Contributed by Linc Smith
IN APRIL, states, communities and advocacy groups across the nation again marked “Cover the Uninsured Week,” an important reminder that nearly 45 million people in this country, including children, are uninsured.
The threat that this number could swell is real. Employers around the country face mounting economic and competitive pressures to “thin” the benefits they provide or, worse yet, discontinue coverage altogether. This is a particularly daunting concern in states like Michigan, where economies have been built to rely on manufacturing giants such as General Motors.
And there are other reasons for concern. As the Altarum Institute’s recent report for the Commonwealth Fund demonstrates, early retirees leaving the workplace with the promise that their previous employer would cover health benefits through retirement now find this coverage is increasingly at risk. This is a worrying reality for thousands of early retirees from the automotive and other industries across the country.
State leaders are right to make insurance reform an urgent priority. But achieving universal access to high-quality care at a reasonable cost requires a systems approach to reform – something that goes well beyond merely providing coverage for the uninsured.
The starting point for real systemic reform comes in keeping people healthy – something that insurance alone will never accomplish, even though it plays an important role.
The workplace is an excellent environment for getting individuals to give more attention to their health. Evidence shows that companies investing in the health of their workforce, combined with adequate levels of insurance, are witnessing an important bottom-line reality – they’re finding that healthier employees are more productive and cost less money.
The value of keeping people healthy sometimes gets lost in the larger debate about healthcare reform. Just as “Cover the Uninsured Week” has focused Americans’ attention on the uninsured, we now must ensure that measures to promote health, including workplace health, are equally prominent in the national dialogue.
Employers, employees and state governments each have a critical role to play in this workplace health dialogue. And each has much to gain if policies promoting workplace health are devised and broadly implemented.
Employers have a responsibility to invest in workforce health; if they do, they also have an opportunity to become more competitive among their peers. Studies, including those from the University of Michigan’s Health Management Research Center, validate that employers who make sustained investments in employee health – through health risk assessments, on-site wellness, education and care programs as well as insurance benefits designed to reward healthy behaviors – are seeing a considerable return on that investment.
For these visionary companies, the burden of healthcare costs is going down, and their market competitiveness is going up. A healthy workforce could well be the competitive advantage for which many states are desperately searching.
Employees have a responsibility to become better-informed decision makers on matters of personal health, and an opportunity to become healthier as they do. Of all the factors affecting an individual’s health status, none is more important than behavior, many analysts suggest. Despite all the attention being paid to optimal health and the cost of poor health, Americans still make relatively poor health choices.
Employees should expect their employers to be active participants in health improvement; they should give workers information resources that facilitate better decisions about healthy behaviors. And employees should also expect that, in time, insurance benefits will be pegged to the health choices they make. This is a controversial reality that needs to be discussed now.
Governments have a responsibility to make adequate coverage available for all and seize the opportunity to design benefits that incentivize people to keep healthy. A growing number of states, including Massachusetts, California and Michigan, have initiatives in place or under consideration to cover the uninsured. As these insurance reforms move forward, state governments have the obligation to encourage the development of insurance products that make it easier for individuals to get preventative health screenings and services, and to promote citizens to take the medications that will keep them healthy.
Getting people healthy – and keeping them healthy – should be a national imperative. The workplace is one place to concentrate our early efforts. The right kind of insurance will be key, but our ultimate success will not come by insurance alone.
Linc Smith is president and CEO of the not-for-profit Altarum Institute, a leading provider of objective health systems research and solutions.