I’ve been pretty quiet on the whole healthcare debate up until now. It’s a mess. It’s more than a mess, it’s a crazed storm of clucking and feather rustling, posturing and lobbying, advertising and cajoling, misinforming and undereducating. But while all this is going on in my former hometown of Washington, DC, people are dying.
Yes, I said people are dying, and I’m not saying it to be dramatic. It’s happening about once every fifteen seconds every single dayÂ in every way imaginable. (Yep, someone just died as you read that stat.)
Is this my employer’s fault? Is it even their responsibility to be in the middle of this mess in the first place?Â I say it is not. But of course I’ve already completed my homework assignments.
As a society we are generally too lazy to study issues that are literally a matter of life and death. Instead we consume sound bites like Milk Duds and never get full despite an obvious stomachache. And by the time we pause due to personal crisis or calamity, it’s too late for the homework to have mattered.
My challenge to you all is to be well-informed citizens and then render your opinion. So roll up your sleeves and let’s get to work.
Assignment #1 – How We Got Here
As Dr. David Blumenthal described in his must-read New England Journal of Medicine article, Employer-Sponsored Healthcare Insurance in the United States: Origins and Implications:
“The heavy reliance on employer-sponsored insuranceÂ in the United States is, by many accounts,Â an accident of history that evolved in an unplannedÂ way and, in the view of some, withoutÂ the benefit of intelligent design.” ~ Dr. David Blumenthal
…and that’s just on the first page. What’s interesting is to learn that FDR has a chance to pass universal healthcare in 1933 as the country emerged from the Great Depression. He elected not to do so for a variety of reasons. But what will we do as we emerge from a similar crisis? Read the article and you’ll be a hit at HR cocktail parties on the origins of the second largest cost center to your employer.
Assignment #2 – The Complexity of the Current System
Now the we’ve raised this unwieldy giant, how difficult would it be to untangle the complex ecosystem and put the genie back in the bottle? This is a two-parter and you need to study both:
This American Life – Episode 391 – More Is Less: An hour explaining the American health care system, specifically, why it is that costs keep rising. One story looks at the doctors, one at the patients and one at the insurance industry.
This American Life – Episode 392 – Someone Else’s Money: A deeper look inside the health insurance industry includes the dark side of prescription drug coupons, the four accidental steps leading to employers paying for healthcare, a story about pet insurance. and a surprising reason why insurance companies dump members.
This is a free podcast. You own an iPod, right? If so, you can download these for free and listen at your leisure. If not, you can click on the links above and listen on your computer at the office while your benefits department attempts to stem the 20%+ rise in annual healthcare costs. No excuses people.
Assignment #3 – Where We’re Headed
This one is going to be the most difficult, but I’m giving you two sources so you have both sides of the debate (which probably has 1,000 sides, so perhaps two is a disservice):
I work to earn pay. I don’t work to earn a prescription, or a physical, or a lobotomy, or chemo, or any of the 100,000+ things that might go awry with my mysterious human body. I offer a service. I receive compensation in return. In my opinion, that should be the extent of the equation.
If we expect to remain competitive we need to innovate and ideate at every turn. But here’s the kicker – employers have a cost albatross around their neck and it’s choking the machine to a halt. I want a government that does care if I live or die, not an employer who wants a health risk assessment upon hire. And if you believe that competitive advantage is a key driver of growth, here’s a map of countries with universal healthcare that just may have a leg up in the very near term:
Ok, I started this debate so please weigh in without sparing my emotions. Should employers be in the healthcare mix at all? Am I single handedly trying to destroy our union (as I’m certain someone will suggest)? Share your comments below and let’s keep the conversation going.