October 8, 2024

Bucks Blog: Employers Use Carrots and Sticks to Promote Worker Health

Employers are using financial carrots and sticks to get workers to adopt healthy lifestyles, in an effort to improve well-being and lower health costs, a new report on employer health benefits finds.

Nearly two-thirds (63 percent) of firms offering health benefits offer at least one wellness program to employees, like nutrition classes or programs that help people lose weight or stop smoking, according to the 2012 Employer Health Benefits report from the Kaiser Family Foundation and the Health Research Educational Trust.

About a tenth offer some sort of financial incentive for participation, like smaller premium contributions, smaller deductibles, higher health-savings account contributions, gift cards, merchandise or even cash.

More than a third of large firms (those with more than 200 employees) reported asking employees to complete risk health assessments. Those assessments include questions about the worker’s medical history, health status and lifestyle. And of those firms, nearly two-thirds dangle financial incentives for them to do so, the study found.

Eleven percent of firms that use health assessments said that workers with identified risk factors must complete a wellness program or face financial penalties, like higher insurance premiums, and 9 percent reward or penalize employees based on whether they meet “biometric” measures, like certain cholesterol levels or a target body-mass index.

The findings were reported as part of an annual review of employer health benefits, which found that overall family health insurance premiums rose 4 percent in 2012, a relatively modest increase.

The report is based on a survey of more than 2,000 human resources professionals at randomly selected firms, and was conducted for the foundation and the Health Research Educational Trust in January through May of 2012.

What incentives or penalties does your employer offer promote healthy behavior? Do you think they’re effective?

Article source: http://bucks.blogs.nytimes.com/2012/09/12/employers-use-carrots-and-sticks-to-promote-worker-health/?partner=rss&emc=rss

China’s Low Roaming Fees Won’t Be Matched Soon

BERLIN — When Su Xiaoqin, a Chinese translator living in Düsseldorf, calls family and friends back in Shanghai, she does not use the mobile network of her German operator, O2. She pops in the SIM card for China Mobile.

As a result, Ms. Su’s calls home cost as little as 2.86 renminbi, or 44 cents, a minute, a small fraction of what a call using the German SIM card would run. That is because China Mobile, the world’s largest operator, with 617 million customers, recently cut its international roaming rates, following similar cuts by its domestic rivals, China Unicom and China Telecom.

“The word has gotten around that the Chinese operators now have the best rates to China,” Ms. Su said.

While Europeans and Americans traveling abroad still face steep roaming charges, travelers from mainland China can call home for as little as it costs to make a local call in that market.

In part, that reflects the growing global clout of the Chinese mobile phone industry, where the three big operators, with a combined 889 million customers, are able to negotiate less expensive roaming deals for their users with international operators.

As a result, one should not expect the lower roaming prices paid by travelers from the mainland to come soon to consumers in Europe, the United States or other parts of the world. In part, that is because European and U.S. operators do not compete directly with their counterparts in China for mobile customers, so they have little financial incentive to match the lower prices.

David Dyson, the chief executive of Three U.K., a British mobile phone operator owned by Hutchison Whampoa, the Hong Kong company, cited another reason. He said that high roaming prices in Europe, especially for downloading data, reflected the operators’ profit expectations, not the true costs of service.

Mr. Dyson said that smaller operators, especially, could not lower roaming rates because of what it costs them to connect calls using the networks of larger operators, whose rates are driven by those profit demands.

In 2007, the European Union stepped in to limit the price of mobile roaming charges in the 27-nation bloc, but those retail price caps — 35 euro cents, or 50 U.S. cents, a minute for making a call — are higher than those paid by consumers from mainland China. In the United States, the level of roaming charges is not regulated by the government but set by American and international operators through private agreements on the costs of using each other’s networks to connect calls.

For travelers from the United States, the roaming charges can still be startlingly high.

In May, Paul O’Brien, the general legal counsel of an international maker of industrial sealants based near Philadelphia, returned home after a business trip to Milan and Rome to a $2,300 roaming bill, which he had incurred in two days of normal calling and surfing.

Mr. O’Brien described his iPhone activity during his Italy trip as moderate — making and receiving calls to the United States through Telecom Italia, and downloading and reading e-mail.

Just two days into what was a four-day trip, his U.S. operator, which he declined to name, shut off his service, citing his company’s policy.

“I was blindsided,” Mr. O’Brien said, adding that he did not know what the limit was that he had exceeded.

Local operators — in Mr. O’Brien’s case, Telecom Italia — tend to reap the most profit from roaming charges, said Deep Basu, the vice president for product strategies and consumer products at Roamware, a software maker in San Jose, California, that helps operators manage roaming traffic. But the U.S. operator, which has more customers than Telecom Italia and thus more clout in negotiating deals on roaming rates, would have received a sizable slice as well.

