Healthcare Policy in America: Perpetuating a Vacuum of Failure

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A recent article in the Detroit News reported that, according to key findings obtained from a survey of 203 local company executives by John Bailey & Associates, a majority of businesses in Southeast Michigan expect to either scale back on health insurance coverage for their employees or eliminate them entirely. Over 60 percent of the companies surveyed are considering reductions in future health care benefits for employees while another 27 percent may eliminate medical insurance altogether.

It’s no secret that the burden of skyrocketing healthcare costs has become too much for small business (and their employees) to bear. As unclearness and anxiety over the issues would have it, there is no lack of finger-pointing to go along with it, either. In an interesting twist, the tone of the Detroit News article and statements of the executives interviewed were wrought with indicting concerns over the issue of unhealthy employee lifestyle and its effect on the high cost of health insurance coverage. This is only a mirror of the incoherent healthcare message emanating from Washington that has America in the grips of frustration and inertia. No one seems to really know what’s wrong, how it all went wrong or how to fix it. The worst of it is that no one really seems to want to try. The consensus in Washington is, there is no consensus.

Most in Washington are determined to selfishly tend their little plot of political/ideological real estate, at the expense of a simple little thing called common ground. Meanwhile, the vast adjoining American landscape is littered with the healthcare plight of the medically unattended, uninsured and disenfranchised. If only there were a few in Washington with the undiluted vision and conviction to lift their eyes toward the horizon and view the collateral damage.

President Bush would like America to become an “ownership society”. All well and good, however, those words will continue to ring ironically impotent until Washington resolves to take ownership of America. The famously expired Senate “Health Week” dissolved in unmerciful scorn of the ever-widening procession of the sick and lame, while America helplessly looked on in hope of some political higher power ascending to “stir the waters”.

The runaway cost of health insurance in America requires that two major issues be honestly and urgently addressed: the untenable pricing of network-wide healthcare services that is the result of too much provider-milking of the proverbial health insurance cash-cow and the cost driving nightmare of having to purchase, market and manage health plans through an entangled mess of no less than 50 various state-imposed insurance code packages.

American workers have been precariously hostage to a healthcare system that has navigated them on a course of steadily evaporating choice and access; a system pirated by an unholy alliance of politics and provider imprudence. The money has been easy, something along the order of shooting fish in a barrel, the American worker and his disposable income being the savory target. The easy-money politics of inertia have kept the dollars flowing, but, the incredible folly is that network providers have royally out-priced the market resulting from years of network-wide gravy train riding and the system is collapsing, like a house of cards, under the weight of its own acquisitiveness. Network prices have exploded beyond containment, beyond anyone’s ability to pay and sadly, for him, the healthcare consumer’s pockets are finally empty.

Can we continue to maintain health care policy that has spewed so much damage and failure, that has empowered providers to engage economic impropriety so freely; to operate in a vacuum, with the restraining power of consumer choice in absentia? Can we continue to support a healthcare system that perpetuates such a fundamental imbalance of economic/political power, so much so, that it has rendered healthcare consumers powerless, on their knees and scrambling for healthcare crumbs? Of course we can federally subsidize it, prop up its current price-bloated, imploding state and call it “National” (Universal) health insurance. Maybe it’s the only answer left; the intervention of federally imposed pricing and coverage criteria that will harmonize code and downsize network pricing structure.

These New England Journal of Medicine statements capture much of the harrowed mood of healthcare consumers and policymakers alike: “Without reform, the U.S. health care system will hit the proverbial brick wall in the not-too-distant future…..After not wanting to touch health care reform with a 10-foot pole in the immediate post-Clinton era, policymakers are again confronting the fact that change is desperately needed. The direction of that change, however, is anything but settled. Does the solution lie in private markets, greater government involvement, or some combination of the two?”

Perhaps, with the deplorable 73 percent cost increase of health insurance premiums since 2000 and the continual rise of American workers declining unaffordable employer-sponsored health insurance, the concept of ERISA (Employee Retirement Income Security Act) directed Association Health Plans (AHPs), such as SBHPs (Small Business Health Plans, Enzi, S.1955), propose a compelling direction worth examining. Large companies who self-insure seem to have escaped some of the current healthcare debacle because ERISA empowered options have allowed them to pursue more cost-effective coverage and management strategies (large company self-insure entities, which are wholly exempt from state imposed regulation, are deployed and managed through the Department of Labor (DOL) according to criteria and safeguards proceeding from ERISA). Maybe its time to level the playing field and offer small business some of the same options and priviledges through ERISA deployed AHP’s and provide some relief to small businesses and workers like those hamstrung in Detroit.

Are there answers in Washington? If there are, it has never been more obvious that without a bipartisan consensus reached through honest deliberation, unanimously embracing the sobering urgency of the times, they will never be found. A notable marketing expert(1) who is required by her clients and company to succeed on an every day basis in the corporate world had this to say about honest deliberation; “I work with inspired copywriters and art directors every day, and when I observe them closely, I realize that they rarely have “the” right answer. They simply ask a lot of questions, reach the deepest understanding they can glean, and then invent from there.” Accountability and spirited consensus can deliver powerful results. Best of all, perhaps, you get to keep your job. This process somehow works nicely in the corporate world, where equivocation and arrogance go unrewarded.

The time has come to measure it out in Washington, apply liberally and end the healthcare policy gridlock that is accomplishing nothing more than perpetuating a vacuum of failure ….and quite literally, the killing of America.

You can obtain a free copy of the special DOL Report on AHPs, Association Health Plans – Improving Access to Affordable Quality Health Care for Small Business , here.

(1) The Idea Generation by Lisa Seward; Media Post’s Media Magazine, June 2006

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This article appeared in American Chronical, June 30, 2006.

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