Health as Human Capital - Illustrated Research SummariesThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader, such as GoogleReader, or to display this data on your own website or blog. Subscribe to this data using MyMedWorm.Subscribe to this data using GoogleReader.Subscribe to this data using Bloglines.Subscribe to this data using MyYahoo.

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Letting employees manage their own time off? Maybe it’s a win-win. Entry 23 – 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
At the Health as Human Capital Foundation, we often witness scenarios where employees, when given the choice and proper incentives, actually spend company time and money MORE wisely than they would under a strict set of rules or governing policies.This is just that sort of example.Most every company we work with has an extensive paid-time-off policy, detailing what days are allowed, for what purposes, and at what times during the year. There are extensive rules governing its use and tracking their frequency. But it’s worth asking: even when companies spend time and energy defining a thoughtful policy and system, is there...
Source: Health as Human Capital - Illustrated Research Summaries - November 8, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

When someone else pays, you simply care less (and spend more). Entry 22 -2009.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Do you honestly believe that individuals deserve the right and responsibility to make their own choices about health care? Before you answer, remember, the ultimate decision-maker is the one who spends the money. So, giving individual patients control also means putting them in charge of healthcare dollars.When it comes right down to it, most people say they support patient rights, but only in the context of someone else paying the bill. Here’s why those two issues cannot be separated:When discussing health savings accounts with employers, I often hear concern that connecting financial factors to health decisions will le...
Source: Health as Human Capital - Illustrated Research Summaries - October 25, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Part IV: Business Practices—A major, modifiable driver of healthcare costs. Entry 21 - 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the previous blog, we covered three out of the four drivers of healthcare costs: 1) Basic costs & bad luck;2) Demographics and labor market; and3) Health status. We learned that #1 and #2 account for a portion of healthcare costs that are non-modifiable, and that health status is a less influential driver than one might expect.We move to the final driver of healthcare costs, which is both modifiable and significant, but unfortunately too often overlooked: business practices. What do we mean? Business practices are the entire set of employee policies and practices captured in everyone’s workplace environment ...
Source: Health as Human Capital - Illustrated Research Summaries - October 10, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

How much does health drive healthcare costs anyway? Entry 20 - 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When medical and disability costs are high, conventional wisdom assumes there must be more illness driving up costs, right? But how much of total cost can we actually attribute to health status versus other things?Four Parts.There are actually four driving components of health and absence cost, the first three of which we’ll cover here, and the fourth in the next blog. To give away just a little of the secret in advance, it may surprise some readers to learn that health status is not as powerful a predictor of cost as one might expect.Believe it or not, our research on nearly 2 million employees and their families across...
Source: Health as Human Capital - Illustrated Research Summaries - September 26, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

What patients should be fighting for: Control of both dollars and decisions. Entry 19 -2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
If those who have the money are the ones with decision-making power, why not let patients have both? As government and insurers debate over who should grant permission to doctors about which treatments and care regimens are acceptable, why not award ultimate control to the person in the best position to decide—i.e., the person receiving the care?Consider this story:In a radio interview last month, I heard two doctors (specifically, both called “interventional cardiologists”) debating the merits of their preferred approach to unclogging heart arteries. One followed guidelines based on evidence that when patients are s...
Source: Health as Human Capital - Illustrated Research Summaries - September 12, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

The day an entire work force got sicker – or did they? Entry 18 – 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Imagine being a benefits manager for a large corporation boasting three straight years of flat medical and absence costs (1). Like many benefits managers, you might be proud and vocal about the many programs you’ve purchased to encourage health and disease management. We have all seen such flat trends attributed to health interventions provided by the employer. This example was no different.If health programs or active management of disease could be credited for a three-year flat trend, how does one explain what then happened to the same company in the following 15 months? Did everyone suddenly become ill in the fall of ...
Source: Health as Human Capital - Illustrated Research Summaries - August 29, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

