Employee medical benefits are withering. Although most companies still offer health plans as part of their compensation for the rank-and-file, workers who have them are paying more, often much more, and getting less, often much less.
In fact, a recent report from the Kaiser Family Foundation found that employees surveyed were paying 50 percent more on deductibles than they had been five years before -- a not-insignificant $1,500 per employee. The increase was an average $2,100 for those working at smaller companies.
We could blame the “gig” economy, Obamacare, the free market, rapacious drug companies, whatever. It doesn’t matter, really, what’s causing this seemingly inexorable problem. Low- or no-cost employee medical benefits -- once an expected part of any full-time job in America -- are dying, perhaps even, as they say, of natural causes.
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It’s only going to get worse: A HANYS employer survey recently found that 77 percent of employers surveyed were considering offsetting increased healthcare costs by passing more of those costs on to employees. Even wellness programs are being considered as a way to shift costs to less healthy employees while doing little to improve actual health.
It’s a race to the bottom.
As an MD concerned about the long-term effects on our nation’s health, I can offer a revolutionary alternative. And that is? Entrepreneurs, forget basic healthcare; forego that useless wellness plan; run in the opposite direction. Instead, win points on everything from your brand to your sucess in recruiting, retention and productivity by providing the kind of healthcare the wealthiest executives already receive.
Madness? Irresponsible? Not at all. It may sound counterintuitive, but having a competitive edge in recruitment at a time when unemployment is low may be a smart thing to do.
Concierge care, personalized care . . . options exist.
Newcomers to the corporate health scene -- companies like Newtopia, a startup that personality-matches lifestyle coaches with employees at risk for metabolic risk syndrome, and Color Genomics, which has introduced genetic screening for hereditary cancer risk into the workplace -- are pioneering the notion of incorporating personalized medicine into the workplace and seeing the positive benefits.
Aetna’s pilot program with Newtopia, for instance, saw its healthcare costs reduced by $122 per month, per employee, in the first year of its program. Now, that's a positive return on investment.
What I’m suggesting here sits on the opposite end of the quality spectrum from those dime-a-dozen wellness programs you hear about that track surface information (e.g., self-reported cholesterol, blood pressure and BMI levels) and often come up with incomplete and misleading assessments.
Not that it’s a bad idea to capture heart health readings or lifestyle statistics; it’s just that wellness programs as they are designed today do not go deep enough to be effective. They can even lead to a false sense of security. For instance, data from one award-winning wellness program showed that, for participants, more key measures of health declined than improved.
In my view, the very health guidelines most wellness programs use to assess risk are based on reactive clinical signs and symptoms: They are more backward-looking than predictive. Such “health-risk” measures do not and cannot detect a health trajectory trending downward, before disease erupts and productivity declines.
They can't pick up on an impending catastrophic health event that could grind productivity to a complete halt.
Fewer hospital visits?
By contrast, something like concierge plans -- where physicians maintain a much smaller group of patients, allowing them to spend more time and provide high-touch care -- claim to reduce the number of expensive hospital visits.
Of course, this all sounds expensive. And it can be. But that’s changing. Look at the degree to which the price for genome sequencing has dropped -- from hundreds of millions of dollars to sequence the first genome 25 years ago, to less than $1,500 in 2015.
Further, technological advancements such as telemedicine can drastically reduce the time away from the office that employees have to spend waiting in doctors' offices. And that's if they can get an appointment at all when they're sick and need a doctor's attention right away. Never mind the savings employers realize by dumping an ineffectual wellness program.
The provision of a premium healthcare plan need not be that much higher than your average healthcare plan/wellness plan combination. Seriously.
After all, on average, typical healthcare plan costs for both employers and employees are rising. The latest study, released by last month in Kaiser/HRET’s annual report, found that the average family plan cost $18,142 in 2016, up 3.4 percent from last year.
In sum, it's time that we come to terms with reality: Healthcare costs are only going to continue to rise. We have an aging population that’s sick and will continue to decline.
Think of it as an investment. When you manage your wealth, are you reactive? Or, do you diversify, plan for risks and look ahead decades to retirement? That’s the mentality we need in workplace healthcare, as well.
So, while it may sound counter-intuitive, in order to curb healthcare costs for employers and our country overall, we have to dig deeper and invest more -- not less -- in proactive health care solutions. They just might be our best hope for the future.