Expert: Employees, employers key to health reform

 by Gigi Wood

IOWA CITY – It comes down to the individual and employer.

True health care reform will not come from the federal government, it is in the hands of individuals, experts said at the Corridor HealthCare Summit, a seminar hosted by the University of Iowa’s College of Public Health and the Corridor Business Journal on Feb. 12 at the Iowa City Sheraton Hotel.

“A big part of the (health-care reform legislation) debate is the role of government,” Rep. Dave Loebsack said at the summit. “The main fault line is going to be the extent to which the government is involved, whether we have a public option or not.”

As small employers look to keep costs down, they need to look internally, he said.

“You (attendees) are talking about workplace health, trying to devise strategies, ways to bring that about, you’re talking about that from a company perspective, companies taking responsibility for the health and welfare of employees,” he said. “But it takes the employee to take some responsibility as well, that has to be a part of it, there’s simply no way around it.”

Doing nothing to improve the health-care system or the health of individuals causes health-care costs to continue to escalate, he said.

“I’m not saying that whatever we do is going to be a silver bullet and we’re going to be able to bring down all these costs and types of things,” Mr. Loebsack said. “At minimum, I hope whatever does come out of Congress in the coming weeks, that it will reduce the rate of increase for premium costs and health-care costs.”

Although employers and employees should work to reduce health problems and costs, the federal government needs to address coverage of pre-existing medical conditions, removing caps on coverage amounts and increasing competition among insurance companies.

“No one should go bankrupt paying for health-care bills,” he said.

Health accountability

Creating a healthier workforce is no easy task, but employers and employees need to “put their money where their mouth is” when it comes to instituting wellness programs and insurance plan changes in the workforce, the seminar’s keynote speaker said.

Michael Parkinson, former president of the American College of Preventative Medicine and principal at P3 Health, a Pittsburgh company that promotes personal and organizational prevention, performance, and productivity improvements, offered a number of suggestions for the workplace. Only 8 percent of Americans follow a list of healthy behaviors that includes low fat and alcohol consumption and no smoking. Unhealthy behaviors contribute to 91 percent of diabetes cases, he said.

“Health-care costs are related to behaviors and they’re worsening,” he said.

The business model for the health-care system, including hospitals, is broken and 35 percent of health-care spending is wasteful and inefficient, he said. To overcome the drastically increasing rate of obesity in adults and children, the health-care system needs to be changed at much faster than the current rate of reform.

“Employers’ costs associated with BMI (body mass index) is real and is coming out of jobs,” Mr. Parkinson said. “The more BMI goes up, the more people lose jobs in Iowa, the more they lose their jobs everywhere. It is a threat to our very vital ability to grow the American economy.”

He urged the audience to not rely on the federal government to fix the system or reduce costs.

Employers need to research consumer health plans, which allow people to choose their own providers, manage their own expenses and improve their own health. Consumer health plans help people take the first steps toward finding inexpensive alternatives to expensive drugs and treatments, he said.

“With anything else, you’re not serious about providing services to your employees or about staying competitive,” he said. “If we only took care of our people the way we take care of our machines.”

Health insurance gets in the way of healthy workers, he said. The system does not provide transparency when it comes to the cost of procedures and medications.

Employers need to address the work climate and make sure leadership pursues healthy choices.

“You need to create a culture of health as a business necessity, not as something nice to do,” Mr. Parkinson said.

Also at the seminar, David Lind of David P. Lind Associates presented the results of the 2009 Iowa Employers Healthcare Study, which showed a 13 percent increase in health insurance costs was typical for businesses with fewer than 10 employees during the past year. Rates increased on average 150 percent for single plans and 110 percent for family plans during since 2001, the study showed.

“It’s very sobering information about what’s been going on in Iowa,” Mr. Lind said.

Workplace solutions

His talk was followed by a panel discussion of how to create healthier workplaces. Eric Upchurch, a insurance broker with AW Welt Ambrisco; Rita Jelinek, vice president of Midwest Metal Products; Kim Frazier, a wellness coach with Mercy Corporate Wellness and Dave Cahill, an employee who won the fitness challenge at Van Meter Industrial last year for losing 44 pounds in 12 weeks, chaired the panel.

Successful wellness programs combine fitness, such as walking into the workplace, along with programs for smoking cessation. Some use incentives, whether its gift cards or reductions in health-insurance premiums. Ms. Jelinek said that when her company began a wellness program in 2004, it was casual and part of the company’s employee expectations.

Ms. Frazier said it is important to address employee motivation.

“(Wellness) coaching takes it down to that individual level and that’s really what is key,” she said. “You have to find out where you’re at, where you want to be and how can I motivate you and give you self efficacy to get you from point A to point B and then hastening that.”

Incentives are another motivator for employees, such as drawings for a free tank of gas to those involved with the program, paying for a portion of a gym membership and providing free water throughout the office.

“The biggest incentive is creating a culture, so participating is about fitting in,” Mr. Upchurch said.