Everyone, including me, is always on employers to do more to improve the healthcare system in the U.S. We’re on them to use their healthcare purchasing power and insured-lives market share to incent health plans and providers to make care more effective, more accessible and more affordable for employees and, by extension, all patients.
Yet not much ever seems to change. That’s despite the smattering of employer health benefits surveys, reports and stories that would lead you to believe that creative, innovative and forward-thinking employers are showing us the way out of the darkness. If anything, care has gotten less effective, less accessible and less affordable even for those with employer-sponsored health insurance.
Last week, the Society for Human Resources Management released the results of its 2019 Employee Benefits Survey. For me, the annual release by SHRM is a reality check on all the gushing employer health benefits surveys, reports and stories that we’ve heard and read about over the past 12 months. This year’s SHRM report, based on a survey of 2,763 human resources professionals, confirms that most employers really aren’t really doing anything new or different with their health benefits to move the ball forward on quality, access or costs. If anything, they’re paring back.
Let’s look at a few key health benefits and see how they’ve (not) changed over five years. In 2019:
- 85 percent of the respondents said their companies offered a PPO option to workers compared with 85 percent in 2015.
- 33 percent of the respondents said their companies offered an HMO option to workers compared with 33 percent in 2015.
- 95 percent of the respondents said their companies offered prescription drug coverage in their medical benefits package compared with 96 percent in 2015.
- 97 percent of the respondents said their companies offered dental insurance compared with 96 percent in 2015.
- 79 percent of the respondents said their companies offered employee assistance programs compared with 79 percent in 2015.
If you’re a glass-is-half-full kind of a person, you might say that the fact that those numbers didn’t budge is a good thing because it means employers aren’t taking anything away from their employees. Ah, but they are, in many areas. For example, in 2019:
- 83 percent of the respondents said their companies offered mental health benefits, down from 91 percent in 2015.
- 78 percent of the respondents said their employees can get their prescription drugs mailed ordered to them, down from 87 percent in 2015.
- 58 percent of the respondents said their companies offered wellness programs with resources to employees, down from 70 percent in 2015.
- 26 percent of the respondents said their companies covered bariatric surgery, down from 33 percent in 2015.
- 24 percent of the respondents said their companies covered laser-based vision correction surgery, down from 30 percent in 2015.
- 24 percent of the respondents said their companies had prevention programs for employees with chronic medical conditions, down from 40 percent in 2015.
- 19 percent of the respondents said their companies covered in-vitro fertilization, down from 29 percent in 2015.
What health benefits are employers expanding for their workers? If you need a standing desk, you’re in luck. Sixty-percent of this year’s respondents said their companies covered the cost of standing desks for their employees. That’s up from just 25 percent in 2015. And if you need help standing at your standing desk, 78 percent said their companies provided free coffee this year, up from 76 percent in 2015.
What this all tells me is that many employers are making their workers pay more in premiums and pay more out of pocket for fewer or less generous health benefits. So, far from being powerful sources for good, many are indifferent to or adding to the problems of cost, quality and access in healthcare. Tell me otherwise.
As for pets versus babies, pets win big. Eleven percent of the respondents said that their companies let workers bring their pets to work this year. By comparison, just 3 percent said they let workers bring their babies under the age of one to work on a regular basis this year. The survey report didn’t specify the age or type of pet that could run under your standing desk and presumably not spill your coffee.A