I had an opportunity to meet WSJ editor and Pulitzer Prize winner Daniel Henninger. We briefly talked about blogging, social editing and filtering; event participants may have as much to say or specific domain expertise that matters as much as the people on the podium. In today's editorial he makes the case for consumer-driven choice and supportive technology.
...Much of the talk was about explosions. Typically, "health-care costs are exploding." Employers fear they'll be buried in the rubble of health costs, now rising at some 15% annually. But other, brighter explosions are also in health's firmament--in genomics (perhaps allowing predictions about individual illness and therapies tailored to individuals); or in information technology (remote medical sensors, implanted monitors, Web-based health-care "wizards"). News arrives weekly of miracles springing from the minds of the U.S.'s remarkable medical scientists.
But here's the biggest explosion, yet to go off: Patient rage. Some analysts argue that corporations producing single-digit profits can't possibly cover double-digit health-cost inflation. So they are taking employee premiums higher for more or less flat coverage. Upwardly mobile premiums for dead-end coverage is a recipe for labor strife, and corporations everywhere are hitting this tripwire. The WSJ/World Congress meeting was about alternatives to turning over the entire bombed-out health-care cost landscape to the government (aka, rising premiums for static coverage)...
He highlights the technology available at my hospital:
All of the new plans provided tools that let employees access health information of a sort they'd never seen before. That included both Web-based programs and human "coaches" who give guidance on dealing with chronic aliments or complex medical problems. Dr. Paul Tang of the Palo Alto (Calif.) Medical Foundation gave an extensive tour of its Web-based program, PAMFOnline, to interact with doctors, renew prescriptions and track one's health care. Take my word; if you saw it, you'd want it.
As a consumer and a small business owner, its easy to see the virtue of choice for employees. Milton Friedman pointed out that third-party payment was an accident of WWII cost control that granted tax exemption for corporations. Employee health care needs are diverse and the lowest common denominator isn't a great thing to offer, so I prefer services like Administaff and Trinet that pool the risk of your company with others to get a volume discount on plans employees can choose. Others have written about how the cost of health care is a killer for startups in California, you have to strive to offer these kinds of benefits. Personally, I like making this investment and its one of the only progressive forms of compensation (you pay more for people who have a greater underlying need), offering choices for additional coverage is a premium, and a healthy workforce is a productive one.
There are a myriad of possible solutions to the health care crisis, and in its present form consumer choice is one of the virtues of the system, especially because the base level cost and of care is so low. It will be interesting to see the tradeoffs of choice and cost as the system evolves.