From the fiscal to the physical: insured workers try to lower their medical costs

This is open enrollment season for those workers fortunate enough to (1) still be employed and (2) still be offered a health benefit.

It’s also the season of economic decline. These workers are making different health and benefit decisions in this fiscally-constrained era, according to Watson Wyatt’s 2008  report, Employee Perspective on Health Care. Some of the most dramatic health behavior changes this year include:

  • Only 19% of employees are willing to pay higher premiums to keep deductibles and copayments lower. In 2007, 38% were willing to do so.
  • 66% of employees are trying to take better control of their health, an increase from 62%.

These survey results are based on a poll taken in May and June, 2008.
According to Watson Wyatt, employers are trying to nudge employees
toward disease prevention as a cost-saving strategy.

But as a result of short-term economic preservation, employees may be undertaking anti-health behaviors that could increase their costs in the longer term, Watson Wyatt warns. The firm said that 17% of employees avoided a recommended doctor’s visit in 2008 to save money. 40% of insured workers said they go to the doctor only for what they see as serious conditions.

17% did not comply with a prescription drug instruction, such as filling the Rx or skipping a dose of medicine. Last year, 13% did so.

Jane’s Hot Points: Suze Orman (one of my personal heroes who motivates me to save $), would be unhappy with another impact of higher health costs in the workplace that Watson Wyatt uncovered: 13% of workers are decreasing contributions to their retirement plans. 20% of workers say that health costs are reducing their ability to save for retirement. Furthermore, health costs have other negative impacts on workers: 11% say they’re depleting personal savings, and 10% need to borrow money.

The Edelman Health Engagement Barometer (which I covered in-depth here) found that 8 in 10 "health info-entials" (those people most engaged with their health), citizens value financial health as a component of their overall wellbeing just after physical health, mental health, and physical appearance.

Watson Wyatt’s data were gathered in the middle of 2008 — several months before the major implosion of the stock market, workers’ 401(k) plans, the near-bankruptcy of GM, and the loss of nearly one million jobs in the U.S. economy.

My forecasting competence doesn’t have to stretch very far to infer from this Watson Wyatt report that employees will be making some short-term financial decisions driven by health cost burdens that will worsen both their long-term physical — and fiscal — health.

Jane Sarasohn-Kahn is a health economist and management consultant who
has worked with health care stakeholders for over twenty years. She blogs at Health Populi, where this post first appeared.

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  1. What you say above Jane doesn’t bode well for the economic future of this country. Citizens need health cost/coverage relief in addition to other mortgage/credit/debt relief. So far this administration has only tried to make more debt available by bailing out credit markets. I don’t know who the new administration will get money from to balance who pays with who profits from healthcare. My feeling is we will pay first, as is happening in Massachusetts, before we get close to the relief part. Decreasing contributions to retirement plans, reducing retirement savings, depleteing personal savings, and more borrowing will only give us never ending economic crisis. We are eating our seed corn. Now we see why a fiscal 1/4 to 1/4 mindset has done nothing to give us sustainable economic stability.