Workforce Developments

Resources to help you make sense of the health care policy debates

As the national debate on health care policy picks up steam, we're going to be inundated with a lot more noise and flashing lights. To make good decisions and have well-informed opinions, we need to get past the sound and fury to find good information.

Here are a few resources I've found helpful. I hope you will too.

Health Reform page at the Kaiser Family Foundation, with multimedia content, polls and more in-depth research.

Health Issues page at Rand Corporation, offering briefs, fact sheets and other short reports to members of Congress.

Health page at the National Conference of State Legislatures, with updates on how states are tackling the problem of rising health costs and rising uninsurance rates.

Health Reform Resource Center at the Paraprofessional Healthcare Institute's PolicyWorks site, which looks at the issues from the point of view of health care workers. The workforce development angle!

Whenever legislation is finally introduced, you'll be able to follow it on OpenCongress.org, most likely on the Health page.

Readers, if you know of other resources with good data and information to help inform the health care policy debate, please share them!

If you feel sick, stay home. Please.

With the swine flu fears on the rise, I thought it would be a good time to reprint a post I first wrote way back in 2007. It's about the cost of presenteeism in the workplace. Seems like the potential costs of showing up to work when you're sick have just gone up. 

If you feel sick, please do your friends and colleagues a favor and stay home.

Save the company money: Don't go to work
Workforce Developments
January 26, 2007

Word of the day: presenteeism. That's when people show up for work even when they feel too sick, stressed, depressed or otherwise distracted to be productive. Think of those people who show up to work sneezing, coughing and sharing germs with the rest of us. Or the ones who are there in body, but are so busy dealing with a family problem that they can't get any work done. It's the opposite of absenteeism, and it's driven by fear and job insecurity. Sometimes people work long hours just to show they're working, even when there isn't that much work to do.

The term appears to have been coined by British prof Cary Cooper in the late 1990s. Several studies have tried to quantify the impact on businesses. A 2004 Cornell study estimated that "on-the-job productivity losses from presenteeism" could make up  as much as 60% of the total cost of worker illness, "exceeding the costs of absenteeism and medical and disability benefits."

In other words, when your boss orders you in to work even though you're sick, he or she could be causing the company to lose money. Many don't see it that way, though, which means it's difficult to solve the presenteeism problem. American workplaces encourage and sometimes require workers to "get over it" rather than find the help or just the rest they need. Downsizing and layoffs make things worse, as more people have more real reason to fear losing their jobs.

Harvard Business School offers advice to help employers address presenteeism. Among their recommendations: investing in employees' health care, medication, mental health coverage and health education could save your company money in the long run. Interesting, in light of ongoing political debates about health care coverage. 

As for workers, how do you know if you're too sick to work? How can you protect yourself if a co-worker comes in sick? This sensible CBC article offers some advice. 

For more advice on how to protect yourself and others from this swine flu outbreak and other illnesses, check out this flu fact sheet from the U.S. Centers for Disease Control. Recommendation #2: Stay home when you are sick.

CDC's advice on Stopping Germs at Work is available in PDF format, suitable for printing and posting at work. It's also available in

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• Tagalog

The term appears to have been coined by British prof Cary Cooper in the late 1990s. Several studies have tried to quantify the impact on businesses. A 2004 Cornell study estimated that "on-the-job productivity losses from presenteeism" could make up  as much as 60% of the total cost of worker illness, "exceeding the costs of absenteeism and medical and disability benefits."

In other words, when your boss orders you in to work even though you're sick, he or she could be causing the company to lose money. Many don't see it that way, though, which means it's difficult to solve the presenteeism problem. American workplaces encourage and sometimes require workers to "get over it" rather than find the help or just the rest they need. Downsizing and layoffs make things worse, as more people have more real reason to fear losing their jobs.

Harvard Business School offers advice to help employers address presenteeism. Among their recommendations: investing in employees' health care, medication, mental health coverage and health education could save your company money in the long run. Interesting, in light of ongoing political debates about health care coverage. 

