October 2005

Saving on healthcare
In the wake of a radio news report yesterday that a secret memo was found circulating in WalMart executive circles that said managers were to make sure every WalMart job involved physical labor of some kind so that no unhealthy people would apply for work--and thus save the company money on health insurance costs--this just in: an extensive report in the Harvard Mental Health Newsletter that indicates mental illness is a lot more common than most of us imagined.

The study's findings are remarkable in that almost half the 9,000 adults surveyed had had at least one psychiatric disorder (as defined by the American Psychiatric Association's diagnostic manual) in their lives. Common individual disorders included major depression (17%), alcohol abuse (13%), social anxiety disorder (12%) and conduct disorder (9.5%). More than a quarter (28%) of the people interviewed suffered from more than one psychiatric disorder. Funded by the National Institute of Mental Health and a bunch of academic institutions and foundations, this study is the first large survey of mental illness and its treatment in the United States in a decade.


In the year before the study, 26% of the interviewees admitted having had a psychiatric disorder (22% of which were "severe," meaning involving a suicide attempt, psychosis, serious violence, substantial disability or being unable to function with family, work and in personal relationships for a month or more [italics mine]. And the authors of the study say these results are undoubtedly short of reality--because people with serious issues notoriously avoid participating in self-reporting studies of this kind.

Now, while WalMart's memo is certainly in clear violation, both in letter and in spirit of EEOC discrimination laws, the fact is this illegal directive is just a drop in the the cost-of-doing-business bucket anyway. People who suffer severe mental illness may have no problem at all doing physical labor, especially when symptoms are not active.

But consider the costs you bear when employees are dysfunctional on the job--productivity levels drop precipitously as people stop focusing on work and cause trouble in collegial and reporting relationships--both up and down the corporate ladder. You're not paying in health care costs; you're paying with a damaged bottom line--but it's not as simple to pinpoint as a line item on the budget.

So what's a business owner to do about the spiraling costs of health care? I know of one enlightened company president who invites his valued employees to participate--right along with him--in efforts to improve their health (lose weight, lower blood pressures, etc.), and thus earn the right to pay a lower employee portion of the then-lower-total burden.

Whatever the solution, if it puts profit over people, it won't work for the long haul (see blog entry below about losing people). Profit's not a dirty word--but the idea that you can improve profitability by cutting certain people out of jobs is a muddy one.

Sincerely,
Barbara