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Gun Violence as a Public Health Issue
Gun violence is a public health problem, but we don’t approach it like one. The debate often gets framed as “guns or no guns” when it isn’t that black and white. In this episode we break down how and why to approach gun violence as a public health problem, what the current research has to say, and what we need to move forward.
Sick and struggling to pay, 100 million people in the U.S. live with medical debt
https://www.npr.org/sections/health-shots/2022/06/16/1104679219/medical-bills-debt-investigation
Elizabeth Woodruff drained her retirement account and took on three jobs after she and her husband were sued for nearly $10,000 by the New York hospital where his infected leg was amputated.
Ariane Buck, a young father in Arizona who sells health insurance, couldn’t make an appointment with his doctor for a dangerous intestinal infection because the office said he had outstanding bills.
Allyson Ward and her husband loaded up credit cards, borrowed from relatives, and delayed repaying student loans after the premature birth of their twins left them with $80,000 in debt. Ward, a nurse practitioner, took on extra nursing shifts, working days and nights.
“I wanted to be a mom,” she said. “But we had to have the money.”
The three are among more than 100 million people in America ― including 41% of adults ― beset by a health care system that is systematically pushing patients into debt on a mass scale, an investigation by KHN and NPR shows.
The investigation reveals a problem that, despite new attention from the White House and Congress, is far more pervasive than previously reported. That is because much of the debt that patients accrue is hidden as credit card balances, loans from family, or payment plans to hospitals and other medical providers.
To calculate the true extent and burden of this debt, the KHN-NPR investigation draws on a nationwide poll conducted by KFF (Kaiser Family Foundation) for this project. The poll was designed to capture not just bills patients couldn’t afford, but other borrowing used to pay for health care as well. New analyses of credit bureau, hospital billing, and credit card data by the Urban Institute and other research partners also inform the project. And KHN and NPR reporters conducted hundreds of interviews with patients, physicians, health industry leaders, consumer advocates, and researchers.
The picture is bleak.
Where medical debt hits the hardest in the U.S.
The share of people with medical or dental bills in collections varies widely from one county to another
In the past five years, more than half of U.S. adults report they’ve gone into debt because of medical or dental bills, the KFF poll found.
A quarter of adults with health care debt owe more than $5,000. And about 1 in 5 with any amount of debt said they don’t expect to ever pay it off.
“Debt is no longer just a bug in our system. It is one of the main products,” said Dr. Rishi Manchanda, who has worked with low-income patients in California for more than a decade and served on the board of the nonprofit RIP Medical Debt. “We have a health care system almost perfectly designed to create debt.”
The burden is forcing families to cut spending on food and other essentials. Millions are being driven from their homes or into bankruptcy, the poll found.
Medical debt is piling additional hardships on people with cancer and other chronic illnesses. Debt levels in U.S. counties with the highest rates of disease can be three or four times what they are in the healthiest counties, according to an Urban Institute analysis.
The debt is also deepening racial disparities.
And it is preventing Americans from saving for retirement, investing in their children’s educations, or laying the traditional building blocks for a secure future, such as borrowing for college or buying a home. Debt from health care is nearly twice as common for adults under 30 as for those 65 and older, the KFF poll found.
Perhaps most perversely, medical debt is blocking patients from care.
About 1 in 7 people with debt said they’ve been denied access to a hospital, doctor, or other provider because of unpaid bills, according to the poll. An even greater share ― about two-thirds ― have put off care they or a family member need because of cost.
“It’s barbaric,” said Dr. Miriam Atkins, a Georgia oncologist who, like many physicians, said she’s had patients give up treatment for fear of debt.
Patient debt is piling up despite the landmark 2010 Affordable Care Act.
The law expanded insurance coverage to tens of millions of Americans. Yet it also ushered in years of robust profits for the medical industry, which has steadily raised prices over the past decade.
Hospitals recorded their most profitable year on record in 2019, notching an aggregate profit margin of 7.6%, according to the federal Medicare Payment Advisory Committee. Many hospitals thrived even through the pandemic.