Customers of China Unicom, the country’s No.2 operator after China Mobile, with 182 million mobile users, pay about 2.8 renminbi, or 44 cents, a minute to call China from most countries in Europe, and as little as 1.5 renminbi from the United States.

The operator makes its low rates possible by running a huge phone callback program, called **100 Program, which assigns local land line phone numbers to its mobile customers while they are abroad and then has a company computer in China call them back over less-expensive land lines to complete their long-distance calls.

China Unicom introduced the service in May, effectively cutting its roaming rates as much as 90 percent. Sophia Tso, a spokeswoman for China Unicom in Hong Kong, said the decision to reduce roaming prices drastically had been made to serve the company’s customers, who are among the 100 million Chinese citizens who travel abroad each year.

Article source: http://feeds.nytimes.com/click.phdo?i=49607679a384ff9dd60232c011325000

Economic View: Seriously, Some Consensus About Health Care

But beneath this veneer of partisanship lie a few fundamental agreements. Consider health care, which will be at the center of the political debate. Here are four aspects of the issue in which Republicans and Democrats have stumbled into consensus.

THE VALUE OF COMPETITION Representative Paul D. Ryan, Republican of Wisconsin, has attracted much attention with his plan to reform Medicare. He proposes replacing the current fee-for-service program, in which the government picks up the bill for medical expenses, with a “premium-support” system in which seniors use federal dollars to choose among competing private insurance plans.

Democratic critics of the plan suggest that enacting it would be akin to pushing Grandma over a cliff. But they rarely point out that the premium-support model is in some ways similar to the system set up under President Obama’s health care law. If choosing among competing private plans on a government-regulated exchange is a good idea for someone at age 50, why is it so horrific for someone who is 70?

Republicans, meanwhile, are eager to repeal Obamacare and so are also reluctant to point out its parallels with Ryancare. We can take heart, however, in the kernel of agreement about the value of private competition.

THE INSURANCE MANDATE Perhaps the most controversial piece of the Obama plan is the mandate for individuals to have health insurance. But think for a moment about what this really means. No one has proposed putting the uninsured in jail. Instead, those without insurance will be fined. A mandate is just a financial incentive to have insurance.

What is the Republican alternative for having more people insured? It is unclear what the Republicans would do if they ever succeeded in repealing the health care reform law. However, their last presidential nominee — Senator John McCain — proposed a tax credit for buying health insurance. That may seem more palatable than a mandate, because it uses a carrot rather than a stick.

But consider who would pay for that tax credit. The answer is all taxpayers. This tax burden would be particularly hard on the uninsured, who would face higher taxes without enjoying the credit’s benefit. In other words, giving a tax credit to those who buy insurance is a back-door way to impose fines on those who don’t.

TAXING THE RICH Democrats want to increase taxes on the rich to fund the looming fiscal gap, which is driven largely by soaring health costs. Republicans object, saying higher taxes create economic distortions, discourage work and impede growth. Last month, John A. Boehner, the House speaker, said that we should instead consider means-testing Medicare. But what does that mean?

Here is how means-testing might work. We could start by choosing some income threshold — say, $250,000 — and then require people over 65 with higher annual income to pay more in Medicare premiums than they do now. For example, for every $1,000 of income beyond the threshold, they might have to pay an extra $10 in annual premiums.

Sounds good, right? But notice that the economic effects of means-testing are much the same as a tax increase. This particular plan is like increasing the income tax rate by one percentage point for high-income seniors. It is only semantics as to whether the $10 is called a “tax” or a “premium.”

Indeed, means-testing could create more economic distortions than would broad-based tax increases. Seniors have more flexibility in how much they work than do typical Americans. In particular, for many people, the timing of retirement is discretionary. The higher marginal tax rates implicit in means-testing will induce people to leave the labor force earlier than they otherwise would. This would deprive the economy of some of its most experienced and productive workers.

BLINKERED OPTIMISM Democrats and Republicans generally have different approaches to controlling the growth of health care spending. Democrats often favor a top-down approach: a panel of experts set up by the recent health care law will decide which medical procedures are cost-effective and which are wasteful. Republicans tend to prefer a bottom-up approach: empower consumers to make their own choices, they say, and the power of competition among private providers will keep costs down.

One thing that the two parties share, however, is the belief that controlling health care costs is possible. Yet many economists believe that the rise in health spending is largely the result of medical advances, which prolong and enhance life at a high cost. Perhaps health spending will inevitably, and even should, keep rising as a share of national income.

This possibility raises a question: If health care becomes an increasing share of the economy, how will we allocate it, and how will we pay for it? That is, if controlling the cost of health care fails, what is Plan B?

That is a question that candidates from both political parties agree on as well: they all seem determined to avoid it.

N. Gregory Mankiw is a professor of economics at Harvard. He is advising Mitt Romney, the former governor of Massachusetts, in the campaign for the Republican presidential nomination.

Article source: http://feeds.nytimes.com/click.phdo?i=d8f76215d98183414c358e76a255518f