Millerwood Communications

Healthcare Reform Misses Mark

What I keep hearing from Washington is that we need to overhaul the system to insure the uninsured and improve the quality of healthcare for everyone. What happened to cost-containment? Wasn't that the primary objective?

If legislation is passed whose sole goal is to insure the unemployed and manage the quality of care,  we are not only going to see increased costs for businesses and individuals, but we may even see the quality and timliness of care decrease. Here is what the healthcare reform should do: 

#1 - Take measures to reduce the overall cost of healthcare in the U.S. Reform how litigation is handled to reduce the cost of malpractice insurance for those in the healthcare profession.

#2 - Build on the healthcare system we have today, instead of dismantling the foundation of private healthcare.

#3 - Focus on prevention communications on a national level.

#4 - Leave Medicare benefits alone, and not cut services to the elderly to fund a government plan.

#5 - Do not increase costs for businesses and individuals by taxing benefits on those who wish to elect private insurance. Wasn't the point to reduce the cost of healthcare?

#6 - Offer government health plans to qualified low-income U.S. citizens, especially children, at a subsidized cost through private insurers, similar to what is being offered in Massachusetts.

#7 - Do not discourage employers from continuing to provide healthcare benefits so that individual citizens can continue to provide their own healthcare.

The path that is being proposed is going to eliminate competition for private insurers, which will drive them out of business. The only option will be go to a public, government funded plan. The choices and quality that we currently have today in the best healthcare system in the world will be gone. 

Originally, I thought healthcare reform meant that everyone could enjoy the same care with contained expenses. I am disappointed in the direction this is taking.

Don't Let Back Pain Cripple Your Business

It's estimated that employers lose $7.4 billion a year from workers who suffer with back pain, according to a study published in Spine. This includes medical expenses and time out of work for doctor's visits and sick time.

Back pain is one of the most common complaints in the workplace, and it can be very painful and debilitating. That's why it's in the best interest of employers to educate employees on how to prevent injury.

Injuries can happen at home while lifting something incorrectly, on the loading dock or at the computer. Communication should include information on how to correctly lift and practice good posture.

To address the costly problem, FedEx has implemented the "4-Before" program. Each employee receives customized instruction for four stretches best suited to be done before they begin their workday.

The company has also placed athletic trainers at its highly populated workplaces so if an injury does occur, employees can request to be taken immediately to a trainer who will analyze the problem and work with them to resolve it.

Trainers will also accompany the employee to the doctor. Fedex has seen a reduction in sprains and strains of as much as 50 percent in some business units.

General Electric provides employees with physical therapists and occupational health clinics on site, but if workers need to see an outside physician, the company offers a list of specialized doctors skilled in occupational health.

With the high cost of health care, this is just one more area employers can be proactive to keep employees healthy and give them the information to manage their health.

Six Steps Employers Can Take to Reduce Health Costs

In addition to encouraging employees to manage their health, there are steps employers can take to contribute to employees' health.

The following six steps were recommended by Miles White of Abbott Laboratories in a recent Harvard Business Review:

1. Provide plenty of nutritious options in cafeteria and vending machines.
2. Make workplace smoke free and help employees kick the habit outside of work.
3. Encourage exercise by offering employees free use of a fitness center, or subsidizing employees' memberships to local gyms. Leaders should set an example by using gym or even just by taking a brisk 10-minute walk.
4. Offer on-site health education and screening for conditions like high blood pressure and high cholesterol.
5. Share the savings generated with the employees who do take care of themselves.
6. Design health care programs with a component that reaches out to employees' immediate families. At Abbott, we cover an average of 1.6 dependents for every employee.

Smokers to Fund Healthcare

Oklahoma has an interesting solution to the healthcare expense issue.

In November 2005, the state implemented the Oklahoma Employer/Employee Partnership for Insurance Coverage. It's a statewide health insurance program for companies with fewer than 25 employees, funded largely through a tobacco tax increase. The state picks up 60 percent of an employee's premium, the employer pays 25 percent, and the employee pays the remaining 15 percent.

The program will help small employers provide benefits and reduce the number of Oklahoma's uninsured, which is currently 600,000.