The key health reform issue no one is talking about...Entry 17 -2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
.....we cannot afford (nor should we strive) to provide unlimited medical services to every person in our nation.Almost everyone agrees: healthcare reform is needed, and the call is loud and clear. Silently, decision makers have also agreed NOT to tackle the hard questions that must be answered before any of the debate can be settled.Ultimately, the healthcare crisis is a simple case of limited resources and unconstrained demand. We might wish healthcare reform could simply be about caring for our fellow citizens, or developing superior science, or implementing uniform efficiencies. But it’s not.We have limited time, mon...
Source: Health as Human Capital - Illustrated Research Summaries - August 15, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

The best prevention doesn’t come from doctors, it comes from your everyday life. Entry 16 - 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I know someone, Jane, who goes to the doctor all the time. She has every ache, bump, rash or other symptom seen by a physician, usually a specialist. Jane often starts a statement with “my (insert a specialist type like orthopedic surgeon) says….” She is vigilant about regular check-ups and timely screening tests, which in her mind means she is practicing prudent prevention.The media (and discussions of healthcare reform), often limit their discussions of prevention to activities like check-ups and screening tests. A recent White House stakeholder’s meeting included suggestions from physicians such as: "the best pr...
Source: Health as Human Capital - Illustrated Research Summaries - August 1, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

If We Ignore Incentives, We’re Going to Need Lots and Lots of Rules. Entry 15 – 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Rule: a prescribed guide for conduct or action; a regulation or bylaw governing procedure or controlling conduct (1). Recently I read a sick leave policy that was six pages long. It was very thorough, describing what constituted illness, how the illness would be verified, how long the person had to notify the company of an absence, and many, many more rules. Although the following words were not written on the document, it was clear: “We are worried employees will misuse this policy, so we are trying to imagine and close every loop hole we possibly can.”Coincidentally, this was the same day the news began reporting on ...
Source: Health as Human Capital - Illustrated Research Summaries - July 18, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Here’s an idea: take wages away from good workers for a benefit most won’t use. Entry 14 - 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Congress is considering a bill that would mandate all employers provide seven days of paid sick leave for employees to care for themselves or a family member (1). There is no provision for workers to cash-in unused sick leave or convert to vacation days if unneeded (2), so the only way to get value from this mandated benefit will be to have seven days of illness in one’s family each year. However, the bill does allow employers to require a doctor’s written excuse for illness absences that last three days or longer.Like all such mandates, the bill sponsors believe it will protect workers from unfair treatment; one shoul...
Source: Health as Human Capital - Illustrated Research Summaries - July 4, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

When you recover from the economic storm, will your top performers still be there? Entry 13 – 2009.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As companies look for ways to cut back in a tough economy, many are freezing salaries and limiting bonus eligibility. While this may seem prudent and logical, performance rewards are the last thing to limit if you intend to retain top performers.With the exception of sales positions, senior executives, hedge-fund managers, and the top dogs at AIG, top performers are already notoriously under-rewarded in U.S. businesses. Compared to base salaries, most companies allocate few resources toward rewards for individual performance. Because companies do a poor job of rewarding performance, those producing exceptional value for a ...
Source: Health as Human Capital - Illustrated Research Summaries - June 20, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

A “Culture of Health” – It’s more than a checklist. Entry 12 - 2009.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Every year, a new catch phrase becomes THE focus of corporate health. This year that phrase seems to be the “Culture of Health.” At almost every conference and corporate benefit presentation, a ‘culture of health’ is the gold standard all employers must strive to achieve. And why wouldn’t everyone want to?But by what measure?Disappointingly, more often than not, ‘culture of health’ is a term used to justify existing programs or sell new health-related activities. This thinking implies that how many health-focused activities a company sponsors, or how many health-conducive facilities they have determines wheth...
Source: Health as Human Capital - Illustrated Research Summaries - June 8, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Twenty years later…let me explain the ROI of better information. Entry 11-2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The first time I suggested to an employer that they put all their data in one common database was in 1989. I was a university professor focused on research then, and was advising managers in HR and benefits about healthcare costs. I drew a hub and spokes, showing how we could take a variety of data sources from around the company and put them all in one central place. This way everyone could better understand what was going on in the workforce.Their reaction could best be described as a blank stare. “Why would we do that?” they asked.Little did I know that over the next two decades, I would hear the same question, lite...
Source: Health as Human Capital - Illustrated Research Summaries - May 24, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