As for workers, how do you know if you're too sick to work? How can you protect yourself if a co-worker comes in sick? This sensible CBC article offers some advice. 

For more advice on how to protect yourself and others from this swine flu outbreak and other illnesses, check out this flu fact sheet from the U.S. Centers for Disease Control. Recommendation #2: Stay home when you are sick.

CDC's advice on Stopping Germs at Work is available in PDF format, suitable for printing and posting at work. It's also available in

• español
•  
• 
  
• Tagalog

National Bike to Work Week meets the One-Stop

National Bike to Work Week is coming up May 11-15, and I'd like to suggest that our nation's workforce development system should get behind it.

I mean, we're all about green jobs these days. What about being green on the job? What about helping employees and the job seekers we serve stay fit and healthy?

Imagine it: National Bike to the One-Stop Week. For your employees and clients.

Biking is healthy, saves you money and lets you be part of the national effort to clean up our environment.

If you're employed, it can save you from the effects of fast food lunches and well-meaning colleagues who bring in baked goods.

If you're self-employed, it helps you get out of the house, shop or office where you already spend way too much time. 

If you're job hunting, it will help you look fit and trim on the job interview (okay, maybe you don't bike to the interview itself). Staying healthy can also help keep your mental equilibrium while going through tough times.

Important tip: You don't have to bike to work or the One-Stop every day. Just once a week or even once a month can make a difference to you and the environment. But start small - just bike to work or the One-Stop once during National Bike to Work Week.

If you're thinking about biking to work for the first time, here's a booklet with more tips to help you get started. Use your favorite search engine to look up local bike to work events in your city.

If you want to encourage biking to work at your One-Stop, check out this booklet, also from the League of American Bicyclists.

Health care as a foundation for the jobs recovery

Last week's unemployment numbers included one upbeat fact worth noting. Overall, our national unemployment may be at a 14-year high of 6.5 percent, and September's figures may be worse than originally calculated.

But in the same month, health services added some 26,000 new jobs.

That's more than ten percent of the 240,000 jobs lost. Not an insignificant number.

The system by which Americans get their health care is in tatters. That's not just health insurance, but physical infrastructure too. It's also the serious shortage of health workers in the US and internationally. Many rural communities are without much-needed specialists, or without any health providers at all. Urban areas are also losing hospitals and clinics. Last year's controversy over substandard conditions for veterans at Walter Reed Army Medical Center is just a symptom of the larger problem.

The continued hiring of health workers suggests this might be a smart place to invest stimulus money. Let's put more money into training health workers and building health care infrastructure - hospitals and clinics. Let's distribute those facilities and workers to the areas where need is greatest. Last week, Dean Baker at CEPR also explained how government investment in health care insurance could serve as a powerful stimulus to the economy.

So many people are cutting back on medications or holding off on trips to the doctor. I suspect this is an area with significant pent-up demand. If we build it, the customers will come, and money will flow.

Hospital photo by Norbert Kaiser

Email driving you nuts?

Today's LA Times has a big front page story that isn't really news: We're being driven nuts by email. I say it's not news because, well, don't you know this already?

A quick Google search shows that we knew about the problem back in March. And we knew about it in 2005, and even way back when the media covered the problem in 2002. Here it is again in 2001.

It's not news that email is interfering with our ability to get work done. You know how distracting it is to stop what you're working on, read and respond to an email, then try to get back into the task at hand. Have you noticed how it's getting harder and harder to stick with the task at hand for more than ten minutes at a time? Whether it's writing a report, building a budget or analyzing a new pile of data, our internet devices are training us to work in short spurts and bullet points. Nicholas Carr's article, Is Google Making us Stupid? in the current Atlantic Monthly puts the phenomenon in sobering historical context. The internet is actually rewiring our brains.

But they're saying email is reducing worker productivity, and I'm not convinced of that. Is that productivity really declining, or is something else going on? After all, Bureau of Labor Stats data shows that worker productivity has consistently risen nearly every quarter in recent years. The first quarter of 2008 saw another 2.4% rise in business sector productivity.

