As health costs continue to rise and the economy slows, employees are being challenged to take more responsibility for their own health. But, in order to develop effective plans and support programs for employees, employers must first understand what drives their workers’ health care decisions.

To narrow the gap between desired and actual employee behavior, employers can listen to the voice of the consumer, their employees. This report, the first of two based on the data, discusses the relationship between health, productivity and costs. The second report, which will be published in early 2009, will focus on the links between employee health and performance at work.

Responses from nearly 2,500 U.S. workers are compiled in the second installment of Watson Wyatt’s 2008 Employee Perspectives on Health Care report. This year’s findings shed light on how employees view their company’s healthcare programs and which health, education and communication programs best encourage employees to accept the invitation to change their behavior and lead healthier lifestyles.

Although responses were collected in May and June of 2008, before the full extent of the financial crisis was known, they illustrate employees’ sensitivity to higher health care premiums. They also indicate clearly that companies can do more to create a culture of health that helps lower workers’ health care costs while improving their health status and productivity.

Key findings this year include:

• Nearly one-fifth (19 percent) of employees are willing to pay more money out of their paycheck in order to keep health costs low and predictable. This represents a marked difference compared with results from 2007, when twice as many were open to higher premiums for more certain health care costs.


• Two-thirds of employees are trying to take better care of themselves, while many others are trying to reduce their health care costs. However, this year more employees are also taking actions (e.g., missed doctor’s visit or skipped doses of prescribed medications) that might lead to larger expenses down the road.


• Many employees believe that their employers could do more to foster a culture of health. Slightly less than majority say that their employer promotes a healthy work environment (41 percent) and that their senior leaders visibly support a culture of health (45 percent).


• A vast majority of employees (85 percent) say they have a primary care physician, a key to preventive care. These employees are more likely to be engaged in their health, and 76 percent are getting preventive screenings.


• Financial incentives are still the most effective way to encourage participation in health related programs. More than half (52 percent) of employees respond enthusiastically to financial incentives that are targeted to their needs by demographic, job type or condition.