When a problem goes beyond illness, the solution must go beyond medicine. Entry 10 – 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Trivia Question: The following three questions are part of a screening that is more than 80% accurate at predicting what? (Clue—this is not about life satisfaction or stress.1) Would you describe your work as monotonous?2) How satisfied are you with your job?3) How tense or anxious have you been in the past week. .....Stay tuned for the answer below.Ask your mother--context is everything.We all know that circumstances affect our reactions to specific events. Depending on what “else” is happening at the time, we respond differently to the same challenge. On some days big obstacles are manageable, while on other days a...
Source: Health as Human Capital - Illustrated Research Summaries - May 10, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Ten misaligned financial policies that communicate the wrong message to employees. Entry 9 – 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pay is probably the most powerful communication tool an employer has.A book on compensation that I read recently explains very clearly how rewards (all pay, benefits and recognition) deliver the clearest message to employees about what is important to the company, and what the company wants from them. The authors remind readers that "few things get the attention of people in a company as well as pay does (1)." This got me thinking that companies “say” many things with money.Pay—depending on how it is designed—can put employers and employees on the same team, or make them adversaries. It can encourage the top perfor...
Source: Health as Human Capital - Illustrated Research Summaries - April 26, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Do we have it backwards? Should we invest in health to get productivity? Or reward productivity to get better health? Entry 8 - 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
An interesting study completed last year should make us all reconsider our typical assumptions about how to improve community health. In short, the study found that communities that experienced a significant influx of jobs and economic opportunity not only had expected improvements in their standard of living, but also increased their practice of healthy behaviors, had improved physical and mental health, less chronic illness, lower reported disability, and felt better.This unique, natural experiment compared tribal populations before and after they opened casinos, to similar tribes who did not have economic development fr...
Source: Health as Human Capital - Illustrated Research Summaries - April 12, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

How Health Savings Accounts save more than money. Entry 7 – 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Health Savings Accounts remain an underappreciated (and sometimes distrusted) tool. When we at the Health as Human Capital Foundation express our support for HSAs as critical to solving the healthcare cost problem, people often assume—incorrectly—that the primary intent is “cost sharing” or “cost shifting.” Make people pay, so they assume responsibility for the expense. Although paying directly for services does encourage people to spend money more carefully, that is NOT our primary reason for supporting HSAs. In fact, when a well-designed HSA approach is funded to cover the full deductible as we recommend, ind...
Source: Health as Human Capital - Illustrated Research Summaries - March 29, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Supporting the whole person, rather than just fixing his parts. Entry 6 - 2009.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In our research for both public and private employers, we find that the top 5% of healthcare consumers in any group cost more than the other 95% combined. They get an amazing amount of healthcare services; the top one percent average 20 different doctors, 20 unique medications (not refills), 60 tests, and 15 procedures in a single year. With this many different healthcare interactions taking place, is it even possible to be safe? Is it possible to keep track of what has occurred, let alone actually have care coordinated? In the current system, I am convinced the answer is ‘no.’For example, I have a relative who is bein...
Source: Health as Human Capital - Illustrated Research Summaries - March 15, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Real help isn’t GIVING TO people, it’s INVESTING IN their ideas and abilities. Entry 5 - 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Imagine a reality far worse than our economic recession. What if you were one of the world’s poorest, born to a poor family in a developing nation, uneducated, illiterate, and without opportunities to move up? If someone were to offer you help, what would you want it to be? Would you prefer handouts and strict rules, or would you want to earn your opportunity and make your own decisions? Would others give you that opportunity?Watching recent news on the nearly $800B stimulus package bail-out, I’ve heard countless and differing opinions about what really helps people. Is it more programs, less taxes, more jobs, higher e...
Source: Health as Human Capital - Illustrated Research Summaries - March 1, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