I think we feel overwhelmed by our email because we're simply overwhelmed by work. Downsizing means we have fewer people doing the same amount of work, and sometimes more. As revenues shrink, people are laid off and those who are left have to do more with fewer resources, sometimes with lower pay. No wonder we feel stretched to the limit.

What's more, back in the day (before my time, for sure), we used to have administrative staff to handle the most mundane communications. Now it all flies directly into our inboxes, along with listserv announcements we never read, notices from our favorite blogs and stores, and all those winning the UK lottery notices.

Yes, there's too much email. But the problem of people feeling overwhelmed by it is more than just the technology itself. By all means, learn how to manage your email better (here are some tips from Harvard Business School). While we're at it, though, let's look at the bigger picture of what's stressing us out in the workplace.

While you do that, I'll check my email.

Online support for families of workplace fatalities

Just ran across the United Support and Memorial for Workplace Fatalities website. The About page explains that "USMWF was formed to achieve support for individuals, companies and other organizations dealing with the repercussions of a workers death and the prevention there of." The organization and site were "formed by Tammy Miser after she lost her brother at the workplace and was unable to obtain the resources needed." 

It's estimated that 16 Americans die in workplace accidents every day.  Last year the House Committee on Education and Labor issued this map showing the locations of just 10% of those deaths from 2006 (Click on the image to see a larger version, or here for the searchable version). 

The USMWF site provides a space where grieving families can post links to their tributes and memorials to their loved ones, information for families, and a separate blog called Weekly Toll tracking workplace safety issues.

Workforce development is good for America's health

Earlier this year the journal Psychosomatic Medicine published a study that found unemployment reduces immune system function, making a person more susceptible to illness. What's more important, they found that after an unemployed person gets a job the immune system quickly recovers.

In other words, workforce development is good for our health, too.

It's something to think about in the midst of presidential debates over how to fix our failing health care system, and the health care trust fund being created by the United Auto Workers and General Motors. The end of long-term employment commitments has put workers at ever greater economic risk - but has it also made us unhealthier? Perhaps it's not just lack of health insurance coverage but also layoffs that strain our nation's health care system. Could employers improve people's health by, well, employing them? By making longer-term commitments to employees?

Workforce development is more important than most Americans know. We don't just help people get jobs. While helping businesses thrive and the economy buzz, we also help people stay healthy.

Translating foreign licenses into American health care jobs

Medical professionals who come to the U.S. from other countries face a variety of barriers preventing them from getting jobs in their field of expertise. Language is one, professional licensing is another. 

In the Minneapolis/St. Paul area, several groups representing immigrant communities and workforce development professionals have joined together to address some of those barriers (the story is also republished here). Workforce Development Inc. of southeast Minnesota has a program in Rochester , MN, specifically designed to help medical professionals credentialed in other countries to get licensed in Minnesota. They're now holding workshops for foreign medical professionals in partnership with the African and American Friendship Association for Cooperation and Development (AAFACD) and the International Institute of Minnesota.

When they come to the U.S., many of these professionals find themselves working in health care positions below the level of their skills and knowledge. For example, IIM reported they have a list of 165 foreign doctors and nurses who'd like to get licensed to practice, and in the meantime are working as nursing assistants in nursing homes. Recruiting foreign health workers isn't going to solve America's health worker shortage - and it worsens the global health worker shortage - but helping skilled professionals who are here get the licensing they need will be good for them and for our health system.

The true cost of coal

The plight of the Utah miners trapped by collapse of the Crandall Canyon Mine is on a minds of many today. Mining is a dangerous industry, with DOL's Mine Safety and Health Administration reporting 72 worker fatalities in 2006, up from 57 the year before. Most of those deaths - 47 in all - were of coal miners. That figure, too is, up from 2005, when 22 coal miners died on the job. 

How much coal did American mines produce in 2006? 1.16 billion tons. That means we lost one miner for every 24.7 million tons of coal produced. At 2005 spot prices (most recent annual stats available) those 24.7 million tons of coal were worth nearly $584 million.