But for many Americans, the law failed to live up to its promise of more affordable care. Instead, they’ve faced thousands of dollars in bills as health insurers shifted costs onto patients through higher deductibles.
Now, a highly lucrative industry is capitalizing on patients’ inability to pay. Hospitals and other medical providers are pushing millions into credit cards and other loans. These stick patients with high interest rates while generating profits for the lenders that top 29%, according to research firm IBISWorld.
Patient debt is also sustaining a shadowy collections business fed by hospitals ― including public university systems and nonprofits granted tax breaks to serve their communities ― that sell debt in private deals to collections companies that, in turn, pursue patients.
“People are getting harassed at all hours of the day. Many come to us with no idea where the debt came from,” said Eric Zell, a supervising attorney at the Legal Aid Society of Cleveland. “It seems to be an epidemic.”
In debt to hospitals, credit cards, and relatives
America’s debt crisis is driven by a simple reality: Half of U.S. adults don’t have the cash to cover an unexpected $500 health care bill, according to the KFF poll.
As a result, many simply don’t pay. The flood of unpaid bills has made medical debt the most common form of debt on consumer credit records.
As of last year, 58% of debts recorded in collections were for a medical bill, according to the Consumer Financial Protection Bureau. That’s nearly four times as many debts attributable to telecom bills, the next most common form of debt on credit records.
But the medical debt on credit reports represents only a fraction of the money that Americans owe for health care, the KHN-NPR investigation shows.
- About 50 million adults ― roughly 1 in 5 ― are paying off bills for their own care or a family member’s through an installment plan with a hospital or other provider, the KFF poll found. Such debt arrangements don’t appear on credit reports unless a patient stops paying.
- One in 10 owe money to a friend or family member who covered their medical or dental bills, another form of borrowing not customarily measured.
- Still more debt ends up on credit cards, as patients charge their bills and run up balances, piling high interest rates on top of what they owe for care. About 1 in 6 adults are paying off a medical or dental bill they put on a card.
How much medical debt Americans have in total is hard to know because so much isn’t recorded. But an earlier KFF analysis of federal data estimated that collective medical debt totaled at least $195 billion in 2019, larger than the economy of Greece.
The credit card balances, which also aren’t recorded as medical debt, can be substantial, according to an analysis of credit card records by the JPMorgan Chase Institute. The financial research group found that the typical cardholder’s monthly balance jumped 34% after a major medical expense.
Monthly balances then declined as people paid down their bills. But for a year, they remained about 10% above where they had been before the medical expense. Balances for a comparable group of cardholders without a major medical expense stayed relatively flat.
It’s unclear how much of the higher balances ended up as debt, as the institute’s data doesn’t distinguish between cardholders who pay off their balance every month from those who don’t. But about half of cardholders nationwide carry a balance on their cards, which usually adds interest and fees.
Bearing the burden of debts large and small
For many Americans, debt from medical or dental care may be relatively low. About a third owe less than $1,000, the KFF poll found.
Even small debts can take a toll.
Edy Adams, a 31-year-old medical student in Texas, was pursued by debt collectors for years for a medical exam she received after she was sexually assaulted.
Adams had recently graduated from college and was living in Chicago.
Police never found the perpetrator. But two years after the attack, Adams started getting calls from collectors saying she owed $130.58.
Illinois law prohibits billing victims for such tests. But no matter how many times Adams explained the error, the calls kept coming, each forcing her, she said, to relive the worst day of her life.
Sometimes when the collectors called, Adams would break down in tears on the phone. “I was frantic,” she recalled. “I was being haunted by this zombie bill. I couldn’t make it stop.”
Health care debt can also be catastrophic.
Sherrie Foy, 63, and her husband, Michael, saw their carefully planned retirement upended when Foy’s colon had to be removed.
After Michael retired from Consolidated Edison in New York, the couple moved to rural southwestern Virginia. Sherrie had the space to care for rescued horses.
