It All Begins with Good Health


If you’re reading this article on the Contact Center Pipeline blog, chances are you are in management or an executive and that sufficient health care has never been an issue for you or your family. That may be presumptuous, but it highlights the divisions by economic class Americans face today, something we hear about more and more. Unfortunately, since we all live and are served by a profit-based health care system, the benefits we receive are largely dependent on how much we are worth—either in our net worth or in our worth to our employers.

Health care is a complicated issue in any society these days, except maybe those of Northern Europe and Canada, whose systems function well and consequently, whose citizens live much longer and report higher levels of happiness than the rest of the world. Here in the U.S., we have an expensive, inconsistent system that provides mixed outcomes depending on who you and your employer are.

Let’s call out the elephant in the room—our frontline call center employees are often “worth” less to our companies than you, their manager or executive, are. Chances are, your company’s healthcare policy reflects that economic reality. Health care is a great example of underlying economics influencing the behavior in your call center that may be beyond your control.

I’m different in that I believe the call center industry can create wealth for workers. I see it not only as a path to the middle class, but also as a springboard to entrepreneurialism, and eventually, to capital ownership.

But our agents will never have the ability to achieve the prosperity and independence that all people within our society seek if they don’t have the one thing that will carry them through the subsequent years: good health.

I’m going to assume that those of us in leadership positions in this industry are not malicious, uncaring for their fellow humans, nor sadists who wish harm on someone else. Examples of such people have been found in some parts of the BPO industry, but let’s not dwell on this fact.

Instead, I assume that you are a good person who wants the best for your agents. In my conversations with BPO leaders, their thinking about health care mostly comes down to the retention issue. They have no hope of retaining the long-term managerial, quality and support employees they need to, the people that really keep the delivery of services going, unless they bite the bullet and provide them with middle-class health benefits conformant to what’s available in their respective societies.

But they tend to be unaware of how economic an issue health care is. They’re not educated on the economic impact of their healthcare policies on their agents, and many times, when something catastrophic happens to one of their agents, they’re sad, but they may not understand how economically damaging a catastrophic health event can be.

It all goes back to people, since we’re in a people business. You have to make the people feel secure in their lives and their jobs if you want them to perform. Health care is a large part of that, which is why we take it so seriously at Rethink Staffing and guarantee it as a right to our employees through ABOR#8.

I could tell you story after story about how catastrophic health events have affected our agents, but I think you know that already. What you may not know is how much power you have to help your agents through your buying decisions and your budgets if you simply reframe your thinking about health care from a retention tool to an economic support tool for your agents.

By deploying some of your existing dollars, you can greatly increase the amount of economic security you provide for your agents by simply providing them with better healthcare services—some of which are traditional, some of which are not. Your agents, who may be the working poor or the lower-income earners, those who earn less than twice of the federal poverty line, are asking four questions in regards to their health care that frames their thinking:

  1. As the agent, do I have health coverage so that if I get sick, I have options and don’t have to quit my job?
  2. Do I have a way to gain coverage for my dependents?
  3. Do I have extra help if something catastrophic happens to me or my family?
  4. Can I get all of this in a way that doesn’t make me poorer than I already am (i.e., compromising between prescriptions and food)?

If you’re not already providing coverage to your agents, you need to start immediately. You may face budget constraints and angry bosses, but the signal that covering agents health sends to the agents themselves is much more valuable to your business in the results it produces than the monthly cost. Further, it should be 100% coverage. Most people want to know that their health care is “taken care of” and they will notice if you do.

In the U.S., if you have agents who are receiving Medicaid, frankly, you should be ashamed. I’m sorry to have to put it in such stark language, but as business leaders, we have a moral obligation to use the strength of our leadership and the economic power of our firms to benefit the people in our lives, our employees and our society as a whole. If you’re angry, like I am, that employer-provided health care has become entrenched in our society, then take it up with your local congressperson (and use your economic power to get their attention). But not before you use the economic power of your firm to make even a small difference in the lives of those around you.

(NOTE: if you aren’t providing health care to your employees, and thus, based on their wages, they qualify for Medicaid, then that is known in economic terms as an indirect subsidy by the federal government to you, because the federal government is shouldering the burden of health care costs that otherwise you should be paying. But the ACA may have corrected that if you employ more than 50 people.)

At Rethink Staffing (RTS), we currently provide free HMO to the agents themselves, and 50% paid for the first dependent that the agent wants to cover. In the coming two years, if we continue along our current growth path, I plan to fully cover two dependents for the agent, on top of fully covering the agents’ HMO payments.