92 percent of coal mined in the U.S. is used to generate electricity. According to the Energy Information Administration at the US Department of Energy, a ton of coal produces about 2,000 kilowatt hours of electricity; one pound of coal can light ten 100-watt bulbs for about an hour.

Even though coal is the largest source of fuel for the electricity sector, it makes up just less than 50% of all their fuel sources. Natural gas, hydropower, geothermal, solar and biomass are all used in different proportions to generate the juice that powers so much of our lives.

Which gets me to thinking about the true cost of coal. One cost that's debated widely is the air pollution created by burning coal (the head of Crandall Canyon Mine's Murray Energy Corporation is outspoken in his denial of global warming).

I wonder if coal is worth the lives of 47 miners every year. To quote the old saying, if we can put a man on the moon - and invent a telephone that does everything except wash the car - can't we come up a way to power up that doesn't put so many lives at risk?

Summer's halfway over - have you taken your vacation yet?

Do you even get one?

The Center for Economic and Policy Research (CEPR) recently issued a report comparing laws governing the right to paid time off from work among the 21 richest countries in the world. If you're feeling overworked and cranky already, you might not want to read it.

No Vacation Nation (press release)finds that twenty of those countries guarantee paid annual leave and most of them guarantee paid public holidays to all workers. France leads the pack in paid annual leave with 30 days off for all workers. Most of the rest provide 20+, while Canada and Japan are almost at the bottom with a guaranteed minimum of ten days off per year. Fifteen countries provide between one and thirteen paid public holidays each year for every worker. For total days off per year, Austria, Italy, Portugal and Spain vie for the top spot, with a combined total in each country of nearly 35 days for every worker.

The U.S. is the exception. How many paid days off are American workers guaranteed by law? I'll give you a hint. It's a ROUND number. That's right, American exceptionalism rules. We're the only industrialized country in the world that doesn't guarantee any paid time off to our workers. That's zero days. We don't even guarantee our workers time off for public holidays.

Why does this matter? Report authors Rebecca Ray and John Schmitt reviewed survey data and found that

In the absence of government standards in the United States, almost one in four workers there has no paid leave and no paid public holidays at all. According to U.S. government survey data, the average worker in the U.S. private sector receives only about nine days of paid leave and about six paid public holidays per year.

Moreover, vacation benefits in the U.S. are distributed unevenly:

Lower-wage workers are less likely to have any paid leave (69 percent) than higher-wage workers (88 percent); part-timers (36 percent) far less likely to have paid leave than full-timers (90 percent); and workers in small establishments (70 percent) are less likely to have paid leave than those in medium and large establishments (86 percent). Even when lower-wage, part-time, and small-business employees in the United States do receive paid leave, they typically receive far fewer paid days off than higher-wage, full-time, employees in larger establishments.

I learned about this report from an article in the LA Times Health section that summarized research that overwhelmingly finds people who take time of from work are physically and mentally healthier. If your employer gives vacation time, they say, you should take it. But what if you don't get any time off?

Do low-wage workers at smaller companies deserve less time off? Are they less deserving of the health and safety benefits that come with time off? Are their employers actually creating a less healthy and less productive workforce, by refusing to give time off? Don't you think you deserve some time off?

A less-known cause of workplace stress

It's Friday, so it's time for a little workforce development humor. A colleague recently forwarded me an article headlined Working With Idiots Can Kill You. Here's the lead:

Stress is one of the top causes of heart attacks -- and working with stupid people on a daily basis is one of the deadliest forms of stress, according to researchers at Sweden's Lindbergh University Medical Center.

The story goes on to explain

"You can cut back on smoking or improve your diet," Dr. Andersson says, "but most people have very poor coping skills when it comes to stupidity -- they feel there's nothing they can do about it, so they just internalize their frustration until they finally explode."

It seemed real enough. After all, Sartre told us long ago, "Hell is other people." But by the time they quoted this Dr. Andersson as saying, "Many of our subjects feel sorry for the drooling idiots they work with," I was laughing out loud.