The couple had diligently saved. And they had retiree health insurance through Con Edison. But Sherrie’s surgery led to numerous complications, months in the hospital, and medical bills that passed the $1 million cap on the couple’s health plan.
When Foy couldn’t pay more than $775,000 she owed the University of Virginia Health System, the medical center sued, a once common practice that the university said it has reined in. The couple declared bankruptcy.
Illinois law prohibits billing victims for such tests. But no matter how many times Adams explained the error, the calls kept coming, each forcing her, she said, to relive the worst day of her life.
Sometimes when the collectors called, Adams would break down in tears on the phone. “I was frantic,” she recalled. “I was being haunted by this zombie bill. I couldn’t make it stop.”
Nearly half of Americans in households making more than $90,000 a year have incurred health care debt in the past five years, the KFF poll found.
Women are more likely than men to be in debt. And parents more commonly have health care debt than people without children.
But the crisis has landed hardest on the poorest and uninsured.
Debt is most widespread in the South, an analysis of credit records by the Urban Institute shows. Insurance protections there are weaker, many of the states haven’t expanded Medicaid, and chronic illness is more widespread.
Nationwide, according to the poll, Black adults are 50% more likely and Hispanic adults 35% more likely than whites to owe money for care. (Hispanics can be of any race or combination of races.)
In some places, such as the nation’s capital, disparities are even larger, Urban Institute data shows: Medical debt in Washington, D.C.’s predominantly minority neighborhoods is nearly four times as common as in white neighborhoods.
In minority communities already struggling with fewer educational and economic opportunities, the debt can be crippling, said Joseph Leitmann-Santa Cruz, chief executive of Capital Area Asset Builders, a nonprofit that provides financial counseling to low-income Washington residents. “It’s like having another arm tied behind their backs,” he said.
Medical debt can also keep young people from building savings, finishing their education, or getting a job. One analysis of credit data found that debt from health care peaks for typical Americans in their late 20s and early 30s, then declines as they get older.
Cheyenne Dantona’s medical debt derailed her career before it began.
Dantona, 31, was diagnosed with blood cancer while in college. The cancer went into remission, but when Dantona changed health plans, she was hit with thousands of dollars of medical bills because one of her primary providers was out of network.
She enrolled in a medical credit card, only to get stuck paying even more in interest. Other bills went to collections, dragging down her credit score. Dantona still dreams of working with injured and orphaned wild animals, but she’s been forced to move back in with her mother outside Minneapolis.
“She’s been trapped,” said Dantona’s sister, Desiree. “Her life is on pause.”
The strongest predictor of medical debt
Desiree Dantona said the debt has also made her sister hesitant to seek care to ensure her cancer remains in remission.
Medical providers say this is one of the most pernicious effects of America’s debt crisis, keeping the sick away from care and piling toxic stress on patients when they are most vulnerable.
The financial strain can slow patients’ recovery and even increase their chances of death, cancer researchers have found.
Yet the link between sickness and debt is a defining feature of American health care, according to the Urban Institute, which analyzed credit records and other demographic data on poverty, race, and health status.
U.S. counties with the highest share of residents with multiple chronic conditions, such as diabetes and heart disease, also tend to have the most medical debt. That makes illness a stronger predictor of medical debt than either poverty or insurance.
In the 100 U.S. counties with the highest levels of chronic disease, nearly a quarter of adults have medical debt on their credit records, compared with fewer than 1 in 10 in the healthiest counties.
The problem is so pervasive that even many physicians and business leaders concede debt has become a black mark on American health care.
“There is no reason in this country that people should have medical debt that destroys them,” said George Halvorson, former chief executive of Kaiser Permanente, the nation’s largest integrated medical system and health plan. KP has a relatively generous financial assistance policy but does sometimes sue patients. (The health system is not affiliated with KHN.)
Halvorson cited the growth of high-deductible health insurance as a key driver of the debt crisis. “People are getting bankrupted when they get care,” he said, “even if they have insurance.”
