Health benefits, considered "fringe" when they were introduced in the American workplace more than fifty years ago, have become a core part of employee compensation packages. According to The American Workplace Report 2005 (executive summary, 11 pages, PDF; full report, available for a fee) of the Employment Policy Foundation, providing health and other benefits to employees while controlling costs has become a major challenge for employers. Healthcare costs rose 8.2 percent in 2004, nearly twice as fast as overall growth in the economy. The United States now spends almost twice as much per capita on health care annually as Canada or the United Kingdom. Only 10 percent of individuals are responsible for 60 percent of U.S. healthcare costs. To address this disparity, 51 percent of companies have adopted disease management programs, and another 30 percent plan to do so over the next year. The report looks at other healthcare containment strategies and benefits, including pension plans, paid leave, life insurance, disability, child- and eldercare benefits, and tuition-reimbursement programs.