It seems not everyone is in on the joke. This story has been doing the rounds via e-mail since 2002, when it first appeared in leading American news source Weekly World News and was widely circulated via Yahoo's entertainment news page. You can get the details from myth-buster extraordinaire Snopes.com.

Foundations want your ideas on health care

Is it a trend?

Last month I reported the Rockefeller Foundation is soliciting new ideas for their portfolio. They've created an online portal where you can submit your best suggestions. Now the Robert Wood Johnson Foundation and Changemakers have created what they're calling an "online, open source competition" looking for Disruptive Innovations in Health and Health Care. To quote from their site, the project

seeks to identify ways in which the health and health care marketplace can offer services, tools and choices that consumers want—but are currently out of reach because of cost, complexity, or because the right idea hasn't come along.

What is a "disruptive innovation?" Harvard business prof Clayton Christenson calls it

a technology, process, or business model that brings to a market a much more affordable product or service that is much simpler to use. It enables more consumers in that market to afford and/or have the skill to use the product or service. The change caused by such an innovation is so big that it eventually replaces, or disrupts, the established approach to providing that product or service.

It's exciting to see foundations opening up to new ideas from beyond their circle of usual suspects - maybe this model will become a disruptive innovation for how foundations do their work. As for me, I'm putting my brain cells together to see if I can come up with something for the contest. Those of us in the workforce development field know the slashing of health care benefits is a leading issue for American workers.

 Click here for all the details. Deadline is July 18.

Paid sick leave is on the march

Got an email from Mary Rickard at ACORN last week, alerting me to their new campaign for paid sick leave for American workers. A 2004 study by the Institute for Women's Policy Research (click here for a summary) found that fully half of all workers don't get paid sick leave. Last week the Senate Committee on Health, Education, Labor and Pensions held a hearing to discuss Sen. Ted Kennedy's Healthy Families Act, intended to address this problem. He introduced it last year (S.932), and plans to again this year.

Legislative action for paid sick leave is on the march. Earlier this month San Francisco passed a mandatory paid sick leave ordinance, and at least seven states are considering similar bills. (Click here for a summary of all state family leave legislation in 2006.) Kennedy's bill would require employers with 15 or more employees to provide them seven paid sick days per year to take care of themselves or a sick family member. 

I wrote in an earlier post about the business costs of "presenteeism," where people show up for work even though they're too sick or distracted by problems at home to be productive. They show up because they can't afford unpaid time off, or fear losing a job. Everyone needs and deserves to be able to take time off without those kinds of risks.

I've heard people complain that if workers are given paid sick leave then they'll use it for non-illness-related days off. Why should employers police the reasons their workers take days off? Those "mental health days" we all take are just as important as "real" sick days for keeping us healthy. I say offer the days off, build it into the budget, and let workers take them as they choose.

Passages: Steelworker leader George Becker

Former president of the United Steelworkers union George Becker passed away over the weekend at 78. He was first elected president in 1993, and served for seven years. Becker was a major player in union participation in the WTO protests in Seattle in 1999.

Becker was a second-generation steelworker, growing up in Granite City, Illinois. This story about his early days as a union rep comes from the detailed obituary on the USW website:

It was as a staff representative that Mr. Becker came into contact with the adverse effects of lead poisoning at a plant he serviced, National Lead, and his outrage over what he saw there led him to become an expert on occupational health issues.

Workers at the plant were punch drunk with lead poisoning. Mr. Becker discovered that the employer was saving money by nightly turning off the bagging system used to purify the air. Reforms were initiated, including clean changing rooms, mandatory showers before leaving work and lead testing for the plant's neighbors. He was soon pressing for safety and health reforms thorughout the District and the union.  

Later, in 1969, Becker testified before Congress as an expert on lead poisoning, in hearings that lead to the establishment of the Occupational Safety and Health Administration (OSHA).