What the federal government can do
The Affordable Care Act bolstered financial protections for millions of Americans, not only increasing health coverage but also setting insurance standards that were supposed to limit how much patients must pay out of their own pockets.
By some measures, the law worked, research shows. In California, there was an 11% decline in the monthly use of payday loans after the state expanded coverage through the law.
But the law’s caps on out-of-pocket costs have proven too high for most Americans. Federal regulations allow out-of-pocket maximums on individual plans up to $8,700.
Additionally, the law did not stop the growth of high-deductible plans, which have become standard over the past decade. That has forced growing numbers of Americans to pay thousands of dollars out of their own pockets before their coverage kicks in.
Last year the average annual deductible for a single worker with job-based coverage topped $1,400, almost four times what it was in 2006, according to an annual employer survey by KFF. Family deductibles can top $10,000.
While health plans are requiring patients to pay more, hospitals, drugmakers, and other medical providers are raising prices.
From 2012 to 2016, prices for medical care surged 16%, almost four times the rate of overall inflation, a report by the nonprofit Health Care Cost Institute found.
For many Americans, the combination of high prices and high out-of-pocket costs almost inevitably means debt. The KFF poll found that 6 in 10 working-age adults with coverage have gone into debt getting care in the past five years, a rate only slightly lower than the uninsured.
Even Medicare coverage can leave patients on the hook for thousands of dollars in charges for drugs and treatment, studies show.
About a third of seniors have owed money for care, the poll found. And 37% of these said they or someone in their household have been forced to cut spending on food, clothing, or other essentials because of what they owe; 12% said they’ve taken on extra work.
The growing toll of the debt has sparked new interest from elected officials, regulators, and industry leaders.
In March, following warnings from the Consumer Financial Protection Bureau, the major credit reporting companies said they would remove medical debts under $500 and those that had been repaid from consumer credit reports.
In April, the Biden administration announced a new CFPB crackdown on debt collectors and an initiative by the Department of Health and Human Services to gather more information on how hospitals provide financial aid.
The actions were applauded by patient advocates. However, the changes likely won’t address the root causes of this national crisis.
“The No. 1 reason, and the No. 2, 3, and 4 reasons, that people go into medical debt is they don’t have the money,” said Alan Cohen, a co-founder of insurer Centivo who has worked in health benefits for more than 30 years. “It’s not complicated.”
Buck, the father in Arizona who was denied care, has seen this firsthand while selling Medicare plans to seniors. “I’ve had old people crying on the phone with me,” he said. “It’s horrifying.”
Now 30, Buck faces his own struggles. He recovered from the intestinal infection, but after being forced to go to a hospital emergency room, he was hit with thousands of dollars in medical bills.
More piled on when Buck’s wife landed in an emergency room for ovarian cysts.
Today the Bucks, who have three children, estimate they owe more than $50,000, including medical bills they put on credit cards that they can’t pay off.
“We’ve all had to cut back on everything,” Buck said. The kids wear hand-me-downs. They scrimp on school supplies and rely on family for Christmas gifts. A dinner out for chili is an extravagance.
“It pains me when my kids ask to go somewhere, and I can’t,” Buck said. “I feel as if I’ve failed as a parent.”
The couple is preparing to file for bankruptcy.
About This Project
Diagnosis: Debt is a reporting partnership between KHN and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on the “KFF Health Care Debt Survey,” a poll designed and analyzed by public opinion researchers at KFF in collaboration with KHN journalists and editors. The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses.
Reporters from KHN and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
Do Higher Hospital Prices Reflect Greater Investments in Quality?
Private insurers pay high and rising prices to hospitals. But whether this is “good” or “bad” depends on what’s behind this phenomenon. Do high prices reflect investments in quality? Or do they instead reflect issues like lack of competition due to hospital consolidation? The answer matters for efforts to reduce health care spending.
