British Columbia bans mandatory high heels at work


I’m sure there will be mixed comments on this, but it makes sense for several reasons:

  • Safety
  • Comfort
  • Productivity
  • Gender equity

As noted in a previous blog, US emergency rooms treated an average of more than 12,000 injuries each year between 2002 and 2012, and the trend is increasing. (1)

Health insurance costs being what they are, how does requiring employees to wear heels make any sense?

So, one Canadian province has taken action. (2) The government of British Columbia has stipulated that employers can no longer require high heels as part of a work dress code.

Very intelligent.  No wonder people live longer in Canada.

This discussion calls to mind a classic issue that has arisen in relation to motor cycle helmets, seat belts, physical fitness, impaired driving, and vaccines — an individual’s actions affect others.

What do you do when one person’s choice can raise health insurance costs for everyone else? Each person who pursues a risky behavior adds a small increment to the costs borne by health insurers, and the little pieces add up. Of course, the health insurer response is to raise rates to cover these costs. Everyone who has insurance pays more. 

US public policy in this area is at best erratic. Some rules support individual liberty; some what is best for the majority. Very inconsistent.


  1. Mary Elizabeth Dallas, “Injuries from high heels on the rise,” Spectrum Health Healthbeat, 13 JUne, 2015.
  2. Jamie Feldman, “New Canadian Law Bans Mandatory High Heels At Work,” Huffington Post, 10 April 2017.

The Employee Benefits Divide


There are immense divisions in US society:ben_franklin

  • Rich versus poor
  • More educated versus less
  • Old versus young (ageism lives)
  • Urban versus rural (fading since most people live in urban areas, but still very real)
  • Ethnic and racial

We can add big employer versus small business to the list.

Large employers are adding benefits for employees that small businesses simply can’t afford.

American Express announced an increase in paid parental leave to five months with added surrogacy and IVF benefits, and Ernst & Young expanded parental leave from three to four months for parents of all genders and added adoption, fertility and surrogacy benefits.

Basically, if you have fertility issues, it really pays to work for one of these large financial services firms.

The larger division is a shift in focus in large companies from the cost of benefits to the total well-being of the employee. That shift has benefits for these companies in terms of worker retention and productivity.

Small companies pay a price for their focus on cost in terms of employee turnover, learning curves for new employees that affect productivity, and errors that affect customer relationships. However, they simply can’t afford some of the benefits that large companies can offer. Nor do they get the favorable pricing for benefits that insurers give to their largest clients.

The size divide isn’t clean. There are small companies that recognize how important their employees are.  I know of one diner (a class of eatery for which New Jersey is famous) that offers a good benefits package to staff, but that’s unusual in food service establishments.

Conversely, large retailers tend to treat employees as replaceable. In one recent study by the ACSI, retailers closing stores were seeing improvements in customer satisfaction ratings. My guess is the stores that were  under-performing had the lowest individual store ratings for customer satisfaction, but the ASCI data aren’t sufficient to address that.  Why not? Minimum wage employees with limited benefits and no career path aren’t motivated to deliver for customers. People do what they are incented to do.

What you need to consider:

  • Students need to think about the kind of company for which they will work in the future.  College is less optional if benefits matter.
  • Small businessmen need to get creative about ways they can invest in employees. The old mentality that “having a job is sufficient motivation” is simply a way to guarantee mediocre staff. Good people can always find another job. When there is turnover, the best are the first ones out the door.


  1. Ann Clark, “Top 5 best work benefit trends for 2017,” BenefitsPro, 6 March 2017.
  2. American Customer Satisfaction Institute, “ACSI: Retailers Improve Customer Satisfaction Amid Store Closings,” 28 February 2017.


How Healthcare Reform Will Hurt Medical Professionals and Patients


The Affordable Care Act is a complex piece of legislation with multiple goals:

  • Universal access to health care regardless of pre-existing conditions17456_1269532813224_1076952025_30803996_7657050_n
  • Reduction of costs of health insurance by averaging costs between healthy and unhealthy individuals
  • Reduction in actual outlays for medical services by
    • Reducing use of expensive emergency room services
    • Screening and earlier identification and treatment or prevention of major illnesses

The “repeal” effort to date addresses none of these goals, and in fact backtracks on them.

In addition, there is a continuing expansion of “cost sharing,” a euphemism for the shifting of costs from employers to employees for those workers who have access to group health insurance.

Physicians saw increased office traffic in 2016, but this is not likely to continue in the future.  Alicia Ault, writing for Medscape, comments,

Use and intensity of services and prices are the two biggest components of American health spending growth, the economists said. Overall use and intensity of healthcare goods and services continued to grow in 2016 as more people gained healthcare coverage through Medicare, Medicaid, or private insurance, and as disposable personal income rose. (1)

As the amount of money consumers have to spend for healthcare increases, their use of health services will decrease.  Economists with the Centers for Medicare and Medicaid Services (CMS, the agency that administers the Federal Marketplace as well as children’s programs) are expecting a reduction in use of physician services just in response to increased cost sharing, even without changes or repeal of the ACA.