Save the company money - don't go to work

Word of the day: presenteeism. That's when people show up for work even when they feel too sick, stressed, depressed or otherwise distracted to be productive. Think of those people who show up to work sneezing, coughing and sharing germs with the rest of us. Or the ones who are there in body, but are so busy dealing with a family problem that they can't get any work done. It's the opposite of absenteeism, and it's driven by fear and job insecurity. Sometimes people work long hours just to show they're working, even when there isn't that much work to do.

The term appears to have been coined by British prof Cary Cooper in the late 1990s. Several studies have tried to quantify the impact on businesses. A 2004 Cornell study estimated that "on-the-job productivity losses from presenteeism" could make up  as much as 60% of the total cost of worker illness, "exceeding the costs of absenteeism and medical and disability benefits."

In other words, when your boss orders you in to work even though you're sick, he or she could be causing the company to lose money. Many don't see it that way, though, which means it's difficult to solve the presenteeism problem. American workplaces encourage and sometimes require workers to "get over it" rather than find the help or just the rest they need. Downsizing and layoffs make things worse, as more people have more real reason to fear losing their jobs.

Harvard Business School offers advice to help employers address presenteeism. Among their recommendations: investing in employees' health care, medication, mental health coverage and health education could save your company money in the long run. Interesting, in light of ongoing political debates about health care coverage. 

As for workers, how do you know if you're too sick to work? How can you protect yourself if a co-worker comes in sick? This sensible CBC article offers some advice.

How foreign aid worsens the global health worker shortage

Laurie Garrett's new article - The Challenge of Global Health - explores some of the negative impacts of a recent explosion in foundation- and government-funded health initiatives in the Global South. She argues that disease-du-jour driven programs siphon workers and other resources away from the broader public health infrastructure, and even from the more mundane but more common causes of death such as complications of childbirth and diarrhea.

Garrett further argues that until the U.S. and European nations address our own health worker shortages domestically and stop recruiting workers from Africa and Asia, we'll continue undermining the very health systems we're trying to strengthen through foreign aid projects. She offers some stunning statistics:

• Zimbabwe trained 1,200 doctors in the 1990s, but only 360 remain today;
• By 2005 Botswana was losing 60% of its newly-trained health workers to emigration; and
• Today, one out of every 5 physicians in the U.S. is foreign-trained.

The U.K. has established a Commonwealth Code of Practice for the International Recruitment of Health Workers to address the brain drain of trained health workers into Britain. Garrett recommends going much farther:

"OECD nations should offer enough support for their domestic health-care training programs to ensure that their countries' future medical needs can be filled with indigenous personnel. And all donor programs in the developing world, whether from OECD governments or NGOs and foundations, should have built into their funding parameters ample money to cover the training and salaries of enough new local health-care personnel to carry out the projects in question, so that they do not drain talent from other local needs in both the public and the private sectors."

She even suggests a kind of Marshall Plan for wealthy countries to invest in improvements to foreign public health systems. I've argued before on this page that here in the U.S. it's time for a new New Deal with public works projects focused on our service sector, rebuilding our crumbling health and education infrastructure. From what Garrett writes, Americans might not be the only ones to benefit.

Bad boss!

Here's a BOLO for new study soon to be published that explores the impact of bad bosses on employee health and job performance. What they've found is - you're not alone. After surveying 700+ workers, Prof. Wayne Hochwarter and students at Florida State found that about a quarter of bosses blame others to cover up their own mistakes, and nearly a third bad-mouth employees to other workers.  Nearly 40%...

Truck drivers and trucking regs

Sunday's NY Times had a great piece on truck drivers, focusing on regulation of the American trucking industry. In recent years federal regulators have loosened the rules that govern how long truckers can drive in a single day, and have elected not to make driver training more rigorous. I suspect most Workforce Developments readers don't know that in 2004 when the Federal Motor Carrier Safety Administration issued new rules for training required to get a Commercial Drivers License (CDL), they set a minimum of ten hours of training, and none of it actually has to be on-the-road and behind-the-wheel of a big rig.

