By Sarah Binder
CEDAR RAPIDS—You have to start somewhere.
That theme applies to both personal wellness and the implementation of health care reform, which were main topics discussed at the Corridor Business Journal’s annual Health Care Summit. More than 300 people attended the event, held Feb. 8 at the Cedar Rapids Mariott.
Health care reform implementation
A question about how small businesses can begin to implement the policies of the Affordable Care Act left the panel of experts from government and insurance in a moment of silence.
“If you have a business, you’re a pretty smart person, and pretty dedicated,” said Mariannette Miller-Meeks, director of the Iowa Department of Public Health. “At least understand the basics of the law — you can get that information online.”
Factors that impact businesses include how many full-time equivalent employees there are, their ages and health, and what current coverage is provided.
“If you’re a small group that’s healthy, you’re going to get hammered,” said Steve Flood, senior vice president of Holmes Murphy & Associates. He predicted costs for this group might increase between 25 and 50 percent.
Mr. Flood said he believes that most of the new people who will come into the health care system are those that are currently uninsured because they cannot afford insurance. So, the same number of people will keep paying for a greater number of beneficiaries.
Some members of the panel debated whether for some companies, it might be more cost-effective to simply not offer health insurance.
“No one wants to be the first employer not to offer health insurance, but it may be that you have to make a decision, whether you pay higher wages and not pay health insurance,” Mr. Flood said. “This is the first time in a long time to look at health care like any other form of compensation. That’s what it is. Unfortunately, with health care, about 90 cents on the dollar goes to about 10 percent of the population, and many of those aren’t even your employees.”
On the other hand, Pranav Mehta, vice president of marketing, and president of Wellmark Health Plan of Iowa, Inc., encouraged people not to make hasty decisions about dropping their insurance coverage.
“This is a journey,” he said. “For me, the wellness journey and the insurance have to be coupled. More important than the financial impact is your employees’ well-being impact. What sort of workforce are you trying to maintain?”
Wellmark recently saw a 12 percent increase for about 150,000 individual plan holders, but Mr. Mehta said for most groups, the increase has been closer to 3 percent.
For those employers who offered health insurance coverage before March 2010, Mr. Mehta said “grandfathering” in their old policies is an option that could save costs. However, he said employers who choose this path need to be prepared to explain to their employees why they won’t have all the coverage promised by the Affordable Care Act.
“I don’t know anyone who’s said, the Affordable Care Act is going to make care affordable,” he said.
Some panelists looked for ways to increase personal responsibility in health care. Ms. Miller-Meeks used an analogy of a wedding: when there’s an open bar, people tend to drink too much, but when they have to pay, they consume less.
“We’ve lost the consumer proposition in health care. Completely lost it, from top to bottom,” said Michael Bousselot, health care advisor to Gov. Terry Branstad. “Without some consumer responsibility for what you’re purchasing, and knowing that you’re getting value for what you’re being provided, there’s no hope of constraining our costs.”
In December, the state announced they would pursue a state-federal partnership model for health care, instead of either a state-built, state-funded exchange or a full federal takeover of Iowa’s health insurance system.
Mr. Bousselot said this decision was made so the state could continue to do what they do well, such as regulating Medicare/Medicaid eligibility, while avoiding what they don’t. For example, he said building websites is not a strength of the state, and building a site where people could browse and purchase health insurance based on-real time information on their income and taxes from the IRS (Internal Revenue Service) would be beyond the state’s abilities.
However, he said there are still a lot of questions on how the partnership will work.
“It’s like buying a car, but not knowing if it’s going to have tires, or what the price of the car is,” Bousselot said.
Mr. Bousselot also addressed statewide health and wellness goals, including the Healthiest State Initiative and Blue Zones project. The Healthiest State Initiative is Mr. Branstad’s goal to make Iowa the healthiest state in the nation by 2016.
He said one of his goals is to keep the discussion focused on the well-being of the individual, rather than rate increases or federal regulations.
“As a government, we owe that to the patient, the employee and the citizens,” he said. “If that’s ever not part of the conversation, we’re failing the citizens.”
Health was not originally among the governor’s top priorities, but Mr. Bousselot said they realized without it, none of the other goals in economic development and education would be possible.
By the year 2040, 60 of Iowa’s 99 counties will have more people older than 65 than people younger than 18. And if the state’s young people are suffering from more preventable diseases, they will be less able to support the health care of the aging.
“Becoming the healthiest state in the nation isn’t a catchphrase, it isn’t a tagline — it’s a must. It’s an imperative,” Mr. Bousellot said.
In the past century, average lifespans have doubled, income has tripled and the cost of food, transportation and communication has collapsed, he said.
“We have overcome huge obstacles in our time,” he said. “I would say health is our next big challenge.”
Worksite Wellness Awards
For the first time, the Worksite Wellness Awards covered the entire Corridor. The awards ceremony was previously known as the Linn County Board of Health Healthy Worksite Wellness Awards and began in 2009.
The winners are:
Honkamp Krueger & Co, P.C., <50 employees
ESCO Group, 50-99 employees and Most Improved Score
Van Meter, Inc., 100-249 employees
Alliant Energy and Cedar Rapids Police Department tied, 250-750 employees
University of Iowa, >750 employees