For anyone who watched the U.S. Presidential Debate on October 9, you might have heard Donald Trump’s comment about Canada’s health care system as being “so slow its catastrophic in certain ways”. He also added that “and if you ever notice the Canadians, when they need a big operation, when something happens they come into the United States in many cases.”
For many Canadians, this comment wasn’t well received as our universal health care system is something many of us hold as a source of pride and as a differentiating entitlement. While some might be confused or unwelcoming of our socialized health insurance plans that provide coverage to all Canadian citizens, it is an arrangement that, especially when needed, is highly valued.
Negative associations regarding Canada’s health care system primarily focus on the length of wait times for specialist appointments and medical procedures. While this is a generalization, there are some elements of truth to wait times that find Canadians looking for alternate arrangements to their health care needs. According to Bacchus Barua, a senior economist with the Fraser Institute, patients can wait up to 18 weeks or more before seeing a specialist to confirm next steps.
The challenge with looking to trends related to medical tourism is the limitation of definite data. In recent years, the Fraser Institute reported on medical tourism by surveying physicians about their patients. The question asked in the survey is, “Approximately what percentage of your patients received non-emergency medical treatment in the past 12 months outside of Canada?” Of note, the report doesn’t include patients who didn’t consult with their attending physician before travelling abroad for medical treatment. This data might therefore not be 100% accurate, but it does provide information to support the trend in medical tourism for Canadians.
In 2015, the Fraser Institute survey revealed that about 1 percent of Canadian patients left the country for elective medical care. This percentage equates to 45,619, which is slightly less than was reported in the same survey the previous year at 52,513 in 2014.
Regardless of the exact numbers, year over year, there is increasing provincial and local provider interest in supporting medical tourism. In addition, with companies like Health City Canada (the Canadian office of Health City in the Grand Cayman Islands) and Destination Health, which showcases featured medical facilities around the world where Canadians can pay to get surgery performed quickly, there appears to be an increasing sophistication of foreign medical tourism operations.
While the wait list for key services continues, the top medical tourism destinations for Canadians includes:
Some countries have invested significantly in their medical infrastructure and have established regulations and standards to facilitate safe and successful treatments. Other countries have different regulations and Canadians who seek medical treatment abroad may risk potential life threatening post-operative complications. When they return home and seek medical attention to remedy their complication, it adds cost to the Canadian health care system requiring the attention of medical staff who might have deployed their skills to reducing the wait time by meeting with other patients in need.
The Government of Canada website addresses medical tourism and asks Canadians to consult Well on your way: a Canadian’s guide to healthy travel abroad. The webpage
asks Canadians to be aware of the implications of receiving medical care in other countries and sites the example that “some countries’ medical services may not test blood for blood-borne infections like HIV or hepatitis B.”
Some may argue that medical tourism saves the Canadian health care system, but others may also consider that the cost of addressing medical complications drains funds out of our medical system when these patients return home.
With 1 percent of the Canadian population pursuing destination healthcare or medical tourism, it is a topic that will continue to be of interest and worth keeping an eye on in terms of the impact to our public health care system and the downstream effects that play out in the group benefits arena. We will continue to monitor this emerging global trend and invite you to contact us if you have any questions. We’re here to help so you can focus on what you do best.
In the last few years, there has been a growing number of fitness trackers and fitness apps filling the market and all designed to motivate and encourage healthier lifestyle choices through increased physical activity. The idea of rewards for activity, growing an online community, and the fun of gamification elements, reveal that wearable fitness tech has caught on like wildfire in the workplace and with consumers in general.
There was a time in the not so distant past when only athletes were able to access biometric data and technical equipment through advanced training centers to help them assess nutrition, body fat, sleep patterns and workout progress.
Today, wearable fitness tech is no longer expensive, unattainable or reserved for professional athletes. The research company, Tractica, predicts that more than 75 million devices will be deployed in the workplace by 2020.