Historical data show that greater cost sharing leads to less use of healthcare, Sean Keehan, a CMS economist, told Medscape Medical News. “People think twice about seeing the doctor if it’s going to be much more than it was before,” said Keehan, who is also lead author on the article in Health Affairs.(1)

Other factors will drive down use of health services over the next several years:

  1. Inflation which will reduce what consumers have available to spend
  2. Relatively stagnant wage growth, meaning that wages will not keep up with inflation

The CMS estimates are optimistic, excluding any impacts of ACA repeal.  A sharp increase in the number of people who cannot afford health insurance would be a game changer, and, frankly, could force some primary care physicians to close their practices.  The areas likely to see the greatest impact are poor and rural communities.

What you need to consider:

  • For most people, money is going to be a problem.  Do you need to improve or acquire skills to allow you to get a higher paying job?
  • Relocation to an area with better local public health services? 
  • How will you deal with older relative who may find themselves in trouble?


  1. Alicia Ault, Physician Services to Decline With More Cost-Sharing, CMS Says. Medscape. Feb 15, 2017.

What’s Your Next Career?


17456_1269532813224_1076952025_30803996_7657050_nAmericans don’t stay with the same employer, or even in the same career.  As White notes, it may be unrealistic to expect that given the number of years of work the average person will have.(1)  For the average person, work life will last more than 40 years, and more than 50 years for those going straight to work from high school.

According to the US Bureau of Labor Statistics (BLS), the average person holds 11.3 jobs between the age of 18 and 46.(2)  Half of these jobs are before age 25, but that still means an average of 4-5 years per job during the prime years of work life.

  • The BLS doesn’t track career changes.  That policy needs to change.

Some of the volatility in the workplace is voluntary, and some is forced.

  • As several studies have shown, people will change jobs to improve benefits, especially healthcare.
  • Of course people will change jobs for money.
  • Company layoffs can force people to find other lines of work.
  • Automation can eliminate jobs, and more of that is coming.
  • Ageism, and the desire of companies to reduce labor costs by dismissing the highest paid (and most experienced workers).

The jobs under threat span all classes of work:

  • Taxi drivers  (self-driving Uber cars)
  • Truck and bus drivers (yes, tests of self-driving tractor trailers are under way in Nevada, and a the Otto start-up in San Francisco, now owned by Uber, offers to retrofit trucks with driverless capability for $10,000 less than the average trucker salary)
  • Doctors — general practitioners (telemedicine)
  • Doctors — anesthesiologists (replacement by robots)
  • Store clerks and cashiers, grocery and fast food (more robots)
  • Statisticians (offshoring and automation)
  • Line cooks
  • Business analysts (offshoring and automation)
  • Auto mechanics (automation)
  • Masons and bricklayers (there’s a robot that can lay 2,000 bricks in 8 hours; the video is on You Tube)

There are issues with how rapidly job destruction through automation will occur.

  • Robots are expensive.
  • Robots aren’t as intelligent or as flexible as some of the people they replace, and that can lead to major problems for the company using them.
  • Legal liability for companies and individuals using robotics are not yet well defined. (3,4)

So, forecasts that up to half of US jobs could be eliminated by mid-century are probably sensationalist.

That said, there’s also a question about how fast the US can create new jobs to replace those being lost.  Right now, losses exceed job creation, which means that people are still downsizing into lower paying work.  That’s limited wage growth in the current economic cycle.

Elon Musk has argued that the government should be responsible for paying salaries to people whose jobs are lost to automation.

“There is a pretty good chance we end up with a universal basic income, or something like that, due to automation,” says Musk to CNBC. “Yeah, I am not sure what else one would do. I think that is what would happen.”(9)

That’s a vision of a world in which all labor intensive jobs have been automated and people who lose their jobs have no meaningful work options.  Happily, we’re not there yet.

What you need to know:

  • Whatever your job is now, there’s a good chance you won’t be in that job or even that type of work five or ten years from now.  Even tenured teaching positions can be eliminated (8).
  • So, what do you want to do next?  What skills or education do you need for that?  You need a plan. NOW!
  • Education and training for advancement in your current job or career is tax deductible.  Education and training for a career change is not.  That needs to change.  Time to complain to your Congressman.