If you’re not covering dependents today, that is understandable. Healthcare costs in America are outrageous compared to societies with well-functioning single-payer systems. However, if the economics of your costing or pricing can withstand it, I encourage you to do so. Just like the agent wants to feel like they’re taken care of, if they’re a parent then, of course, that feeling extends to their children (as it probably does to yours).

If you’re working primarily in the developing world, the cost of covering dependents is lower, and thus should factor into your thinking as you look at your budgets for the coming years. Even if you can only afford to cover one or two dependents, do that and then consider offering an option for the agent to fully pay for additional dependents. The control that this will give them is significant, and they will reward you for it with loyalty and work ownership. I will state again, you cannot underestimate the positive benefit of caring for people’s health, and your company being the one to do it.

If you’re thinking that catastrophe is something that your insurances adequately cover, you may be right. But remember that the working poor or low-income people don’t have the money to pay for the same coverage that we do. They may not have life insurance, property insurance or disability insurance, which are common insurances for more educated, upper-middle-class people. Which is why with the economic power of the firm that we control, we need to provide it for them.

Let me give you a tangible example of something we’ve done that’s making a big difference with a small amount of cost. In addition to HMO, we provide what’s known as a “Catastrophic Fund” that we created ourselves.

Poor or low-income people tend to live in extended family units (because there is then more people to rely upon), which means that a crisis with a member of the extended family can often extend to the agent.

Every month, RTS gives cash grants to those employees who have had a crisis strike their extended family. This includes hospital bills, giving money to rebuild a house after a fire, and once we even gave money to rebuild a small restaurant owned by a family member of the agent after a car accidentally ran through the front wall of the store!

We don’t do it because we want to be thought of charitably. We do it because we know that if people know they have somewhere to turn when crisis strikes, it’s one more bit of security they can feel while they work to make themselves secure in our economically advantaged system.

The cost of this to us is quite small—in our developing world centers, we set aside $3/month per agent. In the U.S., we set aside $15/month/agent. While we often have someone needing help every month, the amount of help they need rarely exceeds what we set aside. When you think about your costs on a per-agent basis, this is a small amount that can make a big difference to the way they live.

Finally, we have all read in the press, especially before the ACA was passed into law, horrible stories about how people were made poorer by health catastrophes that struck them or their immediate family members. This is certainly a risk for your agents, but there are two greater risks out there as well.

First, the cost of medications is a key problem globally. In our centers in the Philippines, some agents report spending close to 30% of their income on medications for themselves or family members. In the U.S., most health insurance plans do cover the bulk of the cost of medications, but that coverage can vary and copays can sometimes be quite high.

Take the first step and do an informal survey of your agents. How do they feel about your health plan? Where are its gaps? I’m sure once you start asking, the information will flow and you’ll learn a lot. Then, talk to your HR executives to try and understand how these gaps in coverage are created. Engage your HR leader in a discussion to see if you can fill in the gaps. Sometimes, just negotiating with your coverage provider may be enough to lessen the burdens your employees may be facing with their daily budgets.

Second, if you believe in social justice then you believe like I do that no person should have to choose between buying health care/medication and buying food. Both—nourishment and health—are necessary to live. Bottom line: You don’t want your agents coming to work having to choose between being hungry or sick. How productive will they be if that choice is on their mind?

If you do make your agents pay for some of their own health care, or some of their dependent care, you need to do a bit of homework. Specifically, will requiring them to pay for some of their health care push their after-benefit wages below the poverty line in your local area? I’ve written extensively about how more call center agents live in poverty than we think; take the time to make sure your health care policies haven’t inadvertently pushed some of them back below the poverty line.

In summary, when you make healthcare a human right and prioritize your company’s role in providing it to agents, it gives your agents a sense of security that allows them to perform well in their jobs. That, in turn, lowers company costs (like retraining and absenteeism), and increases your profits. We’ve seen those same results at Rethink Staffing, and I know that, with some work, you can make a difference in the healthcare economics at play in your call center.

It all goes back to people, since we’re in a people business. You have to make the people feel secure in their lives and their jobs if you want them to perform. Health care is a large part of that, but it’s also good business. An employee who is sick less frequently, who takes care of their health, and most importantly, who knows that if they get sick, they will be cared for, is an employee who can focus on their work and deliver outperforming results for your clients.

Try it, I know you’ll be happy with the results!