Paternalism and the Healthcare Cost ProblemBack to the Blog »
February 9th, 2010
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“Who’s problem is it anyway?”
The Scott Brown Senate election has effectively killed the Democrat-led push for comprehensive health reform in Washington. But the need for systemic change is more acute than ever, as reflected in the recent Health Affairs article indicating that 2009 health care spending increased at the fastest rate in 50 years!!
We spend on average about $10,000 per employee per year for health insurance, and it is a huge expense and a huge problem for most employers. But did anyone actually think the government was going to make the problem go away anytime soon?
The bulk of the cost of private insurance in America is borne by organizations who provide healthcare as part of the employment based system of group insurance that has evolved since the federal government enacted wage and price controls during World War II. Since that time, employers have provided these benefits as a condition of competing for labor in the marketplace, and they have managed these programs with a sense of paternalism that can be described as follows:
Traditional Paternalism: As an employer we provide employees with the richest benefits possible at the lowest cost, while providing them with maximum flexibility and choice, minimal disruption in their habits and little or no impediments to access as much care as they need from whatever providers they choose to use.
This view of paternalism has forced employers to manage costs by shifting incrementally more of the burden to employees while still allowing them to get whatever they want, wherever they want, whenever they want– with minimal influence or incentive to make informed choices about the cost or quality of the care they receive or the personal decisions they make about their health.
Driven by the deep recession, the continued pressure on healthcare costs and the intensity of economic competition around the world, there is a small but growing group of employers who have a different view:
Paternalism Today: As an employer we know that the most important thing we can provide our employees is a solid and stable paycheck, and we are willing to challenge employees and hold them accountable for the decisions they make about their personal health and the healthcare they consume in order to achieve the sustainable improvements for the individual and our organization that will ensure our success in the market.
Solving the problem, as opposed to “managing” it, requires a fundamentally different perspective that reflects the harsh realities of the world today and respects the intelligence and attitude of the employees they are seeking to reward and motivate.
It’s not easy, but it is the best answer to the question “Who’s problem is anyway?”
Posted by Bill in Healthcare Reform