The most important economic principle I ever learned. Entry 4 – 2009.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Q: What do the following situations have in common?· Parents of a young teenager who discover 1600 text messages on their monthly cell phone bill,· Bank executives spending government bail-out money on bonuses or office remodeling,· Legislators adding their favorite pet project to an immensely important stimulus bill,· Homeowners who find that they can’t get the prepaid contractor to finish the last part of a remodeling project,· American customers at restaurants in New Zealand (where tips are frowned upon) find the service everywhere is very slow.A: They are all predictable situations based on who bears the cost an...
Source: Health as Human Capital - Illustrated Research Summaries - February 15, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

I don’t have to write a blog this week—I have a doctor’s excuse. Entry 3 – 2009.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Consider these real scenarios:1) In Belgium, the ministry of health reports that employees in some government departments average 35 days of sick leave per year. The government pays full salaries for unlimited sick leave, which now totals almost 1.3% of GDP. Officials report that most workers on leave have been given a diagnosis of depression and that nothing can be done because: “You can't contradict the opinion of a psychiatrist.” One expert estimates that only 5% are truly “cheating” but that at least 65% of those on government-paid leave could be working. However, they can’t be forced back to work because the...
Source: Health as Human Capital - Illustrated Research Summaries - February 1, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

In corporate turf wars and playground politics, teamwork makes all the difference. Entry 2 - 2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When I was a kid, there weren’t many organized sports leagues, so we mostly played neighborhood games. A few of us owned baseball gloves and old baseballs, but only the kid on the corner, Charlie, had a bat. Together, we would draw bases with chalk and play. On occasion, when Charlie didn’t make it to first base and we called him “out,” he would get mad and take his bat home, ending the game. Without him we could play catch… but not baseball.I’m not sure what business Charlie went into, but lately I have been wondering if he manages a department in a large organization.We continue to be amazed at compartmentali...
Source: Health as Human Capital - Illustrated Research Summaries - January 18, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Third-party Payers of Gourmet Food: It Sounds Good, But What About the Basics We All Need? Entry 1 - 2009.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
What if?Imagine we decided that access to food was a universal right for U.S. citizens. Instead of providing food stamps or some other currency for purchasing food anywhere, low-income citizens now eat all meals at restaurants that forward the bill to our national government.Because different foods, with different nutritional value, prepared by different chefs, with different methods, in different parts of the country have different costs, the government hires experts to determine the relative value of a given meal. A team of 30 experts assigns meal value, which considers a chef’s expertise in allergen-free cooking, lact...
Source: Health as Human Capital - Illustrated Research Summaries - January 4, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Third-party Payers of Gourmet Food: It Sounds Good, But What about the Basics We Need? Entry 1 - 2009.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
What if?Imagine we decided that access to food was a universal right for U.S. citizens. Instead of providing food stamps or some other currency for purchasing food anywhere, low-income citizens now eat all meals at restaurants that forward the bill to our national government.Because different foods, with different nutritional value, prepared by different chefs, with different methods, in different parts of the country have different costs, the government hires experts to determine the relative value of a given meal. A team of 30 experts assigns meal value, which considers a chef’s expertise in allergen-free cooking, lact...
Source: Health as Human Capital - Illustrated Research Summaries - January 4, 2009 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Partnership, not paternalism: Incentives for shared business success. Entry 26 – 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Who should decide what is best for an employee’s health?At a recent conference for medical and business professionals, I presented research showing that employees who were paid based on performance were more productive, and had lower benefits costs across a spectrum of job types and different employers. At the same time, we showed an increasing trend in some corporations and government agencies where paid-time-off (PTO) has accumulated to the point where large numbers of employees are facing the dilemma of use-it-or-lose-it. Our suggestion based on the health as human capital paradigm? Redistribute more compensation to p...
Source: Health as Human Capital - Illustrated Research Summaries - December 21, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Now that we have a recession, there's never been a better time for defining health as human capital. Entry 25 – 2008.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We’re all spending less and feeling poorer these days; individuals, families, businesses, and government agencies are all trying to squeeze more out of their budgets. In times like these we recognize more than ever that resources are finite, everything is a tradeoff. Spending more on some services means spending less on others. We fret about the effects of detrimental cutbacks, especially in healthcare.But economic pressures also create an environment where minds open themselves to new solutions. We invest more wisely, are willing to reconsider our present course, and perhaps are more willing to consider disruptive solut...
Source: Health as Human Capital - Illustrated Research Summaries - December 7, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Hidden Healthcare Pricing: MRIs tell the story, and consumers are the answer. Entry 24 -2008.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