AEA final post: workforce safety on American railroads

The title might have been dry, but the session was fascinating (not just because I'm a big fan of Amtrak): The Federal Railroad Administration's (FRA) Research and Development Agenda to Improve Safety and Safety Culture in the Railroad Industry. Joyce Ranney of the Volpe National Transportation Systems Center and Jonathan Morrell of New Vectors reported at AEA on a series of ongoing projects in the industry.

Derailments are a daily occurance on American railroads. Between 1980-85 there was a 50% reduction in human factor accidents (HFAs) on the railroads. Since 1985 the number of HFAs has remained constant. Because most derailments and accidents happen in train yards - and 98% of our railroads carry freight instead of passengers - few injuries occur. (In Europe, by contrast, 98% of trains carry passengers.) But all HFAs cost money, and the Federal Railroad Administration is working diligently to find ways to reduce accident and improve safety.

Part of the problem is the density of traffic moving on railroads. The stats are stunning. Trains move throughout the country pulling as many as 150 cars each. One rail yard might shift 800 cars in a single shift. New tracks are being laid to meet demand on major routes, such as between Los Angeles and Denver. Production of coal in the Powder River Basin of Montana and Wyoming alone generates 200 trains with 150 cars each of coal every single day. Rail volume is only expected to increase. The trucking industry is maxed out and expecting railroads to pick up the slack as transportation of intermodal containers continues to grow.   

Volpe estimates the railroad industry will need to hire 80,000 new employees over the next five years at all levels, to cover new positions, retirements and other turnover. 100 percent of the railroad labor force is union-represented, although there are thirteen different unions, and they don't all get along. There are five class-one railroads in the U.S. (or check out this article), plus more than 300 small local lines.

Evaluators from Volpe, New Vectors and a few other orgs are conducting a series of quantitative and qualitative evaluations of several new initiatives the FRA has implemented in order to increase safety and create a "safety culture" on the job. They've developed logic models for each of three key initiatives. One initiative is designed to increase the confidential reporting of incidents that didn't lead to accidents but could have (precursers), because getting data on actual accidents is almost impossible. A behavioral-based safety initiative has been developed that trains peers to evaluate and give feedback to each other on safety and workplace behavior.

Each initiative is being implemented at a different level. Most are still at the pilot phase. All of them require the participation of the railroad carriers and unions. If you're interested in more info on railroad safety, the FRA makes a fair amount of data available here, on its website.

This concludes my posts on the American Evaluation Association conference. To read the full coverage from Workforce Developments, click here.

Americans would rather have health care coverage than a raise

I suppose it's helpful that they've quantified it, but is anyone surprised that the Employee Benefit Research Institute has found that Americans are more dissatisifed than ever about their health care coverage? EBRI's ninth annual Health Confidence Survey - released today - finds that six of every ten Americans rates our health system as poor or fair (other choices were good, very good or excellent). The number of those calling it poor has doubled since 1998. 

The study says, "Many Americans report that rising costs have hurt their financial well-being and feel that steps should be taken to slow these increases." Those who saw the cost of their health coverage increase in the past year say their household finances have suffered as a result. Some have cut back on retirement savings (for a drier, statistical look at U.S. retirement saving trends, check out this Congressional Research Service report); others have had difficulty paying for basic needs.

According to the US Census Bureau, 15.9% of all Americans had no health insurance in 2005, up from 15.6% in 2004. Not a big percentage, but that's 1.3 million more people, for a total of 46.6 million without coverage. That means the number of Americans without health insurance is greater than the population of Texas, Oklahoma, Kansas, Nebraska, South Dakota, North Dakota, Minnesota, Iowa and Missouri combined.

Research by the Kaiser Family Foundation has found that health insurance premiums rose by 7.7% from '05 to '06, slower than the previous year but still faster than inflation (3.5%) and wage gains (3.8%). Premiums for family coverage have increased fully 87% since 2000. Also since 2000, the share of employers offering health benefits has fallen from 69% to 61%.

The EBRI survey found that employees would rather get health insurance coverage than a raise. Considering the fact that the cost of health care is rising faster than wages, is anyone surprised?