When is Enough, Enough in Health Care? It is Right Now.
A few of my teammates and I recently celebrated the impending retirement of David Sichel, a long-time employee of the Vermont League of Cities and Towns. Dave has one of the brightest minds in our state when it comes to health care and it’s always a pleasure to listen to his thoughts on the system. At the celebration, David brought out a quiz for us on health care.
The quiz asks for a level of agreement with statements about doctors, hospitals, people, government, insurance companies, and employers. In short, the quiz taker ends up strongly agreeing with all the statements and all of them define what’s wrong with our health care system. Cost shifts. Overutilization. Little accountability. Too much regulation and too little regulation. High costs. Dominant provider systems. Perverse incentives.
We all got it and nodded our heads. When we’d finished congratulating ourselves in understanding what was wrong with the current health care system, Dave asked us to turn the page over and all the statements listed, with which we agreed with so readily, were from 1982. Yes, 1982. Thirty-six years ago.
So what has changed since 1982? Well, we now have the Affordable Care Act and more patient protections, better access to insurance with subsidies and a number of other good things for consumers including new treatment options, which is all great. But the underlying structural problems of the system remain. Costs continue to grow at a rate much higher than inflation. Patient safety is still a concern. Navigating the system remains terrifyingly complex. Prescription drugs are increasingly unaffordable.
And while there are efforts underway to curb some of these problems, like the all payer model and ACO effort in Vermont, it’s not enough. Government, providers and insurers continue to dictate the terms to the non-government payers and those that pay (i.e. employers and individuals) largely remain on the sidelines.
It’s time for us to get off of the sidelines and start acting. In the employer world that we in HR live in, no one is happy with what they have to pay, yet we get mad and bellyache and then ultimately accept the rate increases or breathe a sigh of relief when our premium rates percentage increase is in the single digits. And because the vast majority of employers require a premium contribution from employees, it ultimately affects the end consumer as well. We have become conditioned to the health care machine.
Enough is enough. It is time for employers to have a stronger voice and begin forcing the system to change, for their organizations and their employees. We need to work individually to start being more active in the system – either through being politically active or truly managing and innovating in our health care plans. And we need to act collectively to develop a stronger voice. We need to take back some control and not be dictated to any longer. We can’t just continue to “nibble at the edges” as one CEO I respect recently said to me as I explained what employers are doing in their