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The real cost of healthcare

Leading U.S. newspapers began running stories regarding doctors dropping HMOs for the past decade, usually reporting that it was a financially driven phenomenon. It wasn’t until my doctor informed me that he would no longer be accepting my company HMO plan (one of the top three insurance company HMOs in the United States) that I had to get to the bottom of it. It turns out that, at least in this case, it isn’t about the money.

In this case, the new “guidelines” for the HMO would restrict this doctor to what drugs could be prescribed (many older and less effective), and his ability to refer patients to appropriate doctors for follow-up care would be compromised. Instead, a group of professionals would decide what form the follow-up care might take. I actually felt bad for my physician, a highly respected doctor in the Los Angeles area. He no longer felt he could provide appropriate care to patients he had treated, in some cases for decades.

Last month Marriott International estimated the new Affordable Care Act would cost the corporation more than US$400 million dollars annually. A small entrepreneur I interviewed last week saw their premium increase 30% in the last 180 days, and the Associated Press reported last week that insurance premiums for average Americans’ individual policies under the new healthcare overhaul would increase premiums an average of 32%. But is that the real cost?

As U.S. employees potentially get a lesser standard of care than in years past and follow-up care takes longer to receive, isn’t the real cost our employees’ and ultimately our nation’s health? Is productivity in question when employees have difficulty getting the timely care they need?

Last month in Sacramento, I asked the presenter of  “Covered California” — the new California health exchange system that begins January 1, 2014 — how this was all going to work. They didn’t have the answer.

What can we do?

1. Stay informed. This is an ever-moving target, and the rules are being laid out daily.

2. Communicate with our employees. We may find they are having challenges that we are unaware of in conjunction with the new healthcare changes. These challenges may affect their productivity as well as their stress levels.

3. Encourage good healthcare habits among our teams. The old saying the “an ounce of prevention is worth a pound of cure” may now be an understatement. Provide healthcare information in break rooms and employee areas to encourage new behaviors.

4. Encourage the new, no-cost preventative care that is now available to employees. Your insurance carrier should be able to provide information on access to these new programs.

5. Stay involved in legislation regarding healthcare. There is still much yet to come our way. We must have an active voice in protecting our employees’ healthcare.

6. Consider implementing employee wellness programs.

This is uncharted ground for us as employers and as a nation, but the international community already has faced many of the challenges that are coming our way. I look forward to your point of view.

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