The Good, the Bad and the Ugly in Health Care

Image courtesy of Flickr/Don Graham

I went to college in the South. I frequently wear cowboy boots to work. I own most every Willie Nelson album. Barbecue sauce is a food group and I won’t hear any arguments against it.

Given my affinity for all things country, I was thrilled when I found out that the 35^th annual Midwest Business Group on Health conference had a Western theme. And it didn’t disappoint.

Larry Boress, president and CEO of the MBGH and Matt LaRocco, MBGH board chair and vice president of law enforcement, facilities and hospitality services at the Federal Reserve Bank of Chicago, kicked off the two-day event at the Mid-America Club in Chicago with a bang, literally. Boress carried a toy pistol and both men wore Stetsons as they walked up to the stage to the theme song from “Silverado.” Their commitment to the bit was admirable.

After a few Clint Eastwood references and rough attempts at integrating the word “y’all,” the Western theme evolved from hokey to strikingly appropriate as the conversation shifted to the “wild west” of health benefits and the uncertainty that currently hangs over the field like a cloud of dust kicked up by a cattle stampede.  

James Klein, president of the American Benefits Council, said it best: Much like the settlers who headed west into uncharted territory, the health benefits field doesn’t know what it’s getting into.

Right now there’s a lot up in the air. Klein condensed his concerns into seven top issues: the definition of a full-time employee, actuarial value, auto enrollment, the excise tax, the individual mandate, the employer mandate and subsidies.

With a ruling expected in the King v. Burwell case sometime in June, benefits managers can anticipate some government direction in terms of subsidies, but as for the remaining six issues, it’s a game of wait-and-see.   

And that’s not a comfortable position to be in. Each of those top concerns carries with it a significant tax penalty if incorrectly handled by a company, and like Walgreens’ senior director of health & well being Thomas Sondergeld said in his talk on avoiding excise tax penalties, it’s not going to be the federal government that employees yell at when they are forced to pay a fine. It’s the benefits manager.

The only solution is to start preparing now. Sondergeld urged attendees to get their employees’ data in order, pay attention to court rulings and make their voices heard through their congressional representatives.

Others, such as Dr. Rajiv Kumar, founder and CEO of ShapeUp, a platform to engage employees to participate in corporate wellness initiatives, encouraged employers to help their employees get healthier to proactively avoid the high cost of health care claims.

Either are viable options. Or you could chance it. Or, as Willie sings, you can get “On the Road Again” and ride off into the sunset.