In a new paper in the Journal of Health Economics, Craig Garthwaite, Christopher Ody and Amanda Starc investigated whether the prospect of financial rewards drove differences in hospital quality measures — including things like mortality rates, patient experience, technology adoption and emergency department wait times. Specifically, the authors’ examined whether hospitals are more likely to invest in quality if they will be rewarded through higher prices. This is more feasible if they’re serving lots of commercially insured patients, since private insurers may pay higher rates if patients value those hospitals. But that strategy may not be successful in areas with large shares of the population on Medicare and Medicaid, which do not negotiate prices.
The researchers found that:
- Hospitals in areas with more privately insured patients had higher quality scores compared to hospitals with more publicly insured patients.
- Hospitals targeting more privately insured patients also had higher costs than those relying more on payers like Medicare and Medicaid.
These results suggest hospitals make strategic investments in quality to attract privately insured patients. This is consistent with what one might expect from market competition and the results of other recent research. These findings do not, however, imply that prices are “optimal.” Prices also reflect factors like provider consolidation that have little observable effects on quality. Indeed, hospital prices likely reflect a mix of valuable and wasteful spending.
The analysis does have limitations. The authors used the demographics of the areas around the hospital instead of each hospital’s actual potential mix of patients. In addition, it is possible that some quality differences across hospitals actually reflect differences between patients with private and public insurance which aren’t easy to capture in data. However, the authors’ results were similar across several quality measures, including those where this is less of a concern.
These results can help better inform efforts to reduce health care costs. Policymakers interested in reducing hospital prices should be aware that doing so might reduce investments in quality. This suggests placing a greater emphasis on policies that target prices stemming from clear sources of inefficiencies, like consolidation, since such tradeoffs are likely smaller.
People with these traits succeed–‘not the smartest or hardest-working in the room’
According to Jamie Dimon, chairman and CEO of JPMorgan Chase, the most successful leaders have certain key traits.
″[H]umility, openness, fairness [and] being authentic” are most important – “not [being] the smartest person in the room or the hardest working person in the room,” Dimon, who runs the nation’s largest bank and oversees more than 250,000 employees globally, told LinkedIn editor in chief Daniel Roth in a recent video.
“Management is: Get it done, follow-up, discipline, planning, analysis, facts, facts, facts. It’s [getting] the right people in the room, kill the bureaucracy, all of these various things,” Dimon told Roth. “But the real keys to leadership aren’t just doing that.”
It’s about having “respect for people,” not about having “charisma” or “brain power,” he said.
Having these traits also increases your productivity, along with your success, Dimon said. If you’re “selfish” or “take the credit” when it isn’t warranted, others are “not going to want to work,” which will impact efficiency on the job.
Dimon also looks for these things when hiring, he said in July. When interviewing or assessing a promotion, Dimon asks himself a few questions about the candidate, including, “Would you work for that person? Would you want your kid to work for that person?”
He also considers whether they “take the blame” or “how they act anytime something goes wrong.”
In his role as CEO, Dimon said he tries to practice what he preaches.
“No one would say Jamie Dimon is humble,” he said in July, “but I treat everyone the same, and I expect the same thing. You’d want to work for me if you think I give a s—, if I treat you fairly, if I treat everyone equally.”
To achieve success, “treat people the way you want to be treated,” Dimon told Roth. “Have respect for people.”
The lost art of compromise
In nearly every facet of our lives, all of us are routinely put in the position of trying to settle disputes or disagreements, whether it be with our spouses or significant others, our children, our siblings, co-workers, neighbors, contractors — you name it. It’s part of everyday life. Conflicts arise and we figure out how to resolve them.
Unfortunately, in the politically toxic environment in which we now live, compromise is now perceived as a sign of weakness. Elected leaders are routinely criticized and attacked by fellow party members and their constituents for trying to find middle ground on any issue, particularly those rooted in ideology. The bipartisan agreement reached in Congress last week on gun safety was a rare and welcome exception.
While they hold starkly different positions and come from states that are thousands of miles apart geographically and politically, Senators Chris Murphy, D-Conn., an outspoken proponent of stronger gun safety laws, and John Cornyn, R-Texas, a staunch Second Amendment advocate, found a way to set aside their differences and reach compromise on the so-called Bipartisan Safer Communities Act that was approved by the Senate 65-33 and the House by a margin of 234-193. President Joe Biden signed the legislation into law June 25.
