For all the "Moral Imperative" arguments and other hyperbole that President Obama and his like-minded health reformers have put out in their briefings and town hall meetings about the uninsured, we have to ask, has anyone done the math?  And not just about the extraordinary cost burden of the various Democratic plans, but about the practicality of driving 47 million uninsured into a health system that is already inefficient and understaffed

Today's New York Times actually addresses the issue and highlights the problem the nation could face in 2013 when all Americans would be required to have health insurance, under the House proposal. 

We not only have the demographic boom in the 65+ population contrasted by a leveling off in the growth of the number of physicians, but also the experience of a state that has addressed the problem of the uninsured (chart on right).  In Massachusetts, which implemented universal healthcare in 2006, the health system was so taxed that 24% of residents surveyed in 2008 claimed that they had a hard time getting the care they needed, compared to 16% the year before.  That's an increase of 50% in just one year.   And the state has yet to figure just out how to pay for this plan.

The article also notes that by 2025 (chart on left), the American Medical College projects a shortage of 124,000 physicians without universal coverage, and another 25,000 with it.


Our view is that there are plenty of problems with healthcare in this country.  But logic of pushing more people into a system that isn't working is neither moral nor an imperative.  We should focus on strategies that build off free-market solutions that have proven effective across other sectors such as financial services, auto insurance, or travel.  Use the principles of economic theory that promote choice, price transparency, quality comparisons and other solutions that can allow consumers to flex their market power and drive efficiency into the system.

Part of this also means promoting greater personal responsibility for individual health - which will not come with the Democratic plans.  We're moving in the wrong direction if we provide more power to the government to implement change, rather than to the patient who should be in the driver's seat.


Frank Hone
Author, Why Healthcare Matters


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It's telling that the Obama Administration has already rebranded their efforts to socialize medicine in this country.  Not that the concept of socialized medicine is explicitly stated anywhere in the 1018 pages of the House bill...but it's in there...They have now taken great pains to talk about "Health Insurance Reform," a not-so-hidden jab at the supposed villains in the healthcare system - that is, if you believe Nancy Pelosi's assessment of the insurance industry.  

Interestingly, yesterday's Rasmussen Report conveys that 51% of the American people fear government more than insurance companies.   And there is much more to come.  Despite being one of the traditionally quieter news periods of the year, the next few weeks should prove to provide a much richer and more colorful storyline of the government's plan.  This is good, because most of the voting public were lulled into disinterest in the earlier days of congressional discussion on addressing healthcare change.  People need to be engaged and involved, and their voices need to be heard in the many forums now available for discourse.  The national media will pick up on the events where anger and confrontation occur, but this will only fuel more rational expression about the direction of the debate.

We need to understand the "why" of all this.  What is the ultimate outcome?  Lawmakers seem to be long on tactics and short on strategy.  Their goal is, or was,  to provide health insurance for the majority of the uninsured, but a key question is, to what end?  

Many in the industry would agree that a central outcome should be to improve the health of American citizens.  Is broader insurance coverage the answer to that?  Or do we need to do more work addressing the root cause of poor health in this country?  

In a nation that is, generally speaking, out of shape, noncompliant, happy for a handout and "living in the moment", are we really going to expect health behavior change just because more of the population have health insurance?  This is simply going to add health costs to a system that needs fundamental restructuring.   

The real opportunity is to put more attention toward the demand side of the equation.   Despite the recent vocal public outcry against the government plan, consumer power in healthcare has been extraordinarily weak and disorganized.  Oh, there has been activism around breast cancer, HIV/AIDS and some other diseases, but when it comes to being market-driven, healthcare is at the bottom of the list.  National advocacy efforts would do well to first address personal responsibility and behavior change on the demand side before we put additional untold billions into the dysfunctional supply side.  


Frank Hone
Author, Why Healthcare Matters
Naples, FL


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It seem like the more President Obama defiantly insists that a transformational, budget-neutral, good-for-everyone health reform bill will pass this year, the longer the odds become.  Yesterday, he again chided those that , "those who are betting against us on getting this done are badly mistaken" in a clip played often last evening.

So there was a certain satisfaction this morning to open the leftist New York Times to see the headline, Democrats Grow Wary as Health Bill Advances.  Somehow, he feels that the more he claims the "historic opportunity" facing the nation, the more important the populace will feel about the valor of passing legislation, regardless of the damage will create.

