Without Health System Pain, There Won’t Be Gain

Business executives and others who have a keen interest in the cost of health care are questioning the individualistic nature of American culture, and raising this question: How can the health-care crisis be solved when no one is willing to sacrifice a cent or a service to benefit everyone?

    “Until the system completely fails, it can’t be fixed,” says Jerome Mattern, a member of the Society for Human Resource Management’s national committee on benefits and compensation. “There are still too many entities lobbying to protect their own interests.”

    Mattern argues that insurance companies, employers, drug manufacturers and health-care providers all demand the right to pursue maximum profits without governmental mandates. Workers demand unfettered access to the providers of their own choice without taking responsibility for their own unhealthy, bill-inflating behaviors. Government seeks relief from the private sector for having to foot the bill for the poor and underinsured.

    Lee Exton, vice president of The Segal Company, is more sanguine: “I don’t think the system is poised for collapse. It’s a trillion-dollar industry, and they’re going to keep it going somehow. We’ll probably see more involvement at the government level.”

    That is exactly what worries Kate Sullivan, director of health-care policy for the U.S. Chamber of Commerce. She says that government mandates are impoverishing employers by forcing them to provide coverage they cannot afford, and by requiring that procedures such as gastric-bypass surgery and dermatological disorders be covered.

    But even employers have to look at the problem as a whole and not just from their own perspective, or it won’t get fixed, says Sue Cunningham, benefits program manager at Stanford University. She worries that a single-payer system would be corrupted by politics and special-interest groups, but says that “we have to come together as a nation to provide at least basic coverage for everyone.” It’s in business’s interest to provide at least that, “because it costs too much not to.”

    Americans will not solve the health-care crisis until they reach a consensus on the question: “Is access to basic health care a right?” says Alwyn Cassil, spokeswoman for the Center for Studying Health System Change. “If we answer yes, that means everyone doesn’t get everything.” Cassil says that countries such as Sweden, Finland and the United Kingdom “ration care overtly. We ration it covertly.”

    Mattern notes that the business community is already starting to fracture on the issue of limiting the profits of pharmaceutical companies, with a fight shaping up between the drug industry “and all other employers.” Dan Conroy, human resources manager for Nexen Group Inc., is a sharp critic of pharmaceutical companies. “They’re ripping us off,” he says. “Our employees want to be able to buy their drugs offshore, but we can’t reimburse them” because of the regulations.

Workforce Management, November 2003, p. 34 — Subscribe Now!