How much does the cost of healthcare vary? It never ceases to surprise me.Recently, one of our clients asked us to analyze the cost of MRIs of the knee across six local facilities used by their employees in one metropolitan area. The amounts paid by our client’s two health insurance companies for such MRIs ranged from below $700 to above $2,400, which is more than a three-fold spread! More dramatic: the amount billed to their insurance companies (before discounts were applied) ranged from $1,100 to over $4,000.For those unfamiliar, an MRI (Magnetic Resonance Image) is a type of diagnostic picture taken by an expensive, h...
Source: Health as Human Capital - Illustrated Research Summaries - November 23, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Engaging employees and aligning incentives--- isn't one just part of the other? Entry 23, 2008.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sometimes I worry about the impact of new, top topics. Business headlines are full of reports about the importance of employee engagement (1). It is a significant focus of many national consulting firms—with tools, training, benchmarking and other services to help companies measure and improve engagement levels (2). It is no surprise employee engagement is a hot topic given recent studies. Highly engaged employees are a) more productive, b) absent less, c) less likely to leave, and d) less likely to have an accident or injury.Further, companies with highly engaged employees report better financial results, both revenues ...
Source: Health as Human Capital - Illustrated Research Summaries - November 9, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Dumbing down: Is this what we really want? Entry 22, 2008.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
My sympathies to fellow “swing-state” residents who are being bombarded by political ads. By the time this blog is posted, there will—mercifully—be only a week left to endure. For me, it is not just the message volume, abrasive tone, and truth-stretching that wears me down and sends me reaching for the mute button. It’s that we seem to allow and even encourage the polarization and over-simplification of important issues. In political debates, being thoughtful is a sign of weakness; changing course as facts and circumstances evolve is seen as indecision. Even though we know that almost nothing is completely right ...
Source: Health as Human Capital - Illustrated Research Summaries - October 26, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Why primary care doctors are a dying breed. Entry 21 - 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A True StoryMy coworker’s wife started getting sharp pains across the bridge of her nose and behind her eyes last year. It was uncomfortable and scary. She went to an ENT (ear nose and throat) specialist who suspected a sinus infection. After three rounds of different and progressively stronger antibiotics, a tumor was suspected. When the antibiotics did not solve the problem an inconclusive scope led to a CT scan. When the CT scan did not yield any results, she was directed to a neurologist to have a MRI done. These results did not shed any light either, and the headaches were getting worse, so an invasive procedure was...
Source: Health as Human Capital - Illustrated Research Summaries - October 12, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Don’t let anyone convince you that complex ROI analysis can replace common sense. Entry 20 – 2008.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
“I was surprised but relieved to get the analytical results from our consultant. Even though the participation rate was very disappointing, the ROI analysis showed we saved money.”I listened to a benefits director explain this. When I expressed some doubt, he pointedly asked “why would they lie?” Although I declined to answer such a touchy question, my mind went to incentives. Perhaps the same consultant recommended the program in the first place and needs to defend his reasoning? Perhaps the benefits director expressed a strong need to justify the money he spent? Perhaps the results weren’t untrue, but more of w...
Source: Health as Human Capital - Illustrated Research Summaries - September 28, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Wellness programs: Why other human capital investments need to come first. Entry 19 – 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
First, our beliefs:Prevention is powerful and important. Vaccinations and good hygiene protect us from much illness and disease. A person who exercises regularly, maintains a healthy weight, avoids tobacco, and stays mindful of safety (seatbelts, not drinking and driving, etc.) will likely be rewarded with extra years of active, healthy, independent living (1, 2, 3). We own our own health, and our everyday habits and simple preventive measures go a long way in determining our daily and long-term wellbeing.Here at the Foundation, we are not fatalistic, nor do we ignore overwhelming evidence supporting the power of healthy l...
Source: Health as Human Capital - Illustrated Research Summaries - September 14, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Ill-designed Consumer-Directed Health: A small step won’t get us over a big chasm. Entry 18 – 2008.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Since their arrival, we have watched as consumer-directed health plans (CDHPs) have been set up to fail. They have been overpriced, underfunded, highly-restricted, unfavorably positioned, tentatively introduced and fraught with administrative barriers. Then, surprise, we hear reports (1) that they seem unpopular. Here at the Health as Human Capital Foundation, we write often about the importance of consumers taking an active role in health decisions. Without consumers asking informed questions, understanding options, and—most importantly—holding the purse strings, there will not be an affordable, high-quality healthcar...
Source: Health as Human Capital - Illustrated Research Summaries - August 31, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Tethering unhappy workers with health insurance: perhaps it’s time to break those ties. Entry 17 - 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One of my neighbors is in her early sixties. She works part time for a large company, taking calls from customers making travel reservations. She admits that she a) doesn’t really like the work, b) doesn’t respect the company, and c) doesn’t really need the extra income. So why work? “Because I can get health insurance until Medicare kicks in.” She’s counting down: “Only nineteen more months to go!”From my interactions with her, I assume she performs her job politely and capably. However, I can’t help but think that her real feelings about her job and her employer come through in one way or another. Motiv...
Source: Health as Human Capital - Illustrated Research Summaries - August 17, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

