Steps to Right Healthcare
On the Front Line
While the healthcare debate continues to rage on at a national level, most employers continue to struggle with the increasing health-risk factors of their employees and rising financial trends each year.
Some employers question whether to relinquish these responsibilities to the government or to an insurance exchange. Employers committed to the productivity of their most important asset, their employees, wrestle with what to do next to keep costs under control. Some have added an account-based plan, shifted cost, and moved to incentives (or disincentives) to keep employees healthy. Yet, healthcare insurance costs are projected to increase 12 to13 percent next year.
Big Business versus Global Competition
Healthcare remains one of the most critical issues for America and American companies to address. Healthcare is a big business; it represents 17.5 percent of the GDP, and it is rising.
To remain competitive on a global scale, healthcare costs in other countries must be considered. In terms of U.S. dollars, other countries spend $2,000 to $3,000 per person a year on healthcare while the United States spends roughly $7,500 per person.
The current American healthcare system forces U.S. employers to fund a big business model which is projected to consume more and more of every dollar. Healthcare costs are a major challenge to global competition.
Question the Cost and Variation
Why is the per person cost of healthcare higher in America than in any other country in the world? Why do costs in some major metropolitan areas of the United States run as much as 30 percent higher than in other comparable U.S. urban markets? Quality of healthcare and related costs vary by physician and hospital. For example, in the Dallas-Fort Worth, Texas area, a by-pass procedure at a top quality hospital to treat a heart condition can range from $53,000 to $98,000. For further sake of comparison, in the same metro area, the cost of an MRI ranges from $600 to $2,000 with a similar services being performed. For patients with end-stage renal disease, kidney dialysis can range from $125,000 to $300,000.
Change the Mindset, Change the Approach
The widespread mentality has been that if a medical error occurs, insurance will cover the complication or duplication. Understandably, when life or death is at stake, few have questioned the cost. Those delivering value and quality have not been rewarded by a significant increase in patients. There have been no adverse consequences for healthcare providers who fail to offer competitive costs.
The current cure for rising costs is pre-authorization for procedures or pre-certification requirements. This only frustrates patients, network physicians and hospitals alike with increased administrative steps. This approach adds a layer of cost and delay. The true cost- driver, unhealthy lifestyles, has been ignored.
Aggressive workplace and lifestyle wellness efforts are essential for stopping the destruction of disease and for addressing the cost and quality of healthcare. When employers work with insurers and employees to define expectations from healthcare providers, they can produce the right outcomes in health improvement and cost.