This is not a post about predicting the future.
I was asked to speak at the 25th anniversary celebration of the Dallas Fort Worth Business Group on Health. This group is one of a number of similar groups around the country that don’t get anywhere near the amount of attention and recognition they deserve.
And they should, because groups like this, and their leaders and participants, are building the future of American health care. We live in a health care system in which it is very hard for people to get the right medical care. Our system is the result of decades of looking at health care through a financial lens. We too often ask, “how do I make health care cheaper?” rather than asking the more fundamental question, “how do I make health care better?”
It’s starting to change. And although the government’s health care reform has gotten all of the media attention, health care is changing even more in the private sector. The people who pay for about half of U.S. medical expenses – private employers – are doing what they do best: Being innovative, taking risks, discarding the old and trying the new. (I highlight some of this innovation in the new blog carnival I launched this week, here.)
So here are three lessons I learned from this terrific event.
1. Employer-based health benefits are here to stay. Some say that in the post-reform world, employers will just drop health coverage to save money. I’ve never heard an employer suggest anything like this. Rather, employers see their health benefits as a way to drive competitive advantages. Dr. Fikray Isaac of Johnson & Johnson described surveys in which they asked employees what was most important to them. Top on the list: that their employer cared about their well-being and did things to prove it. So when employers help their workers live healthy lives, give them good benefits, and help them work their way through the health care system, they find that their employees are happier and more productive. Dr. Isaac said that for every dollar spent on these kinds of programs, J&J sees a significant return on investment in not just health care costs, but also in improved productivity. Sophisticated employers know this, and it’s why they are racing to capture this advantage. They aren’t going to outsource their employee benefits to the government anytime soon.
2. Patients have to advocate for themselves. Employers are skeptical that health care reform is going to fundamentally transform the way health care is delivered anytime soon. And so one message is perfectly clear – as a patient you must do everything you can to make sure that you don’t fall through the cracks of this broken health care system. Employers increasingly encourage their workers to know as much as they can about their health status when healthy, and to use every resource at their disposal when sick. They’re even grappling with more complex issues that aren’t on the political radar screen. For instance, Dr. Randy Axelrod talked about how it is now possible to test people for genetic problems that may predispose them to (currently untreatable) conditions. Should patients be tested? Should employers pay for these tests? The answers aren’t clear, but for consumers, these are the questions you need to ask yourself.
3. Prevention, prevention, prevention. I made a little bit of fun of Nancy Pelosi when she described prevention as being “exciting,” but she had a point. It is the hottest topic among benefits executives. They want to keep their employees healthy and productive, and know that addressing problems like obesity, smoking, diabetes and others are critical. So there are a large number of programs designed to deal with these issues. If you want proof of how trendy this is consider this – contestants from the Biggest Loser are highly sought after motivational speakers for wellness companies, working to encourage people to lose weight and be healthy. Though obviously now a Biggest Loser contestant, my favorite speaker in Dallas was Dominique Wilkins. He spoke eloquently and bravely about his personal struggle with diabetes. Employers have a terrific ability to motivate their employees to change their lives, and they are doing it.
So, if you want to know how the future of American health care will look, ask the people who are building it.