Employers should buy into employee health

Quebec is about to undergo an election in which quality of working life is an issue.

The recent Quebec budget helped stake out the position of the Parti Quebecois government on the issue. It’s devoting $20 million a year to support businesses with fewer than 200 employees for programs, such as a four-day work week, flexible hours, work-time organization and special leave for parents. The government also passed legislation extending leave provisions to make family caregiving easier and to guarantee caregivers jobs upon their return.

By improving work-life balance, Quebec is recognizing that employee health and population health costs are two parts of the same issue.

What is happening in Quebec may be an early sign of a long-term shift that may occur across most of the developed world, fueled by governments’ frustrations at the costs of health-care systems.

For the past two decades, governments have responded to the costs of health care by reluctantly paying the bills while trying to streamline health services. The strategy has only partly worked.

Governments will increasingly look to other parties to foot part of the bill and take on some of the responsibility for health. Recently, for instance, Newfoundland announced public consultation will be held on the development of a provincial health charter to outline government’s responsibility for health and community services. The consultation will also specify the public’s role in maintaining their own health and in using the health system.

To date, however, there has not been much change in how governments view employer contributions to the health of citizens. But that may change soon.

To be sure, governments have legislated minimum standards for workplace health and safety for more than a century. But they may be sorely tempted to move one step further — to insist on greater involvement by employers in other areas of workplace health not covered by traditional occupational health. Like Quebec, governments may start with encouragement. But take note, governments often move beyond encouragement to legislation when it is in their interest to do so.

They might start by re-examining the nature of workplace health.

A 2002 document from the European Office of the World Health Organization, Good Practice in Occupational Health Services: A Contribution to Workplace Health, has identified “emerging challenges in Europe that require policy changes for health at the workplace.” The report lists some of these: aging of the working population (resulting in different occupational health needs); changing structure of employment (increase in temporary employment); outsourcing; increased number of interpersonal contacts at work; psychosocial problems; intensification and repetitive work; unpredictable working hours; and violence and harassment at the workplace.

“None of these problems can be solved using traditional methods focused on reduction of physical, chemical or biological hazards at work. However, they can be addressed by the holistic approach to management of health, environment and safety.”

Turned into political logic, this reframing might lead to the following statement: “Because of global market changes, workplaces are unhealthier places than they used to be. We, the people, pay the lion’s share of the costs of ill health. But since you, the employers, run the workplaces that can cause bad health, we will expect you to bear more responsibility, and if necessary, more costs, for health in the workplace. This will save the taxpayers money; it will save you money too, because the return on your investment in workplace health will be a healthier, more productive workforce. So this is what you must do…”

To date, employer associations across the developed world have been able to stave off many perceived incursions of government into the workplace through a political rhetoric of their own:

“Anything you make us do will cost us more, therefore making us less competitive, thereby damaging the economy. So leave us alone…”

This approach may well be ineffective if governments become so desperate to control health spending that they dragoon employers into shouldering some of the responsibilities and costs of health. Government’s press-gang role will be made all the easier if they can present a compelling argument that employers actually benefit from workplace health investment. In short, we the people will make you the employers do it because it is good for you.

So what can employers do?

They can contrive to control a greater share of the workplace health agenda. The vast body of expertise about workplace health lies within workplaces themselves, often in HR departments or in health-specific departments in larger companies. Employers should collectively take that body of expertise to the tables at which governments and employers negotiate with each other.

Employers should then say: “We recognize the bind you face. We can be your partners in developing strategies to recognize the roles and responsibilities of workplace health. In return for our partnership and expertise, however, we expect that you will base your approach to workplace health on dialogue with us, rather than on knee-jerk reaction to the costs of health.”

To do this would require the private sector, in particular, to turn off some of its ideological switches and to turn on some of its entrepreneurial and bargaining switches.

“Just Say No” as a reaction to greater government involvement in workplace health is too short-sighted a strategy. And human resource professionals in enterprises will have a crucial role to play if employers decide to be bargainers and partners in the future of health.

John Butler, a regular contributor to Canadian HR Reporter, is president of the Agora Group, a Markham, Ont.-based HR and health care management consulting firm. He can be reached at (905) 294-9762.

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