While the new law does not go nearly as far as Senator Murphy and most of his fellow Democrats wanted by, for instance, banning the sale of assault rifles or at least increasing the age to buy them, the willingness to finally get something done after 30 years of Congressional gridlock was a long-overdue victory for common sense.
Bipartisanship has also been evident in Congressional support for military funding for Ukraine and the 2021 Infrastructure Investment and Jobs Act, but little else.
Despite the glimmer of progress in our nation’s legislative branch of government, it appears that polarization now has a firm grip on our nation’s top court. In trying to find middle ground in deliberations on Roe v. Wade, U.S. Supreme Court Chief Justice John Roberts sought this compromise with his five fellow conservatives and three liberals on the bench: support Mississippi’s prohibition against abortion after 15 weeks, but preserve some semblance of reproductive rights for women by not overturning Roe v. Wade or the court’s 1992 ruling in Planned Parenthood v. Casey.
“The Court’s decision to overrule Roe and Casey is a serious jolt to the legal system — regardless of how you view those cases,” Roberts wrote. His incremental approach found no takers among his entrenched colleagues on either the right or the left. Hence, constitutional protections for abortions that had stood for nearly 50 years — and are supported by the vast majority of Americans — were stripped away in a 5-4 vote, leaving the power to individual states.
Unfortunately, bipartisanship can be equally elusive in state capitals around the country, which does not bode well for reproductive rights advocates in 21 states where abortion is now illegal or have “trigger bans” that will take effect within 30 days of the Supreme Court’s June 24 ruling.
Regardless of whether the issue is abortion or other divisive topics such as immigration, gun safety, voting rights, bail reform or LGBTQ rights, governors and state legislators of one controlling party or another routinely dig in and take intractable positions, leaving little or no room for negotiation.
We would all be well served to reintroduce ourselves to the art of compromise, for the good of our family relationships, for the good of our respective professions, for the good of our country and society in general, and even for the good of our own personal health as we consider whether to consume that extra helping of food or another cocktail.
Moderation is key in our lifestyle choices and it could also go a long way in trying to find middle ground with those who have differing opinions. If adversaries are truly motivated to do the right thing, not political gamesmanship, they should always choose their words carefully, listen with an open mind and always be open to making concessions. In short, we should all start by embracing civility.
These are the questions candidates must ask during a job interview
Job seeking is a grueling process, but it is also an opportunity to put your best foot forward in order to find a company that is the best fit for you.
Although it can be nerve wracking to sit through one interview after another, candidates should remind themselves that these interactions are a two-way street, and they have every right to ask challenging questions to make a decision, should the offer come.
Here are the critical questions you as a candidate must ask during a job interview—because remember, you’re interviewing the employer, too.
QUESTIONS TO ASK YOURSELF BEFORE APPLYING FOR THE JOB
Before setting off on your job search, make a list of the types of companies you’re interested in.
- Is this a place you see yourself thriving in?
- Do you believe in the mission?
- Why do you want to work at this place?
- What attracts you about the organization?
Oftentimes, our current situations dictate how we go about making our next move. Perhaps you’re working in an environment that you find suffocating and want out, or you’re seeking more responsibilities, or are looking to become a people manager.
Whatever the case, be sure to keep in mind that in every new workplace, there will be pros and cons, no matter the salary or job description. So be cognizant of all the aspects of a new role that are truly important to you; also, be mindful of what your personal dealbreakers are.
PREPARE A LIST OF STRATEGICALLY PLANNED QUESTIONS
Interviewing is a two-way exchange. While candidates are being scrutinized by the potential employer, the skilled candidate will have an opportunity to evaluate the company based on the flow of the conversation.
Typically, candidates aren’t given the opportunity to ask questions until the very end of the interview. That’s not to say there aren’t ways to integrate specific queries into the conversation, as long as you remember that you’ll get full control of the floor in the grand finale.