How did high-priced, questionable technology become a good cause? Entry 16 - 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Not long ago, I attended a charity auction raising money for a small-town hospital. The event included a high-priced charity golf tournament, several social gatherings and an auction. The event was well-attended and quite fun; everyone was excited to rally around a “good cause.”I admit I didn’t really think about the specifics of the charity. I presumed it would provide services for people unable to pay for prenatal care or perhaps screening programs for the community at large. So, I bid happily on some smaller items in the silent auction and watched the fun as wealthy, wine-drinking bidders waged in friendly competi...
Source: Health as Human Capital - Illustrated Research Summaries - August 3, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

How labels get in the way of trusting ourselves - Entry 15, 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One day in 2000 I became overweight. No, the reading on my scale didn’t change, but the definition used by the World Health Organization did (1). Instead of being in the “normal” category (Body Mass Index up to 25.8), I slid just over the boundary (2). Or, more correctly, the boundary slid just below me. In the language of epidemiology, I instantly became “at risk” for several diseases and health events. I wasn’t any different--I already knew I should lose a few pounds--but the label said I was.Of course, it is natural in science (and life) to classify things as good or bad, problematic or not. Plus, defining c...
Source: Health as Human Capital - Illustrated Research Summaries - July 20, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Cars, Medicine and Businesses: A Crash Course in the Dangers of Specialization. Entry 14 - 2008.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As regular readers of this blog already know, here at HHCF we examine the interconnectedness among an array of workforce characteristics, corporate policies and practices, and outcomes. These factors all affect each other—absence policies affect health care costs, compensation policies affect prevention rates, management practices affect turnover, and so on. Whether we are talking about the “whole patient” or the “whole workforce,” it is literally impossible to optimize wellbeing one system at a time without considering its context within other systems.In medicine, almost everyone has heard of examples like the f...
Source: Health as Human Capital - Illustrated Research Summaries - July 6, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

