The Sacramento Bee reports today the California Public Employees’ Retirement System will boost health insurance premiums next year for its 1.3 million public workers and retirees that pencils out at 9.5 percent and represents “one of the biggest increases in years for CalPERS,” which is one of the largest purchasers of the health care in the nation. As such, CalPERS health insurance costs serve as a closely watched barometer of where health coverage costs are headed.
This article makes a point also made on this blog: that increasing access to health care fails to address the root cause of increased health care utilization and particularly lifestyles that lead to preventable chronic conditions that are a major driver of that utilization.
Employers are becoming increasingly sensitive to the rising cost of health care, driving interest in prevention and wellness programs designed to reinforce healthy behaviors such as exercise. Some are paying workers rewards to take good care of themselves and even strapping pedometers on them.
But will these measures have a meaningful, long-term impact on getting rising health care costs under control? I’m doubtful because I view this not so much as a workplace issue but more of a work-life time management issue, particularly for office/information workers. If they are commuting to an office five days a week there’s often not much time or energy in the workday for a significant and beneficial amount of exercise and the seven to eight hours of sleep many medical experts say people aren’t getting but should. Sitting in a commute and then sitting in a cubicle for eight or more hours does not a healthy lifestyle make. Just look at the many supersized workers who inhabit this work environment.
One employee wellness intervention that employers of this large category of workers should consider implementing to get measurable results is allowing them to work from their homes or from locales close to their homes for some or most of the workweek. The freed up commute time can then be used for an hour of exercise based on the average U.S. commute time. There’s also the added plus of more sleep time since teleworkers can start work soon after rising without having to prepare for a trip to the office.
The health insurance crisis is essentially a health care cost crisis. Two articles in today’s Sacramento Bee provide insight. One spotlights hospital costs and the tensions they stoke between hospitals and insurers that pay their bills.
Another profiles Dr. Walter Bortz, a professor of medicine at Stanford University. Bortz criticizes the demand side of the health care cost equation, proclaiming the simple truth that rising health care costs can be contained with healthy lifestyle choices rather than more and more treatment once we become ill due to poor diet and lack of exercise.
Bortz’s profile reflects the philosophical divide between advocates of healthy lifestyle choices like himself and a medical industrial complex dependent upon treating people for costly, chronic conditions for the health of its own top line. Medicine as currently practiced in the United States is “a whorehouse” in Bortz’s blunt assessment.
The take away from these articles is we are being forced to choose the preventative lifestyle cost control measures Bortz advocates because our economy can no longer absorb the cost of providing “sick care” as it’s called by some. No amount of adversarial finger pointing between payers and providers can alter that fact and only portends the coming meltdown of the current paradigm.