In a previous Fast Company story, Patrick Mullane, executive director of Harvard Business School Online, shares how interviewees often will drop the ball when the interviewer tosses out the famous line, “Do you have any questions for me?”
“Candidates forget that when they’re given control of the discussion, it’s an opportunity to do two very important things. First, it’s a chance to learn something genuinely useful about the firm you might be joining. Second, you get to show that you’re thoughtful and conscientious,” he said. “Both are hugely important as you look to make a change. Don’t waste the opportunity.”
When it comes to the questions candidates typically ask companies during an interview, the “big three” revolve around corporate culture, the interviewer’s personal experience (“How have you liked working here?”), and growth.
Rather than default on these inquiries (which interviewers likely receive quite often and may respond in kind with generic answers), Mullane challenged candidates to take these questions and reframe them in a more thoughtful, strategic way:
Culture questions: Rather than asking, “What’s the culture like here,” ask something along the lines of, “Can you share a time when the company’s culture made you excited to work here or helped you during a challenging time?” This bypasses a typical answer like “It’s collaborative,” and dives into the intersection of employees and culture, offering an in-depth look into a specific, and perhaps relatable, scenario.
Personal experience questions: Instead of “How do you like working here?” try, “I noticed you left X company for this one. What convinced you to make the jump?” This reframing achieves two things: It shows the interviewer you did your research and gives you insight into their decision-making, which may help you make your own.
Company growth questions: A question like, “I noticed the company is growing rapidly. Do you expect that to continue?” will often bear a generic, dead-end answer. To get additional, more useful information, put a spin on it. Ask something like, “I noticed the company is expanding rapidly. Is this putting a strain on your customer service team?” Getting information on a company’s financials is not particularly difficult, especially if it is already publicly traded. But asking a question of this nature is especially useful if you are interviewing for a role like Customer Success Manager, as it allows you to get a better sense of how growth impacts the day-to-day of the team.
Overall, it will only work in your favor when you do your due diligence in gathering intelligence on the company you are interviewing for; also, you’ll be setting yourself up for success by having prepared questions that lead to a conversation and present yourself as a thoughtful and conscientious candidate.
“In a hot job market, it’s tempting to be lazy when doing the upfront work to prepare for an interview,” said Mullane. “It’s easy to figure that the interview is over when the person interviewing you gives you the floor. But it’s not. Asking better questions in the right way can significantly increase the chances you’ll not only impress the interviewer, but also gain valuable insights that can help you decide if the position is right for you.”
COVER THE BASICS
It can be easy to get caught up in nerves when interviewing for a company you are extremely attracted to—or even in general. Interviewing is a lot of pressure!
However, when preparing to ask your questions, the areas that you as a candidate must focus on should give you a well-rounded perspective on multiple aspects of the company, not just the specific job description.
This Fast Company article shared a roundup of all the pertinent focus areas that your questions should fall under to get you the best answers, which include:
- The specific role you are interviewing for
- The management style of your would-be boss or team
- Company culture and reputation
- What performance metrics look like
- What kind of colleagues you can expect to work with
- Opportunities for growth
ASK TOUGH BUT FAIR HIGH-LEVEL QUESTIONS
Sometimes it’s not enough to consider the high-level questions, such as salary and work culture. Many of us are in a unique position in life, whether that involves our personal situations, families, health, or other concerns.
When considering your interest in a company, it’s helpful to understand how they can help or support you as an individual beyond your contributions to the job.
On the flip side, you’ll want to know other aspects of internal support for employees. How does this company support internal mobility? How do managers deliver feedback? In other words, what will a day in the life of this role really be like?
Prepare to ask the employer a series of questions tailored to your situation. FlexJobs’ team of career coaches offers guidance in this Fast Company story, including specific inquiries to ask your interviewer, such as:
- Why is this position available? This can give you some insight into the way things are handled at the company. Was someone fired? Are they unable to keep the position filled because of the workload?