The placebo effect, high prices, and someone else’s money. Spending the most and getting the best aren’t the same thing. Entry 13 – 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Whenever I hear people (especially those who do not work in healthcare industry) exclaim that "America has the best healthcare in the world," I wonder how they formed this opinion. Certainly we have many wonderful medical capabilities, but we also have tremendous challenges.The challenge most people are aware of is cost. But that problem either gets blamed on government—for not providing better access to insurance, or corporations—for being greedy. So, the next comment is often something like: “Medicine is so great, what a shame the costs are so out of control.”In casual conversation, I rarely question a person's g...
Source: Health as Human Capital - Illustrated Research Summaries - June 22, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Paying workers for time spent not working....a misaligned tradition. Entry 12 - 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I have a friend who holds a director-level position for a government agency. Recently, she reached her maximum limit for time off that can be rolled over; so in order to avoid losing days she “must” take two days per month, plus her usual vacation time. While admitting that she neither needs nor wants that many days away, and knowing her department runs better when she is there, she is hesitant to forfeit this portion of her total compensation. And with no option available to convert time off to money, foregoing time off is forfeiting pay. Is this the choice workers should be forced to make?Most organizations buy into ...
Source: Health as Human Capital - Illustrated Research Summaries - June 8, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Money Matters. What do skinny people in big houses have to do with flu shots and bonus pay? Entry 11 - 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion Paper no. 1287-04, 2004,2. Drewnowski, A., C. D. Rehm, and D. Solet. "Disparities in Obesity Rates: Analysis by ZIP Code Area." Soc Sci Med 65, no. 12 (2007): 2458-63.3. Flint, A. J., and T. E. Novotny. "Poverty Status and Cigarette Smoking Prevalence and Cessation in the United States, 1983-1993: the Independent Risk of Being Poor." Tob Control 6, no. 1 (1997): 14-8.Footnote*A technique called CHAID (Chi squared Automated Interaction Detector)not only examines what factors are significant, but which ones account for the greatest difference in likelihood. (Source: Health as Human Capital - Illustrated Research Summaries)
Source: Health as Human Capital - Illustrated Research Summaries - May 26, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

No, we haven’t given market solutions in healthcare a chance. Entry 10- 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this political season, we each have our positions. When it comes to choosing a candidate, or even a political party, for better or worse, all issues get combined into one big package (foreign policy+ science+ religion+ education+ healthcare+ sound bites+ everything). Voters align with a person or party who supports their most important issues, and accept (or tolerate) the rest.While we like to think of one party (ours!) as right and one as wrong, if we were honest, we would probably admit that the “other guy” can have some ideas worth considering. Too often we simply nod in passive agreement with our general package...
Source: Health as Human Capital - Illustrated Research Summaries - May 11, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

In the end, we all have costly choices to make. Entry 9 - 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
“America is the only country where people don’t believe that the death rate is one per-person.”A former colleague of mine used this line to get a laugh, and make a point (1). We do seem to characterize death as something we can avoid, delay and overcome, rather than as our inevitable, natural fate. Whether we say it or not, our society considers death an adversary against which we must never stop fighting. To stop fighting means death wins and we fail.Recently, several of us discussed the often difficult choices that accompany treatments for late-stage cancer. I mentioned that—if ever faced with that choice—I mig...
Source: Health as Human Capital - Illustrated Research Summaries - April 27, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

The cost problem: Why other high-tech products get more affordable over time and healthcare doesn’t. Entry 8 -2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Technologies advance. Products and services improve. When they do, consumer expectations also change to demand more for a better price. These days if our phones do not include thousands of wireless minutes AND a camera, a calendar, email, media players, an alarm clock, instant messaging, blue tooth connectivity, speaker phone, games, a calculator, maps of the entire globe, and an internet browser, we think it is an inferior product. Oh, and all those features come in a smaller size and a lower price than any of the phones or calculators or CD players we bought just five years ago. Like technologies, services also change in...
Source: Health as Human Capital - Illustrated Research Summaries - April 13, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

The cage, the cliff, and letting healthcare consumers “fly” safely on their own. Entry 7 – 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study demonstrates consumers’ ability to make sound personal decisions regarding health and necessary care. The result was more efficient use of healthcare, lower personal cost, and none of the often-feared dire consequences.Economic incentives are a powerful tool in helping consumers make value-based decisions. When someone else pays the bill, consumers have little incentive to distinguish among providers or to use the healthcare system efficiently.References1. Wharam, J. F., B. E. Landon, A. A. Galbraith, K. P. Kleinman, S. B. Soumerai, and D. Ross-Degnan. "Emergency Department Use and Subsequent Hospitalizations ...
Source: Health as Human Capital - Illustrated Research Summaries - March 30, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

