trade agreements, including a temporary across-the-board tariff on imports, with the exception of a few essential products such as oil.

Alan Tonelson, a co-author of the council’s report, says insensitivity to Americans’ job losses, stagnating wages and declining benefits can be found even among liberals.

“There is a very substantial portion of the Democratic Party and of American liberals who are just as clueless as to the real plight of the American working class,” Tonelson says.

A new company focused on workforce productivity emerged late last month, one rooted in a veteran HR research organization.

On November 28, the Institute for Corporate Productivity announced its arrival, saying it had agreed to buy the assets of the Human Resource Institute. HRI is a not-for-profit organization dating to 1965, with offices in St. Petersburg, Florida, and more than 100 corporate clients.

The new for-profit institute was founded by HR industry veterans Kevin Oakes, Debbie McGrath and Jay Jamrog. Oakes, former president of learning management vendor SumTotal Systems and current chairman of the American Society for Training & Development, a professional group, is the new institute’s CEO. McGrath, founder of the Web site HR.com, is the institute’s chair. Jamrog, the current executive director of HRI, will serve as the new firm’s senior vice president of research.

The company has four primary offerings: research, community, tools and technology. In its materials, it reduces its formal name to the slangy acronym I4CP, and even Oakes acknowledges that the nickname conjures up memories of “Star Wars” robot C-3PO. But the company’s goal is a serious one: better productivity.

There is a lot of talk in the industry about managing human capital and human resources, or managing talent, Oakes said in a statement.

“These terms are really only a means to an end—the end being improved productivity. That’s why we chose the name the Institute for Corporate Productivity, to signify clearly what we feel is most important to senior leaders.”

Jim Walker, a human resources consultant in La Jolla, California, said the new firm has a sound foundation in HRI.

“I’ve always thought very highly of the HR Institute,” he says. “I’m sure this is building something better.”

Walker, who has spoken at an HRI conference, speculated that the new institute may explore alternatives to in-person conferences, such as webcasts. A challenge to the new organization and existing ones is HR leaders’ reticence to travel, he says.

“It’s getting increasingly hard to get people away from their offices to get to meetings,” he says.

The new organization will emphasize connecting people through the Internet, Jamrog says. In addition to event webcasts, the new institute plans to establish blogs and “wikis,” or sites where community members can contribute ideas on different topics.

Traditional conferences will still be part of the mix. The institute plans to formally launch its new products and services at a February conference in Florida featuring speakers like Coleman Peterson, a consultant who once was head of HR at Wal-Mart.

Oakes sees research groups like the Corporate Executive Board and the Conference Board as rivals to the new institute. He says I4CP will stand out by offering practical tools for taking action on research results, such as a calculator for determining the financial impact of a low retention rate and online guides to improve retention and monitor progress toward that goal.

The new firm plans to charge corporate customers annual subscription fees. Oakes declined to provide a range for the fees, saying prices will vary based on the products and services selected. “We feel quite comfortable that our pricing is very reasonable when compared to other competitors,” he says.

For-profit status, Oakes says, will allow the institute to raise venture money and fuel the group’s expansion. In the short run, I4CP will rely on HR.com for help with operations, such as marketing and finances. The new company’s headquarters will be in Seattle, where Oakes lives. The research arm will remain in Florida. Oakes says he can’t provide a figure for the price of HRI’s assets because he does not have a final assessment of the purchase.

HRI has 22 full-time staffers involved in research. It produces about 2,500 pages of original research per year and provides clients with access to another 7,500 pages of external research it collects and validates, Jamrog and Oakes say. HRI has relied on selling annual subscriptions for its research services to major companies, including 3M, American Express and Johnson & Johnson. Traditionally, HRI has not sought money from HR industry vendors. The new organization plans to seek vendor sponsorship for areas of research, but intends to retain its objective stance, Jamrog says.

The shift, he says, relates to the way corporate HR department budgets have shrunk in recent years. Companies are more value-conscious, Jamrog says, and want practical guidance in addition to pure research.

“They need more than just what I used to do,” he says.

The recent news that 38,000 Ford Motor Co. employees agreed to take the company’s buyout offers might have been welcome news for the Dearborn, Michigan-based automobile manufacturer.

It wasn’t for the United Auto Workers, which has already seen its membership fall to 598,000 from 1.5 million 20 years ago.

Industry experts say the union may need to take some type of drastic action if it wants to continue to wield the clout that it once had.

“I woudn’t be surprised if the UAW decided to merge with another industrial union,” says Jim Hendricks, a founding partner in the Chicago office of law firm Fisher & Phillips. “The buyouts at General Motors and Ford severely reduce the number of active members paying dues at the union, and this in turn affects the union’s ability to organize.”

For employers in manufacturing, a UAW merger could result in a jump in organizing activity.

“We might be heading in the direction of having one big industrial union,” says Mark Neuberger, a partner in the Miami office of Buchanan Ingersoll. “This could result in more political clout for labor, especially if the Democrats retain control [of Congress] in 2008.”

Labor attorneys say that logical mergers for the UAW would be either with the United Steelworkers of America or the International Association of Machinists and Aerospace Workers.

Both the UAW and the machinists union have been trying to organize retail auto dealerships, so a merger among them might make sense, Hendricks says.

But the UAW has tried to merge with these unions before. Ten years ago, a merger between the autoworkers, steelworkers and machinists fell through because the three groups couldn’t see past their differences, says Gary Chaison, a professor of industrial relations at Clark University in Worcester, Massachusetts.

“There were too many differences in the way they selected officers and were organized,” he says.

But trying again might be the easiest option for growth the UAW has, Neuberger says. The only alternative it has would be to try to establish alliances internationally, particularly in China, where the auto industry is taking off.

“It would be easier for them to try a merger than set up a union in China,” he says.

—Jessica Marquez