"This is what the debate in Congress is all about: whether we'll keep talking and tinkering and letting this problem fester as more families and businesses go under and more Americans lose their coverage," Obama said Saturday in his weekly radio and Internet address. "Or whether we'll seize this opportunity — one we might not have again for generations — and finally pass health insurance reform this year, in 2009."

A major problem with the proposal is that the main intention is to provide universal coverage.  That didn't work in Massachusetts, and it won't work on a national level.  But, perhaps even more concerning, is the desire to push more people into a system that is already dysfunctional.  It would sure be a lot more logical, from a strategic management standpoint, to fix the many systemic problems first, then encourage more access.  

And with regard to the public health option, why not encourage private health insurers more ability to better compete, like by eliminating the state-level controls and allowing them to provide coverage in all states? 

Finally, we must give more attention to the demand side of the healthcare equation, rather then focusing solely on the supply side.  By effectively driving health behavor change and personal responsibility at the consumer level, the nation's healthcare system could be relieved much of the burden of lifestyle-related conditions and diseases.

So, despite the president's defiant urging, sentiment and support for this massive reform bill seems to be eroding as more and more legislators and voters gain perspective that it is not the right solution.  Change is needed, but it must come from market-oriented approaches, not socialist measures.


Frank Hone
Author
Why Healthcare Matters


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Effective this week, Frank Hone has joined Healthways, the Nashville-based provider of specialized, comprehensive disease management and wellness solutions.  Healthways is a fast-growing company on the cutting edge of health improvement for thousands of clients and millions of consumers in the US, with an expanding presence in overseas markets. 

His role will be to serve as Sustainable Engagement Leader in their Innovations group, with a mission to advance the state-of-the-art in participant enrollment and ongoing use of Healthways services.  This includes identifying the best ways to attract participants, sustain their involvement, and use physical, mental, and sociological programming to create deep and on-going engagement that lead to positive health outcomes.

This is an exciting opportunity and will allow him to leverage his experience in healthcare consumerism, direct-to-consumer advertising, new product development, consumer insights, strategic planning and global marketing to help advance and improve the company’s already outstanding service offerings.  He'll be based in Naples, FL, with frequent travel to Nashville and many other points around the country.

He expects to maintain an active industry presence, advocating for prevention and wellness, greater consumer involvement and personal responsibility, and increased emphasis toward demand side solutions in addressing our nation’s healthcare challenges. 

Frank Hone
SVP – Sustainable Engagement Leader
Healthways, Inc.
frank.hone@healthways.com
www.healthways.com
7865 Hawthorne Drive, #401
Naples, FL 34113
917 375-7716
Author, Why Healthcare Matters

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As Congress debates the massive efforts to reform healthcare in this country, many of the concerns relate to the growing cost of effectively delivering quality service to the broadest number of Americans in need.

But while this is going on, and most of the populace have little or no real input in the process, there is a lot happening on the other side of the equation – the demand side.

Many leading-edge employers have begun to create a culture of health in their workplace and have developed programs and incentives to help improve health behavior of their people. 

Last Friday’s Wall Street Journal featured an opinion piece called How Safeway is Cutting Healthcare Costs, by Steve Burd, CEO of Safeway.  Burd has long been an advocate of market-based solutions for the nation’s health crisis, and he summed up the problem in simple terms:

Safeway's plan capitalizes on two key insights gained in 2005. The first is that 70% of all health-care costs are the direct result of behavior. The second insight, which is well understood by the providers of health care, is that 74% of all costs are confined to four chronic conditions (cardiovascular disease, cancer, diabetes and obesity).

He further noted that majority of people at risk for these four disease states can actually prevent them.  Safeway has developed a health insurance model that rewards good behavior and penalizes bad behavior – not unlike the auto insurance industry – and it’s working.  They’ve been able to keep costs down and improve health outcomes and productivity.  We wholeheartedly agree with this approach, and believe that Business holds far more weight in addressing healthcare than Washington gives them credit for.  I sent the following note to the Journal which was published online:

Steve Burd is a hero to all proactive and pragmatic business leaders that want to do what is within their power to address the cost and productivity issues of healthcare. His thesis is clear and cogent and leverages the principles of healthcare consumerism.  The stale and regressive arguments from the left in the current health reform debate pale in comparison to this refreshing and effective views of a CEO who has first-hand experience of stimulating behavior change in middle-class and often transient workforce of supermarket employees. Let's hope that Congress takes a close look at his piece and listens to his sage advice.

Business has a lot to offer in building appropriate interventions, incentives and support programs to improve the health of our people.  Congress needs to learn more about all that is happening in this area in corporations across the country, and they should encourage deeper involvement of corporations in healthcare reform initiatives.


