Information about health care floods the media daily -- from hometown newspapers to the Internet. With that, there is quite a bit of advice on how to "fix" your company's health care problems.
But the solution to the so-called health care crisis has to come from employers and employees. The long-term solution will come from insurers, doctors, or the government.
Employers and employees will need to lead the way, yet some employers and most employees feel differently. Some employers don't want to face reality that they will have to do some heavy lifting.
Who can fix it?
The federal government cannot fix health care. And everyone agrees no single company can fix health care. It must be a combined effort by a lot of companies on a national level who get the federal and state governments to quit legislating health care as an entitlement.
Health care is a national problem; the federal government, corporations and workers should join forces to find ways to make the system more efficient. A key step would be to find out what is driving health care costs higher and weed out the system's inefficiencies.
Another important component would be to develop or acquire information technology expertise to help develop a system for keeping electronic medical records as another way of reducing costs.
Health savings accounts and health reimbursement accounts have emerged as a way to cut employers' costs while encouraging better employee utilization of health care services.
Other trends are emerging as well:
- The rate of change in information is increasing exponentially and creating information overload. So, historically, have corporations been able to better access and adapt to change and process information better than the federal government?
- As a percentage of GNP, health care costs and its infrastructure are growing faster than any other sector. Do you agree management at corporations has listed health care costs as a critical issue and the federal government cannot get Congress to make it the top priority?
- Employees and consumers want to make their own decisions about health care. Is that more the thinking of management at corporations or does the Congress and federal government really agree with that philosophy?
New York's "Fair Share for Healthcare Act" attempts to increase individual health care coverage through costly mandates on businesses. This proposal would ultimately cost employees up to 100,000 jobs and business more than $9 billion. This still leaves 83 percent of the uninsured without coverage. The devastating impacts of this bill are illustrated by an employment policies Institute-sponsored study conducted by University of Kentucky and economist Aaron Yelowitz. The study found that while only 17 percent -- 466,000 people -- of New Yorkers in need of health care coverage would be affected by the bill, businesses will be forced to pay for what is essentially redundant coverage for more than 586,000 insured New Yorkers.
Furthermore, since it would mandate redundant coverage for many already insured employees, the cost per newly insured employee could be as high as $19,617 a year.
"It's obvious that trying to remedy the health care crisis through employer mandates does little to address the problem of the uninsured," says EPI's John Doyle.
New York's mandate is ineffective, not to mention costly.
Massachusetts's mandated health care coverage will be successful in the long term after the first three years.
When a state mandates that certain coverages like maternity, unproven surgical procedures, designer drugs and mental health coverages must be included, then the ability to control health care costs is minimized. The Massachusetts proposal requires individuals buy certain health insurance and they claim it is like buying car insurance, passing the responsibility to the employee. The problem is car insurance does not require that you insure it for collision and repair-only for catastrophic incidents. The difference is clear, and you will see escalating costs in Massachusetts' health care after more than three years.
Can it work?
It is obvious the employee is slowly becoming more educated and interested in controlling his own health care destiny. For instance, a 2005 Blue Cross Blue Shield survey revealed 60 percent of Americans did their own research to make a more informed medical treatment decision. Nearly 95 percent who didn't said they would if they or other family members needed medical care. While 80 percent said they still talk to their primary medical provider, 70 percent of them say they still use the Internet as their basic research tool.
According to a Council for Affordable Health Insurance survey, Americans are ready to become better health care consumers, if given the proper tools.
Zogby International surveyed the public's attitude about the need for pricing disclosure in the health care system and whether consumers would take advantage of that information.
The nationwide poll of 1,209 interviews asked: "Do you agree or disagree that hospitals, doctors and pharmacies should publish their prices for all goods and services?" And 84 percent agreed, with only 14 percent dissenting. The survey also asked: "If you knew the prices a hospital, doctor, or pharmacy charges, how likely would you be to shop around for the best price?" Nearly 80 percent said they would be likely to shop for the best price (51 percent "very likely" and 28 percent "somewhat likely").
Today, Americans are used to seeing and comparing prices. The question is why would health care be an exception to the rule? It probably wouldn't be. People want to know how much it costs if they are paying for it. The transition to a consumer-driven health care society is imminent. The consumers know it. Do the health care providers know it, too?
The poll also found that: "Among those most likely to say they would shop around for the best price are Hispanics (89 percent), 20- to 34-year-olds (88 percent), and those earning between $25,000 and $35,000 a year (84 percent)."
It's true the federal government also is going to release pricing information, at www.medicare.gov. It will soon list prices the government pays for common procedures through Medicare, Medicaid, the Department of Defense and the Federal Employees Health Benefits Program. This price transparency and availability will help, but only if the end user or the employee/consumer uses that information to make better decisions.
Another example of an employer offering a creative solution to understanding health care pricing is eDoctorsOnline.com. eDoctorsOnline.com provides board-certified physicians, nurses, and psychologists 24 hours a day to answer all customers' health care questions. The service helps its members make better decisions regarding their own health care and can save unnecessary, expensive trips to the doctor. Questions are answered within 24 hours, guaranteed (generally in two to three hours).
Members also have access to the 24 hour Nurse Advice Line. All of the patient's medical information, questions and replies remain completely private and confidential.
The United Benefit Advisors survey also reveals the following:
"An astounding 99 percent of all employers consider both company health costs and the impact of higher costs on employees either a critical or significant concern," said David LoCascio, UBA's Co-Founder. "This level of concern following the lower, although still significant cost increases of the past two years implies little faith by employers that a real solution to the underlying drivers of healthcare costs has been found or implemented."
The No. 1 strategy to lower health care costs for the last five years has been either reducing plan benefits or increasing employee premium cost sharing.
But from all these surveys you can see the future strategy is consumer driven health care, which incorporate HRAs, HSAs, FSAs and wellness programs that use individual health risk assessments and expanded disease management programs to help employees manage chronic health conditions.
Consumer driven health care remains the best solution available to employees today.