There are so many apps and devices to provide us with helpful personal biometric data. Fitness Trackers and smart clothing interact with Smartphones and track workouts and progress through an accelerometer as well as monitor heart rate through a gyroscope. Many wearable fitness trackers also replace watches as they include a time telling feature.
Examples of fitness trackers include Apple Watch, Fitbit and Jawbone. They monitor sleep patterns, nutrition, activity levels, offer challenges, rewards and can make fitness fun. Smartwatches are quickly taking a leading position in the category of workplace wearables.
In addition, there are many free motivating audio apps to encourage fitness including Nike +, Training Club, Sworkit, FitStar Personal Trainer, Rockmyrun and PaceDJ. The last two, match music to your workout tempo.
Wearable fitness tech offers a huge boost to corporate wellness programs. Employers who offer voluntary campaigns or promotions that involve wearable tech gently encourage employees toward healthier lifestyles. In so doing, they are also positively nudging the needle toward greater productivity outcomes where healthier employees equal healthier bottomline results.
Companies like BP received a lot of attention for their "Million Step Challenge" as they partnered with StayWell and offered employees -- on a voluntary basis-- a free Fitbit tracker and with every million steps an employee walked, they earned 500 wellness points, which accounts for 50% of their annual target. There are other ways this campaign encouraged wellness, but the emphasis shows the influence of wearable fitness tech in the workplace as an embedded component of the company's wellness and benefits program.
What's ahead for wearable tech in the workplace?
As wearables become more accessible and commonplace, employers will increasingly look for ways to integrate them to improve morale and productivity. While big data has many upsides, there remains a realistic point of caution. Not everyone feels comfortable sharing so much data with an employer about their activity, sleep patterns and nutrition. Maintaining confidentiality and employee trust about the way data will be used -- if harvested through a company workplace program -- should be clearly identified and communicated to employees upfront.
Wearable fitness tech will continue to evolve, and it is clearly becoming an integral part of wellness initiatives for companies throughout the world. Understanding how to optimize the effectiveness of wearables to meet the needs of employees and employers will be an ongoing challenge.
Staying on top of the trends and discussing the implications for you and your company is something we're excited to do. Please contact us. We're here to help so you can focus on what you do best.
As 2016 quickly winds to a close, it is a good time to reflect on what you've accomplished based on the goals that align with your organization's bigger picture. And in so doing, there is value in considering the impact of your benefits program in conjunction with the overarching benefits philosophy -- if one has been established. Otherwise, it is an important time to consider the influence the benefits program had on the success of company goals and specifically, its impact on human resources recruiting and retention outcomes.
Questions to consider:
Who's unhappy at work?
It is widely held that employers hope to get the most from their employees. What many surveys have consistently reported doesn't provide reassuring results. In growing numbers, employees are experiencing higher levels of stress and much of it translates into their experience at work. Based on a recent Staples Advantage Workplace Index survey, more than 50 percent of employees feel overwhelmed and burnt out. Their emotional and physical well-being also reflects in their level of workplace engagement.
This same survey reported: (based on responses of 2600 US and Canadian workers)
When employees aren't happy at work, they expect to change jobs within the next 12 months. What 82% of employers haven't factored in is the cost of employee turnover; reflecting that only 18% of employers calculate the true cost of turnover for their business. Accordingly to a Standard Life report, if an average salary of $48,000 is assumed, the average turnover departure cost per employee equals $18,000. If a company with 500 employees loses 50 employees in a year, it represents $900,000 -- that is a big chunk of change that might have been invested in benefit program enhancements instead of being redirected into loss of productivity, replacement and retraining costs.
Compensation and benefits programs don't need to add fuel to the fire of workers who report disengagement in the workplace. So as 2017 approaches, it is time to review your current benefit program to assess its relevance and competitiveness?
Prep with a benefits review checklist
In preparation of hitting the ground running with a great head start in 2017, consider adding "review existing benefit program" to your pre new year's "to do list".
