This trend coincides with the obesity epidemic, which has made the problem worse. During the '80s, computers began taking over our lives, reducing exercise time, making us fatter, and contributing to expensive problems like diabetes and heart disease.
Health care executives say the number of people who have sought medical treatment is down about 15 percent from several years ago. Higher deductibles and the bad economy have made people more cautious, and elective surgery less likely.
The Affordable Care Act does little to curb higher costs and, in fact, builds in many additional requirements that will increase the cost of care and what insurance covers.
It should be called the Unaffordable Care Act. Consider just one element: the requirement to accept anyone who applies regardless of pre-existing conditions, with limits as to how much you can charge according to a type of "community rating." That busts the cost/price equation.
Don't think for a moment that when so-called "exchanges" become available in 2014, that insurers will provide lower prices, or that health care systems will be quoting great discounts to the insurers. No way. They will be protecting themselves from losses.
If you turn your employees over to the exchange system, you will lower and better control your costs, but you'll be doing them a major disservice. They might complain so loudly that they create another significant argument in the national health care insurance debate. That is, extending Medicare to everyone. But that's speculation.
What's missing from all the debate is what employers need to do to make us less reliant on expensive health care.
The two-pronged solution is a fitness health habit and a mentality – not just wellness.
There's a business argument why CEOs should be insisting on this solution for employees. Computers have made us couch potatoes, requiring less physical energy and creating a host of health problems.
The national guideline for exercise is the equivalent of a 30-minute fast walk, at least five days a week.
Expand that to include four elements of healthy living: eating nutritious food, eating the correct portions, doing aerobic exercise and doing strength training.
If your employees follow those four solutions, they will increase their daily energy output by up to 25 percent. Their ability to do complex thinking will improve by up to 70 percent, according to a study at Purdue University.
Think about what that means for their workday. Greater output. Better thinking.
Why aren't we requiring that right now? Why aren't we building it into our workday? Why aren't schools requiring exercise at the beginning of the school day, since similar studies show the impact on learning and grades?
If you're serious about helping solve this problem, consider these steps:
- Allow only nutritious foods in the workplace. In your cafeteria, reduce or eliminate sugar.
- Help pay for smoking cessation programs.
- Develop an environment with lots of stimuli for healthy activity. Provide small rewards for exercise.
- Have monthly exercise contests in which everyone is on a team. It's been proven that teams entice the people most resistant to exercise to begin participating, and they eventually find out it's not so hard.
You can collect more ideas from many websites. The Healthy Lifestyles Cooperative in Green Bay, at HealthyLifestylesCoop.org, has exposed more than 200 member companies to ideas and practices. The anecdotal stories are legion and prove that participating companies are less reliant on medical treatment.
Most of us are now on high deductible plans, and at least 75 percent of employee families aren't even spending their deductible today. It's having an impact.
During the past three years, most health systems have seen their revenues drop because fewer people are using in-patient beds and services due to fewer elective surgeries and high deductibles. As a result, they're spending less, and medical systems are scrambling. They're eminently aware and concerned that the cost/value consequences of the Affordable Care Act may be a prelude to Medicare reimbursement level expansion, which will require massive consolidation and cost reductions. They're preparing for that. And it might not be a bad thing.
As a TEC chair in Green Bay, I don't have a good perspective on what's happening with Milwaukee companies. But one organization here in Green Bay, BayCare Medical System, with 450 employees and 100 doctors, has tied employees' premium levels to their fitness levels--not to their health risk assessment scores, or computer-calculated step totals, or self-reported anything.
Each employee has to take a five-level YMCA fitness test, which includes a lot of strength and aerobic exercises. The test, which also measures body fat, determines the employee's premium level. Fitness levels drive virtually all thinking about taking care of our bodies and practicing a set of healthy lifestyles.
A few other small organizations have also adopted this model. If an employee doesn't take the test, they're charged the highest total. If they flunk, they can take it again in three months. If they pass it, they get the premium reduction but have to pass it three months later to prove the improvement isn't a fluke.
There's lots of solid data that higher fitness test scores, higher health risk assessment scores, and lower body mass index scores result in fewer trips to the doctor and hospitals. To date, the provider systems have increased prices to at least partially offset this trend.
But that won't continue as transparency improves. One concern is that some of that 25 percent that's using health insurance uses it at a very high level due to multiple chronic risk factors.
Think about it. By adopting this model, you're doing your employees and your organization a favor. They will be more productive and better thinkers, serve your customers more efficiently and be able to perform better on the job.
Fewer illnesses and diseases mean using the health care system less, and that means less absenteeism, lower costs for employees, and better attitudes.
What's not to like? n
Phil Hauck leads three TEC CEO groups in northeastern Wisconsin, and a group of marketing/sales leaders. He is a former Wall Street Journal reporter. He can be reached at firstname.lastname@example.org.