This is a creative approach to providing benefits to employees of small companies, and it should work. It is ironic, though, that the key to providing benefits lies with smokers, typically an unhealthy group. If wellness plans and increased education reduce the number of smokers, or the amount a person smokes in Oklahoma, the funding for the plan could be reduced. It almost gives the state incentive to encourage smoking. Plus, it gives tobacco companies one more public relations tactic.

I can see the ad campaign now. "A puff today insures our workers tomorrow."

Another Reason to Communicate Health Awareness

Educating employees on how to avoid medical mistakes may not only save costs, it may save lives.

According to the January issues of Shape magazine, 44,000 Americans die each year as a result of medical errors and "near misses" in doctor's offices, hospitals and pharmacies. Fortunately, a new law requires reporting of mistakes to a federal database, which researchers will use to analyze problems. At some point in the future, the public can view the findings at the US Department of Health & Human Services web site at www.os.dhhs.gov.

To avoid mistakes, employers can:

• Communicate the URL for the web site so employees and their covered dependents are aware of potential issues.
• Advise employees and covered dependents to ask questions of their doctor so they thoroughly understand a diagnosis and treatment.
• Encourage employees and dependents to review all prescriptions with a pharmacist to ensure that the medication and dosage are correct.

Wal-Mart Does it Their Way

Wal-Mart was mentioned in an article in Sunday's Boston Herald as a "welfare abuser" because they do not provide health insurance for all employees. No, Wal-Mart does not provide a robust health care plan, even for full-time employees, but they don't have to. In an effort to keep prices low, they have made the strategic decision to not attract employees with a full benefits plan.

There is a large population of workers who do not need or want a high-quality health care plan. For example, people covered by their spouses, college kids covered by their parents, and employees who work part-time, and don't want coverage.

Wal-Mart is capitalizing on this group of available workers, and it works. They keep prices down, people continue to shop there, and the business keeps many people employed.

If employees need a better health care plan, they can get a job somewhere else that provides it. Target, for example, offers health care benefits, including medical insurance, dental benefits and flexible spending accounts.

Wal-Mart has a different approach. The Wal-Mart way creates high turnover, and possibly many disgruntled employees. That's Wal-Mart's problem. But I'm sure turnover is no surprise to Wal-Mart, and they are prepared to deal with it.

We don't have to continually bash Wal-Mart on the health care issue. If employees and customers feel strongly about it, they can stop working and patronizing the stores. So far, I don't see that happening.

Simple Stress Relievers

Trying to get employees to switch to a healthy lifestyle to reduce health care costs takes time.

To be effective, communications must include information on how bad habits, like smoking and overeating, cause disease. Communications should also show how disease contributes to the costs of health care and how those costs are shared among employers and employees. Some of these issues are complicated and difficult to explain. Therefore, a communication strategy has to be long-term and easy to understand. 

One tactic is to create a campaign focusing on one major cause of illness at a time; for example, stress. Instead of creating communications that link stress to increased health care costs, design a plan that helps employees relieve stress on a daily basis. Fun, simple ideas can get the point across and still be educational and interesting.

1. Encourage employees to organize their to-do lists each morning. Writing down deadlines, appointments and projects will help the day go more smoothly. Keeping it all in your head can jumble thoughts and make the day feel chaotic.
2. Distribute lavender mist to employees who wish to use it. A light misting at a stressful point in the day can have an immediate calming effect.
3. To reduce tension caused by excessive keyboard time, advise employees to take a quick break every 15 minutes. By moisturizing and massaging hands for one minute, hands and arms will feel energized and have the added benefit of reducing injuries caused by excessive typing.
4. Getting outside for a few minutes can help clear thoughts and improve mood. Try to get employees to take a walk at lunch or take an outdoor break in the afternoon.
5. Have herb tea breaks where employees can gather for a few minutes each day.
6. Mint toothpaste, peppermint mouthwash and mint tea all soothe nerves and stomach. Provide meeting presenters with a calming kit of these items.
7. For late nights at the office, prepare a package of fuzzy slippers, candles, sparkling water, take-out menus, energy bars and a radio. Being comfortable, fed and hydrated will keep employees from getting hungry and run down.
8. Give employees flowering plants for their desktop. The scent will provide relaxation and inspiration.
9. Remember locker clean-out day in high school? Create a designated time to organize desks and brief cases. Provide garbage receptacles so trash can quickly be removed. Organized work areas will encourage organized thoughts.
10. Hold a reflexology class so employees can use acupressure to relieve stress discretely at their desk.

