Sunday, October 11, 2009

Health Care Coverage for the Uninsured Has Become a National Crisis

Where is it written that every citizen should have health insurance? Or every child should get periodic physicals? Or pregnant women should have regular prenatal exams? Nowhere! Yet common sense tells us maintaining one's health is vital. And having health insurance encourages people to do the right thing, such as getting regular checkups and needed attention before situations turn critical.
It's a matter of having "coverage" and not just "access" to medical attention. Not convinced? Let me explain.

We all pay

Anyone can walk into a hospital and receive care in an emergency. That's "access." But if the person has no insurance, the cost is allocated in part to the patient and in greater part to those who have insurance -- to the tune of nearly 20 percent of their premiums. If the patient has insurance -- "coverage" -- then the cost is borne by the patient's insurance plan and the patient. If everyone has coverage, you and I stand to pay less for our insurance -- and for other products.

Business Basics 101

So why do we care that nearly 48 million Americans are without coverage? Or that the number of uninsured Kentuckians is approaching 700,000? Or, that eight out of 10 are working and are too poor to pay or have no plans available? Well, first of all, because people should stay healthy. And, second of all, because businesses need workers who are what I call "action ready" -- physically, medically, and psychologically ready. (They also need educated workers, but that's a different problem.) Unhealthy workers do not motivate businesses to expand or relocate new businesses to areas where the work force is not "action ready."

Taking control

Certainly, there is a cost associated with getting everyone insured. So why change? Because, as the saying goes, "You either pay now or pay later, but rest assured, you will pay." Indeed, we are paying -- right now! And the cost is only going to increase unless we take control. In these uncertain economic times, some think the cost is being deferred, if not completely avoided. Any number of small employers say they can't afford health insurance for their employees. And many workers are choosing food and fuel over health care, assuming they have a roof over their heads. Yet everyone is paying the price. More than 25 percent of the cost of a new automobile is attributed to employee benefit costs. And that cost reflects both the wellness of the manufacturer's workers and the 20 percent up-charge noted earlier for those without insurance. Add to the equation indigent and emergency-room costs that are increasing exponentially, and the total tab begins to look like the national deficit.

Where the action is

Something has to be done. Just as buildings and equipment have to be maintained, so does our work force. And, while presidential candidates campaign on the subject of health care reform, any number of states are actually doing something about it. Tennessee has launched Cover Tennessee to provide schoolchildren, the elderly and small-business employees with affordable health insurance and medication. California has proposed a plan that is stalled in the legislature, but the governor continues to bang the drum in support of adoption. Massachusetts now requires coverage for all its citizens, just as any number of states require no-fault auto insurance.
Still others are moving ahead to address the need, such as Maine, with the Dirigo Health Reform Act, which is aimed at improving the quality of care while containing costs. And Community Care of North Carolina, a provider-led health care network, has gone statewide to ensure patients have a primary care doctor and a medical home where chronic diseases are monitored and treated -- all in the name of improving access and quality of care while saving millions.But while it's tempting to think everything can be done at the state level, the reality is that action needs to be taken at every level.

-R. Brayton Bowen is a business consultant with The Howland Group, a strategy consulting and change management firm based in Louisville. He is also author of "Recognizing and Rewarding Employees." This article appeared in Business First in April of 2008.Reprinted by permission.

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