- What makes it a great day at work, and what makes it a challenging day? Answers to this question can vary depending on the personal experience of the interviewer, but it’s good to get a sense of how they approach the question.
- How are criticism and feedback handled within the team? Mistakes can happen, and knowing that managers on the team can handle employee errors with grace will offer a sense of relief rather than unnecessary conflict when they do occur.
- Do you have any Employee Resource Groups (ERGs)? How do they support the company’s DEI plans? This question gives you an opportunity to understand where the company stands in terms of diversity, equity, and inclusion (DEI) and how well they support the objectives of ERGs, as well as pushing forward their higher-level strategy.
- How does the company approach salary differences? This can highlight whether the company pays people differently based on location, if they work remotely, in-office, or hybrid. It can also shed light on whether the company has done a pay audit to achieve equity, especially for women and underrepresented groups.
- What’s the company’s approach to supporting work-life balance? Many companies have put forth specific benefits and incentives to support employees in the past two years, including mental health initiatives, fitness classes, therapy, and flexibility. This critical question will help you determine just how the company views employees as individuals and not just by their work output.
An example of a tough conversation to navigate can pertain to how the organization supports employees in specific work situations. If this particular job requires you to relocate, an example of how to navigate the question of moving-cost accommodations might go something like this:
Candidate (C): I noticed this position is based in San Francisco. Is there an option for potential hires to work remotely?
Interviewer (I): I’m afraid our new company policy is to operate on a hybrid schedule. This particular role is based in the Bay Area and requires the individual to come into work three times a week.
C: I understand. Sometimes companies need to make tough decisions based on their needs.
I: Do you think you would be willing to relocate, should we decide to move forward with your application?
C: I think this role is a wonderful opportunity for me, and I truly believe my personal values align with those of this company and its culture. If all goes well, I’d like to learn what the company’s budget is in regards to supporting moving and transition costs.
In this scenario, the interviewer is honest about the new hybrid model their company has adopted. If you, the candidate, are first learning about this aspect during the interview, it’s important to ask direct questions about how the company plans to support potential moving costs, rather than framing the question in a way that offers a loophole or an out.
Organizations are aware that with the plentiful options of remote jobs, finding talent willing to relocate or adopt a hybrid work life will be tougher. Know that the ball is in your court and be straightforward about expensed costs if you are willing to relocate.
WRAP UP THE INTERVIEW WITH THESE KEY QUESTIONS
This will likely be the last time you interact with this team member before either moving onto the next stage or the decision-making process.
In a prior Fast Company story, the founder of executive search firm The Mullings Group shares the best questions to ask when wrapping up.
Don’t let the conversation end without answers to the following questions, so you have enough information to help you reflect on and assess your experience and understanding of the company.
Am I a good fit for this company? The feeling needs to be mutual. Be sure to determine whether your skills, interests, personality, and goals align with the direction of the company.
What are the expected deliverables for this role over the next three months to a year? Depending on the role of the person you are interviewing with, you may get different answers. This is a good question to ask to get a sense of the priorities as it relates to different stakeholders.
How will we both know that I have succeeded in this role? This is another question in which the answers may vary, but it will be helpful for you as a candidate to understand how to work toward specific goals and measure your own impact so that, when it comes time for a raise or promotion in the future, you have the evidence to back it up.
What are the growth opportunities in this role, and what important skills will I learn? It’s not enough to make a lateral move. You need to know how will working for this company enable you to grow and thrive.
Who will I become? Your environment and the people you work with will directly influence your work output, ethic, and your future values. Asking questions about the kind of people you will interact with regularly will help you get a sense of what your day-to-day experiences will look like.
Getting a new job is a big deal. You will be working 40 hours a week in a specific environment that supports a certain culture and hires a certain type of colleague. It’s not just the job description that matters, nor the skill set the company requires to perform in that role. A new job is a combination of your livelihood, a commitment to learn and grow, and contribute.
Remember to be selective in your process because you’re interviewing your next employer, too.
HENRY KOTULA 