  1. Mary White, “Career Change Statistics,” undated.
  2. US Bureau of Labor Statistics, “Number of Jobs Held, Labor Market Activity, and Earnings Growth Among the Youngest Baby Boomers: Results from a Longitudinal Survey Summary”, press release, 31 March 2015.
  3. Casey Sullivan, “Is It Time to Grant Legal Rights to Robots? What About Legal Liability?” FindLaw, 29 August 2016.
  4. Mady Delvaux, “DRAFT REPORT with recommendations to the Commission on Civil Law Rules on Robotics” (2015/2103(INL)), European Parliament, 31 May 2016.
  5., “9 Jobs Most Likely to be Taken Over by Robots,” undated.
  6. Olivia Solon, “Self-driving trucks: what’s the future for America’s 3.5 million truckers?”, The Guardian, 17 June 2016.
  7. Gavey Alba, “Amazon’s Real Future Isn’t Drones. It’s Self-Driving Trucks,” Wired, 20 December 2016.
  8. National Education Association, “The Truth About Tenure in Higher Education,” undated.
  9. Catherine Clifford,”Elon Musk: Robots will take your jobs, government will have to pay your wage,” CNBC 4 November 2016.

Child Abuse Awareness

From Lyn’s blog

Who Protects the Child?
©Lyn Crain
Denial, not my daughter or son
They wouldn’t hit anyone
Maybe they yell at lot
Or sometimes give a swat.But that is not abuse
Where do people get these views?

Based on the unique number of victims, an estimated 78 percent (78.3) suffered neglect, an estimated 18 percent (17.6) were physically abused, an estimated 9 percent (9.2) were sexually abused, an estimated 8 percent (8.1) were psychologically maltreated, and an estimated 2 percent (2.4) were medically neglected. In addition, an estimated 10 percent of the victims (10.3) experienced “other” types of maltreatment such as “abandonment,” “threats of harm to the child,” and “congenital drug addiction.”


via Child Abuse Awareness — lyncrain

Land of Opportunity, Revisited


In a post earlier this month, I commented on the declining mobility of American society.  Why that matters is that job growth in the recovery from the Great Recession of 2008 has been uneven. So has growth in personal income.  Is where you are the best place to be?

The areas with the highest rate of job growth, for the most part, simply aren’t where the people are.

The five largest states in terms of population are (Census, July 1, 2016 estimate)

  1. California  39,250,017
  2. Texas  27,862,596
  3. Florida  20,612,439
  4. New York  19,745,289
  5. Illinois 12,801,539

The five top states for job growth are

  1. North Dakota  20.7%
  2. Texas  15.3%
  3. Utah  13.6%
  4. Colorado  11.8%
  5. Washington  9.8%

Washington is the anomaly.  There has been sufficient migration, largely from California, such that despite growth, the unemployment rate has increased.

If we rank the states in actual numbers of jobs gained, the big winners are

  1. Texas  1,612,800 jobs
  2. California  1,134,100
  3. New York  644,800
  4. Florida  531,100
  5. Massachusetts  272,000

For every winner, there’s a loser.  The five states that have lost the most jobs since the Great Recession are

  1. Wyoming   -5.2%
  2. Mississippi  -2.3%
  3. New Mexico -2.2%
  4. Alabama  -1.9%
  5. Connecticut  -1.6%

Of course, percentages don’t tell the whole story.  Wyoming has a smaller economy than Connecticut, so a loss of 15,400 jobs is a high percentage of total jobs in Wyoming than a loss of 27,300 jobs is in Connecticut.

Job growth doesn’t correspond to income growth.  Texas shows high job growth spi0616coupled recently with declining per capita income.  Maine has a declining population but is showing good per capita income growth, in part due to a shortage of workers.

In some states, there’s a clear logic to people staying put.  In California, the out-migration is probably more due to housing costs than jobs, even though it will make it harder for employers to keep jobs filled.  However, there are good reasons for people to be leaving the deep South and areas of the Plains and West.  Mississippi is a particular problem as the data I’ve posted shows that they don’t fund social services, don’t fund schools and don’t do an adequate job of providing work for residents.

What we don’t know is the size of the Gray Economy in each state.  That’s employment that’s off the books — that people try to hide from the IRS.  It exists and is potentially large.  A poster child for that is a news stand in NYC that was reporting $30,000 in annual sales and conducting $800,000 in off the books drug sales annually.  (Sadly, I read this years ago in The New York Times and can’t find the citation for it.)



Alcohol — Statistical Oddity


24/7WallStreet has people who browse public data and can be fun reading.  (No, I don’t pay steinattention to their stock tips, so I can’t comment on them.)

The latest is a review of “self-reported binge and heavy drinking rates among adults in U.S. metro areas from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.”

You can understand the involvement of UW in this when you notice that 11 of the 20 heaviest drinking Metropolitan Statistical Areas in the US are in Wisconsin.  The number 1 MSA in the country for excessive alcohol use is Appleton, WI.

In context, there are more than 3300 MSAs in the US.  Having this concentration in Wisconsin is not a random event.

I grew up aware of an association between Milwaukee and beer, but this is ridiculous.