When Did Anything Abnormal Become a Treatable Disease? Entry 6 – 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When I was a child, my family often told a funny story about my grandfather. In the 1920s he was screened by an eye doctor and found to have better than 20:10 vision. Instead of celebrating, the doctor prescribed glasses to “correct” his vision to a normal 20:20 level, which would be “easier on his eyes.” Apparently, it was believed that seeing too well might he harmful in the long run. As the story goes, he got the glasses, but chose not to wear them. We all laughed at how unsophisticated medicine was in the “old days” when doctors didn’t know better. Certainly, with all the technology and medical advancemen...
Source: Health as Human Capital - Illustrated Research Summaries - March 16, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

If we only consider one possible cause, we will be left with only one type of solution. Health status is not the only predictor of medical costs.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Here is a comparison of medical costs for two different companies. Company #2 workers are 84% more costly. Can you guess why? Does Company #2 have older workers? Do they have more chronic illness? Do they live in a geographic region with higher rates of obesity or smoking?No, no, and no.In fact, these two groups are as identical as we could make them in our modeling: same type of workers, same age, same gender, same job, same salary. So, why is there a difference in costs? (We give you the answer later.)Costs and HealthMore than once per week I discuss medical or disability costs with someone who works in health promotion ...
Source: Health as Human Capital - Illustrated Research Summaries - March 2, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

It’s not more medical tests we should be fighting for, but more information and choice. Entry 4 – 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
At least once a month, I hear about or receive a pass-along email regarding a medical test someone is “fighting for.” An advocacy group may be demanding a legislative mandate to have insurance cover their issue, or a patient fighting to have his insurance company approve payment for a specific procedure in a unique situation. Almost always, the story tells of a vulnerable individual in the clutches of a profit-hungry business, and uses strong emotional appeal to incite fear in readers who wouldn’t want such a thing to happen to them. But we rarely hear the other side of the argument. Adding more tests adds to the tot...
Source: Health as Human Capital - Illustrated Research Summaries - February 17, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Taking “Mother, May I?” Out of the Employment Contract. Giving employees more control over their decisions. Entry 3 – 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Can I get surgery? What about more time off? Can I have dental work? What about better life insurance? Can I?How often do we think that payment rules govern our permission to do what we want? “I can’t X, because my Y won’t pay for it.”For X, substitute “get a procedure,” “take time off,” “use a specific vendor,” or “buy a particular product.”For Y, substitute “my company”, “my health insurance,” “my employer,” or “my pharmacy plan.”More than we realize, employment and health insurance arrangements are just business agreements about payments. Too often, our society mistakes payment ru...
Source: Health as Human Capital - Illustrated Research Summaries - February 3, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Aligning Incentives: What do bonuses have to do with reducing absence? More than you might think. Entry 2 - 2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Five years ago, if a benefits manager told me he had a low rate of short-term disability at his company, I would have responded: “Great! What sorts of health improvement programs do you have?”Today, that’s definitely not the question I would ask. What have I learned in the last few years?Regular readers of this blog know we are great believers in the power of incentives. Other things being equal, a person will choose options that produce the greatest personal benefit.Often, when we mention “incentives,” readers from human resources and health industries think we are referring to specific rewards for specific beha...
Source: Health as Human Capital - Illustrated Research Summaries - January 20, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs

Motorcycle-riding, sky-diving, and cigarettes. Should your employer be minding his own business, or yours? Entry 1 -2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I met someone last week who was quitting his job after 15 years. The company he worked for was acquired by another firm that had very different rules of conduct for its employees. The new company instituted very detailed guidelines about attire (all shoes must have laces), workspace (no food or drink at the desk), and behavior (no leaning on the side of desks—yes, an actual rule). Further, their health insurance policy had exclusions for items that the executives considered unwise: no coverage for treatments resulting from motorcycle accidents, sky-diving, or sexually-transmitted diseases.Can companies do that? Certainly...
Source: Health as Human Capital - Illustrated Research Summaries - January 6, 2008 Category: Health Management Authors: Wendy Lynch, Ph.D. Source Type: blogs