Improve Health, Improve Wealth

Need another reason to encourage your workforce to get healthy?

A new study done by Ohio State University has found that people who reduce their body mass index (BMI) increase their net worth. The study, however, doesn't give definitive reasons for the increase, but I'm going to make the following conclusions:

• Employees who increase their fitness level increase their energy level and their ability to resolve problems and generate new ideas. The increased performance at work can give way to possible promotions and increases in pay.
• Employees who feel good about themselves are more apt to show confidence in all aspects of their life. This new confidence may spread to their interactions with other employees and managers, increasing their workplace involvement and the courage to accept new job-related challenges. Again, this can pave the way to promotional opportunities.
• Employees who are healthy have less sick days. For employees that are paid hourly and not paid for sick days, they can simply increase their income by working more.

To calculate BMI, go to fitnessonline. Click on Body Mass Index under Fitness Online Calculators.

Uncompensated Care Pool of Massachusetts

Recently, through a personal experience, I became aware of the Uncompensated Care Pool of Massachusetts to support patients without health insurance. I had not heard of the Pool before, so I did some investigating.

If I understand the policy correctly, any patient who incurs a charge of $10,000 or more from a healthcare provider receives a bill for 2.9% of the total charges. The bill is to be paid by the insurance company to the provider. The provider then makes a monthly payment to the state of Massachusetts. The state then allocates the money back to the providers based on services provided to the uninsured.

Here are some facts about the 2004 Pool:

• $712 million was billed to the Pool.
• The Pool paid for an estimated 44,000 inpatient and 2.0 million outpatient visits for 454,288 different individuals.
• The most common use of the Pool are young adults ages 25-44 with incomes under the Federal Poverty Guidelines.
• 8% (approximately $5.7 million) of the pool was used for alcohol and drug-related disorders

Having worked with many employers on programs to control healthcare costs, I immediately saw some flaws with the Pool. I don't believe the government fully understands, or maybe cares, who will ultimately pay for the cost of the Pool. This is just a roundabout way of having the cost assumed by organizations providing medical insurance, and those employees paying for it.   

Here is how this plays out:

• Healthcare providers need to hire resources to administer the payment process. They need to process the billing, complete monthly forms, make monthly payments and apply for reimbursement. Not a problem for the provider, since they can increase healthcare fees to cover the cost.
• Insurers need to pay the cost of the surcharges. But this is not a problem for insurance companies, since they can increase the cost of their premiums to cover the cost of the surcharge.

Who, then, incurs the cost of the Pool?

• Employers providing medical insurance - Employers will have to pay the higher premiums for medical insurance.
• Employees - Higher premiums for employers means that employees will likely see their premium cost go up. Higher medical fees means that the employee cost for co-payments will also increase.

In addition:

• Increased costs for medical insurance may cause more employees to opt-out of medical benefits, increasing the number of uninsured in Massachusetts.

The Pool, while providing a much-needed service to those without insurance, is adding to the healthcare cost problem. And all the efforts made by providers, employers and employees to reduce costs will continue to be offset by programs like this.

Instead, there needs to be a program that directly invites employers to participate, like the National Access Program, that doesn't hit the insurers and providers and, in the end, employers and employees.

Support for a Culture of Wellness

Employers are better off financially when they have a healthy workforce. That's just common sense.

Healthier employees are more productive, energetic and present. But now we have more than just our common sense to support this theory. I've gathered the following statistics from several sources:

• Smoking will cost an estimated $157 billion in health care expenses and lost productivity - Center for Disease Control (CDC)
• Tobacco use will claim more than 163,500 lives in 2005 - American Cancer Society
• $ .18 to $ .79 per smoke cessation program participant can yield savings of $1.70-$2.20 per participant after five years - Kaiser Permanente's Center for Health Research and America's Health Insurance Plans
• Obesity is costing employers 39.3 million lost workdays and 239 million days of reduced productivity annually - Environmental Health Perspectives
• Two-thirds of Americans are overweight - CDC
• Adults age 50 who added a moderate level of exercise four or more days a week reduced their health care costs by $2,200 annually - HealthPartners
• Obese employees who added an exercise session once or twice a week produced a total savings of $790,000 - Journal of Occupational and Environment Medicine 2003 GM Study