What's happening in the tech sector?
It may also be a worthwhile exercise to consider what employers in the tech industry offer by way of their benefits program. The tech industry is known for driving innovation for the services and products it offers, but it is also can't be discounted for its influence in the benefits and compensation arena. Trends in employee benefits show that traditional health and dental programs have become table stakes in the tech world and millennial workers have expectations well beyond the traditional package. They are being offered unique health perks that include annual fitness allowances as well as fitness reimbursement programs, free healthy lunches and snacks at work, comprehensive wellness programs and flexible hours and vacation policies.
What's expected in terms of benefits packages in the tech sector will inevitably bleed into other industries. Consider revisiting your workforce demographic make-up, regional variances, KPIs for recruiting and retention and surveys or focus groups to avoid guessing about the value of your current benefit program offering.
We understand what is trending in various sectors and what positively influences employee engagement. We invite you to contact us to discuss ways your benefits program can maintain a strong competitive and relevant place for your organization and within your industry. We're here to help so that you can focus on what you do best.
It is perhaps a blessing and a challenge to think that we are living longer and healthier lives. As a result of better medical treatment, improved nutrition, and accessibility to medical information, people in Canada and in developed nations can expect to live longer. While living longer in good health is great news, the worry for many facing retirement involves concerns about living beyond one's savings.
The 2007 HALE data (the most recent year data is available), indicates that Canada's life expectancy is 80.7 years with the expectation that people could live in good health until age 73 -- representing 90.5% of life lived in good health. While the medium may be age 80 for life expectancy, many are living well into their 90s and those that reach the Centenarian milestone are growing. Statistics Canada's projections indicate that by 2031, there could be more than 17,000 people who will celebrate their 100th birthday. By 2061, this number should be closer to 80,000.
What does this mean to employers who have benefit plans and employment arrangements designed with the understanding that retirement age remains age 65? Many benefit plans and succession plans (if they exist at all) don't factor in the growing numbers of mature workers with no plans to retire early or at age 65. Many plans were built around the mindset that workers generally retired at age 65. With the abolishment of mandatory retirement in 2006, some employers have yet to adopt a different way of approaching this "grey" cohort of workers.
Back in 1971, the median age of the population was 26.2 years. Then in 2009, it was 39.5. In 2036 it is expected to be between age 42 and 45. As of July 2015, for the first time in history, Canadians 65 and older represented more of the population than those in the under age 15 category. This number represents close to 5.8 million people in a nation of 35 million. While by international standards, the population of 65 and over is comparatively smaller than other G7 nations, it is still a force to be contented with particularly when addressing workforce planning and benefit plan management.
As per the Administration on Aging (AOA), in 2014, persons 65 years or older represented 46.2 million or 14.5% of the U.S. population or 1 in 7 people. In Canada, comparatively, 1 in 6 people are over age 65 and represent 16% of the population. By 2040, this cohort is expected to grow to 21.7% of the U.S. population and this number might be slightly higher in Canada.
Employers are finding they need to address how to handle the mature workforce. Statistics Canada reports that 25% of Canadians are working past the traditional retirement age of 65. Sun Life's Unretirement Index agrees and reports that there is a growing number of Canadians expecting to be working full-time at age 66.
The trend in providing coverage to reflect the needs of this elder cohort isn't keeping in step. A particular focus should be given to benefit plan language and the wording around retirement and age limitations specifically pertaining to life insurance reduction and long-term disability coverage.
More discussion with plan sponsors should involve how they wish to extend coverage and how their benefits philosophy aligns with their core values and mission statement. As we track these important workforce trends, we layer a deep understanding of how they relate to benefits and pension plan funding, administration and management. We invite you to contact us to discuss strategic plans for navigating the waters of benefit provisions for mature workers. We're here to help so you can focus on what you do best.
Dave Dickinson, B.Comm, CFP, CLU, CHFC
Experienced Benefits Specialist ready to optimize your group benefits and pension plans.