Healthcare reward packages can be incredibly difficult to design for global workforces.
A healthcare benefit such as insurance could be literally life-changing for an employee in one country, but completely redundant for an employee in another.
Even at a personal level, a reward that’s meaningful to one person could have no meaning at all for someone else.
Below, we will unpack some of the factors that impact the relative importance of one healthcare benefit over another to global employees, then provide tips for how to accommodate all preferences in a total reward offer.
How Employee Healthcare Burdens Vary Around the World
Let’s start with the financial burdens of healthcare for people around the world because this is the easiest way to make apples-to-apples comparisons, at least at a national level.
According to Matthew McGough, Imani Telesford, Shameek Rakshit, Emma Wager, Krutika Amin, and Cynthia Cox at Peterson-KFF, the average American spends much more annually on healthcare costs than their peers in other wealthy countries. In France or Sweden, the average person spends just more than $6,000 per year on healthcare costs. In the U.S., that number is nearly $13,000.
That gap translates to measurable health outcomes. A 2021 study from The Commonwealth Fund found that half of lower-income American adults reported having experienced financial barriers to healthcare provision. Among lower-income adults in Britain, by contrast, that figure was just 12 percent.
But the U.S. is the outlier here. Among the other countries in the Peterson-KFF study, average spending ranged from about $4,700 per year (Japan) to about $7,400 per year (Germany) with a mean figure around $6,000.
And those other countries have different payer models.
In Germany, Japan, the Netherlands and Switzerland, insurance mandates require citizens to purchase health insurance, with subsidies available for low-income individuals, writes Chris Slaybaugh, a consulting actuary at Axene Health Partners. In Australia, France, Sweden and the U.K., a hybrid model combines insurance mandates with a single-payer system to provide coverage for all citizens.
That’s one reason a healthcare benefit for a French employee would have a very different impact than it would for their coworkers across the border in Switzerland.
Taking a Wider View of Employee Healthcare
But healthcare benefits shouldn’t be limited to policies that extend access to things like primary or emergency care.
Mental health, oral health and overall wellness need to factor in, as well. In many countries, single-payer and private insurance policies are spotty in their coverages of these aspects of care. This is something employers can address to make their total reward packages impactful for employees around the world.
Let’s take these one by one.
Mental Health
People everywhere deal with external factors that can harm their mental health. The World Health Organization has a comprehensive list of work-related factors that include:
- Workloads that are excessive.
- An unsustainable pace of work.
- Skills gaps, whether that means a person’s skills aren’t being put to use, or they’ve been insufficiently trained for the job they’re assigned.
- Lack of control over when, where, or how they work.
- Unsafe or poor working conditions.
- Threats of violence or harassment at work.
- Job insecurity.
- Conflicts between home and work demands.
There are personal and cultural factors — e.g., stigmas around mental health and its care — that impact how people deal with these stressors. As such, providing mental health benefits can be less impactful or people aren’t inclined to use them.
“This is why selecting a mental health solution that offers a multifaceted approach and breaks down barriers to access and use of the benefits is imperative,” writes Cynthia Castro Sweet, senior director of clinical research at Modern Health.
Sweet notes three factors that “influence whether employees will utilize a mental health benefit when offered to them”:
- The aforementioned stigmas around mental health.
- Awareness of care options available to them.
- Whether they can access and use those benefits easily.
The second and third factors fall within the scope of what employers can provide. As with any benefit, make sure your employees understand the help available to them and that they have easy access to it.
Dental and Oral health
In many countries with single-payer systems or insurance mandates, dental health coverage falls outside of most people’s policies. Non-emergency oral care thus becomes an out-of-pocket cost for many people.
These costs impact employers. According to the U.K.’s Oral Health Foundation, “more than two million people in the UK say they have taken time off work in the last five years due to poor oral health.”
The World Health Organization reports that oral diseases will affect nearly half of the world’s population at some point in their lives, and the WHO is therefore advocating for universal oral care coverage by 2030.
“In high- and middle-income countries, oral health services are often poorly distributed or inaccessible to vulnerable or disadvantaged groups in society,” the WHO writes in its 2022 “Global oral health status report.”
“… In many low-income countries, the situation is far worse. In these settings, oral health professionals tend to be concentrated largely in urban areas, inaccessible to much of the population who live in rural locations. In these circumstances, people often spend considerable time and cost for travel to seek professional oral health care.”
Overall Wellness
Finally, making room in a rewards package for general wellness can be quite motivating for workers anywhere.
“Gym memberships often run less than $50 per month, making this a highly affordable perk for even the smallest of businesses,” Preston Wickersham at Remote.com writes. “It may feel like a small salary increase in disguise, but earmarking money for fitness helps employees feel more in control of their physical wellness.”
Your Options for Providing Support
The case for providing healthcare benefits is a relatively easy one to make, as is understanding what types of benefits to include. The hard part is figuring out how to deliver those benefits.
Anja Simic at global payroll company Deel has several options, including:
- Working with in-country partners. These people can help you ensure compliance with local laws and that your benefits are in line with local standards for medical coverage. The downside to this, Simic writes, is “local companies have their standards and packages, so the willingness to adapt and offer your employees an individual approach is not likely.”
- Paying employees a medical stipend. You can also give employees a monthly amount to cover any recurring or ad hoc medical expenses. As Nadia Ponomareva at employer of record platform Horizons writes, stipends can be useful in creating choice for employees, who may wish to spend that money on wellness programs or sports.
Health reimbursement programs or health reimbursement arrangements (HRAs) serve as alternatives to monthly stipends. “With an HRA, you provide your employees with an allowance for their health expenses,” Chase Charaba at PeopleKeep writes.
“Employees request reimbursement, and qualifying health expenses are paid out, usually on their next paycheck. In the U.S., HRAs are tax-free for the employer and employees. Employees can use their allowance for individual health insurance premiums, prescriptions, and out-of-pocket expenses if the employer allows it.”
Learn More
Tailoring healthcare and wellness benefits to the needs of individual employees is a major aspect of personalized total reward — exactly what we built uFlexReward’s platform to deliver.
To learn more, request a demo today.
Images used under license from Shutterstock.com.
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