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Can the Health Care System Fix Our Health Crisis?

The Patient Protection and Affordable Care Act (PPACA) is a huge gesture towards fixing our spiraling health care dilemma. Health care costs are rising, increasing numbers of Americans do not have access to health care services, and the overall health of Americans is declining in epidemic proportions. As we look to employers to implement workplace wellness programs, can we depend on the health care system as we currently know it to offer the tools we need to turn this trend around?

The World Health Organization (WHO) published a study in 2009 indicating that the leading risks for mortality in the world are high blood pressure, tobacco use, high blood glucose, physical inactivity, and obesity. In addition to their role in global death rates, these five risk factors are also responsible for increasing the risk of chronic degenerative diseases such as heart disease, cancer, and diabetes. They affect health status in all income groups across the globe.

In 2012, the Centers for Disease Control (CDC) sites four common causes of chronic disease; physical inactivity, poor nutrition, tobacco use, and excessive alcohol consumption.

As we correlate this data with our concerns over economic growth, employee wellness, Return-on-Investment (ROI), and Cost-of-Illness (COI) metrics focus on pairing financial statistics and projections with those identified high-risk factors and behaviors noted above. The following figure projects statistics we expect to see for 2011 with a comparative note on the substantial difference between direct costs associated with treating chronic illness, and the soft costs herein noted as lost productivity. When we think of costs associated with employee illness, we often think of the cost of doctor visits, prescription drugs, or hospital care. However, lost productivity associated with employee poor health can actually cost a company more than the health insurance premiums it pays.

The soft costs of ill health include employee absenteeism, presenteeism (when an employee is at work, but not able to be productive) and turnover. What is important to note is that the soft costs associated with productivity consistently outweigh their associated direct costs.

Can the Health Care System Fix Our Health Crisis?
The bottom line is that illness is costing a lot of money. The problem with our current model is that we are not initiating real change through a difference in how we are analyzing the problems nor in our proposed solution vehicles.

By requiring all Americans citizens to carry health care insurance, we do in fact save money on the front end by getting illness in earlier stages and by promoting the proper utilization of health care services. But in the long term, are we really just providing another government buyout to a failing industry without initiating meaningful change to a failing business model?

The Wellness Council of America (WELCOA) argues that the health care system as it currently exists will bankrupt American business and their employees. How so? Let’s look at some statistics:

  • The cost of healthcare has increased to 274 times what it was in 1950 even though the average cost of all other goods and services increased only eight times. If we translated those numbers to our grocery bill, we would be paying $80.20 for a dozen eggs and $24.20 for a roll of toilet tissue.
  • The Department of Health and Human Services published a report, “Health, United States 2004” citing that at least half of all Americans are on at least one prescription drug. For our elderly population, that jumps to three or more prescriptions.
  • As many as 129 million Americans under the age of 65 have medical problems that would have marked them for higher health care premiums or rejection by insurance companies (prior to PPACA)
  • Ninety-one percent of hospitals report overcrowding

By 2020, it is estimated that we will have shortages of:

  • 85,000 to 96,000 primary care physicians
  • One million nurses
  • 157,000 pharmacists

1,500,000,000,000 Insurance claims:

  • Include a 30% error rate
  • 15% of those claims are “lost”

Some more shocking statistics:

  • Studies suggest that approximately 100,000 people die each year from the side effects associated with prescription drugs
  • Another 100,000 deaths annually are attributed to medical errors#
  • The annual premium in 2008 for an employer-sponsored health plan covering a family of four averaged $12,500
  • In 2008, premiums for employer-based health insurance rose by two times the rate of inflation for employers with 25 or more employees – more for smaller employers
  • Health care coverage is a company’s largest expense outside of payroll

“But what’s becoming better understood is that our health care crisis is fundamentally a business problem.” — John Hammergren, “Skin in the Game”

Does this all mean that medical treatment has no place in our health plan? ABSOLUTELY NOT!

Combining medical treatment with self-care and behavior modifications to address the root cause of any degenerative illness is the only way to achieve sustainable change. A comprehensive wellness program that includes education, wellness coaching, and solid business plan for implementation will create a positive Return on Investment for large and small companies. Additionally, we have to look at all of the factors that play a role in degenerative illness – such as stress, depression, culture, the food industry, and sleep deprivation.

This problem is more complex than push-ups and portion control, and the solution requires thinking outside of the box.

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article references:

“An Unhealthy America: Economic Burden of Chronic Disease” Milken Institute
“100,000 Americans Die Each Year from Prescription Drugs, While Pharma Companies Get Rich“,Alternet, June 24, 2010

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