Hey All:
Are you ticked that health care seems to be more expensive every year and that it pays for less and less? - Upset that your pregnancy is treated the same as a life threatening illness?
- Are you a small business owner who struggles to be able to offer competitive wages and health care for your workers?
- Are you a worker who has employer sponsored health care, but still ended up paying huge amounts of money out of pocket when you or a member of your family had an accident?
Many of us can relate to one or all of these stories. Today, Obama appointed Tom Daschle to spearhead the health care reform efforts int he United States. The plan is to get started ASAP. The White House Transition Team is looking for feedback about health care reform from Americans. P Lease remember that democracy is not a spectator sport! Make your voice heard here before Dec. 31, 2008:
http://change.gov/page/s/healthcareIf you need a little fodder to get you started feel free to borrow from what I wrote:
The reasons I care about health reform are as personal as the loss of my dear grandmother to preventable disease many years earlier than she needed to go and as global as wondering why a country that spends so much on medicine ranks so low in terms of population health. As a businessperson I also see that in America's current economy and society we've lost touch with food, community, with moving our bodies and this problem is not simply one of sloth, but of a system that on every level rewards the wrong behaviors - behaviors that ultimately don't lead to greater health and prosperity. Particularly I see this burden shouldered by poor people, people of color, small business and their employees - the very people who do the everyday work that has moved this country and economy. I very much appreciate this forum that you have created and hope that all Americans who are affected by this issue will make their voices and ideas heard.
I work in the field of preventative health but not with the same, tired, boring message that has been flatly ignored for years. Recently I was inspired by this campaign:
http://corporatewellnessprogram.recesswellness.com/2008/11/can-we-make-america-healthiest-nation.htmlI think it speaks to what is truly needed:
1 - The end to subsidization of insurance companies whose model is patently ridiculous. Current federal programs divert money to health plans that do not manage that money effectively. $50,000 to amputate a foot but not $40 for a nutrition class for a diabetic because the amputation is deemed more "effective"? This is insanity. I literally heard the CEO of a major Oregon health plan tell a room of 250 insurance brokers that "prevention doesn't work." From their business model's perspective this may be true, but from a societal perspective these are reckless words.
Having worked intimately with the behind the scenes claims and health reporting data from various health plans, the inefficiencies are rife. These organizations should be subject to standardized reporting of qualitative and quantitative claims/portfolio data - similar to SEC reports for publicly traded companies, but around various health benchmarks and other efficiency and quality of care metrics. These metrics should be publicly available so that we can truly evaluate the quality of managed care between carrier portfolios. Currently there is no telling which business is better run because the all quantify their metrics differently. It is MADDENING. With as much money and public well-being that is at stake I cannot believe how inefficiently the insurance industry is run, bench marked and evaluated. It's the wild wild west out there.
2 - HIPAA not only is not working the way it was intended, but is is a meaningless drain on health care providers. I say this not as a provider, which I am not, but as a consumer who thinks the mountains of paperwork and red tape are wasteful and environmentally destructive and as a business owner who knows how flimsy those stacks of paper really are in preventing health information from getting into the "wrong hands."
HIPAA is useless, a drain on time and resources that could be better spent on implementing IT and training the health professionals who use it. We also need a system where providers are rewarded for doing the right thing - referring patients to preventative programs and screens, social workers and triage prior to escalating preventable situations past the point of reason. Often, as is referenced above, this unfortunate situation stems from a lack of incentive for the health care provider since insurance companies will pay for costly, surgical treatments but may seldom fund prevention. I think all we need to do is look at the most profitable providers and business segments in health care to see the perversity of misplaced financial incentives on public health.
3 - Employers and private business pay more than a third of the total
cost of health care in the United States (and that is only when you don't count one of the biggest employers - the federal government). The cost of health care is a drain on the bottom line - to be sure - but employers are also in part responsible for the problem. Ultimately the CDC says that 75% of health care spending is on chronic, preventable illness. Many of these illnesses could be slowed or prevented through
better diet and exercise.
American workers work the longest hours of any industrialized nation. We spend most of our waking hours at work, have little time or energy outside of a long day of work to engage in our personal health. The solutions offered by many employers (normally health fairs, Web portals and other such nonsense offered for free through their health plan) are cheap, unimaginative and ineffective at encouraging better employee health. And these are the employers who are actually trying to make an impact.
Employers need tax incentives for putting in place effective,
multi-component health promotion programs that have
high levels of employee engagement. High levels of engagement (over 40% eligible) are key, as many programs that I have seen behind the scenes that are offered by employers tend to have low engagement (10% or less) and are usually used most by employees who are already healthy. This is not acceptable. The workplace is a very good place to offer healthy food and exercise alternatives and to encourage such behavior.
Those employers who are brave enough to recognize that this is not just a public service but that it also benefits the bottom line in terms of productivity, employment brand and absenteeism should be given a bit of a financial break in the early years of the program when it is less likely to show economic return. This could come in the form of tax credits or relief from paying into a health care fund (if that is the plan) if they show evidence of
mutli-component wellness programs with high engagement.
4 - Ask any American to name 5 whole grains. My guess is you will have a hard time finding many who can. We are completely out of touch with our food system, our bodies and our health as Americans. A study published in the Archives of Internal Medicine showed that if you took all of the Americans who: do not smoke, maintain a healthy weight, consume five or more fruits and vegetables per day, and exercise the surgeon’s general’s recommended 30 minutes 5 days per week, you’d have a whopping 3% of the US population.
We need an inspiring, fun, grassroots movement to work on building systems that connect eaters with local farmers, promoting whole foods, encouraging children to cook. We need a movement and an example from our leaders that helps bring back the American meal - enjoyed over the family table rather than the fast food counter. At the end of the day if we are going to turn this ship then we need people engaged and healthier. We can do a lot to shift costs and make the current broken system more efficient, but we must also shift the bedrock of disincentives to being healthy that we as a culture have in place. Investing a spirit of fun, adventure, service and goodwill into this (instead of the same, tired, sorry guy in a white lab coat approach of past public health messages) will capture the imagination and inspire.
I thank you for creating this forum to discuss a topic that is of central importance in my life and the lives of so many people. I believe that when we as humans are healthy that it improves everything in our lives - our vitality, our engagement in our world and so I am heartened by your efforts and hope I can be one of the many who make them a resounding success.
Sincerely,
Tanya Barham
CEO, Recess
recesswellness.com
Labels: corporate wellness, employee health, wellness at work
So within our current food system, the cheaper foods are also the most detrimental to our health.