Frank Hone
Author, Why Healthcare Matters



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Today's NY Times featured a piece by Economic Scene writer David Leonhardt on the issue of rationing relative to health reform.  He argues that rationing is part of life in these United States, whether we are talking about healthcare, vacation spots, or prime steaks.  He notes that the key is to "ration well", as opposed to simply rationing. 

That, I would agree, does make good sense, but to achieve this, we must have a system that is more market-based than government-run.  The government certainly hasn't proven itself an rationing arbiter extraordinaire, whereas effective markets do self-regulate in a way that should lead to economic fairness. 

Perhaps I expected more from an economist on the topic of rationing, as it does not stand alone, but rather is one part of an extremely complex economic puzzle.  So from a bigger picture perspective, I offered the following in my letter to the NY Times, published this morning:

Author David Leonhardt makes some good points about rationing in his piece on health reform.  As the rhetoric and position-building in Washington grow in intensity, we should actually hope to hear a whole lot more in the way of rational economic perspectives about health reform.  A few thoughts:

• A basic tenet of economics is the law of supply and demand.  But why then, is there so little discussion of the demand side?  Nearly all the storyline we hear out of Washington relates to ways of adjusting, expanding or re-pricing the supply side.  We know that some 70% of healthcare costs are behavior-related, yet there is very little emphasis on the role of individuals to take greater personal responsibility for their own health.

• A basic lever in economic theory is incentives.  But why then, are so many of the incentives based on tests and procedures the physician performs, and not related to the outcomes they achieve with proper care?  We do not pay accountants, auto mechanics, butchers or barbers for the steps they take in their work, we pay them for results.  And to the point of the demand side of the equation, where are the consumer incentives that can actually drive better behavior? 

• Critics continually cite the amount spent on healthcare in the US versus other counties, but fail to note that this spending is actually a powerful economic engine.  Not that it’s all well spent, but that it does support a variety of industry subgroups and thousands of companies.  The US is more of a market-driven economy than any other nation on the planet, which by the way, suggests that the way to improve on the inefficiencies of the health system is with market-based strategies.

• Mr. Leonhardt makes the point about employers having to pay higher insurance premiums which often lead to minimal pay raises.  This is true for corporations that are not proactive in addressing health in the workplace.  On the other hand, there is substantial documentation about the return on investment for companies that have made employee health a priority, instituted disease management and wellness programs, provided incentives for health behavior change and focused on individual personal responsibility.

He’s correct that we will continue to hear about “rationing” as a key issue from critics of socialized medicine.   That concern can be set right with more effective use of demand-side approaches and incentives, attention to improving health behavior, and allowing the market to work by promoting price transparency, greater choice and broader access.

Frank Hone
Author, Why Healthcare Matters
Naples, FL

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Now that the healthcare debate in Washington is getting the attention of both common citizens and influential business leaders outside the Beltway, it is coming clear that a lot of what's being proposed is just wrong for this country. 

While complex and inefficient, our nation's current healthcare system is still far better than the socialized medicine offering of European countries or Canada.   The Obama Administration would do well to more closely examine the efficiencies of systems where medical care is rationed in order to manage demand.

The United States is the freest country on the planet - why would we stoop to the sort of government-run program that deprive citizens of freedom of choice?  More importantly, why are we not using the power of healthcare consumerism to drive better efficiencies from our current system?  This is achievable, and is one of the main theses of a new book, Why Healthcare Matters: How Business Leaders Can Drive Tranformational Change. 

Why Healthcare Matters offers a big picture perspective on what’s wrong with healthcare in the US, and provides a set of practical, market-based strategies and solutions. 

The book explores an array of contributing factors and competing interests that have fed the decline in the healthcare system and led to out-of-control health insurance costs, higher disease incidence and sub-optimal medical care.  This includes discussions around medical errors, medical malpractice, healthcare quality, administrative costs, and the uninsured along with a complete evaluation of the Medical Model and its inbred biases

Why Healthcare Matters offers an insider’s view on the nation’s growing healthcare crisis with ideas for substantive change.  It calls on corporate leaders to more actively participate in the transformation of healthcare in the United States by devising C-level strategies to approach employee health within their own organizations. 

Today 60% of the US population (over 170 million American adults) is covered by such plans.  For too long, the employee health benefit has been farmed out to a third party.  Companies now need to regain control of this increasingly important and costly investment in human capital.

Why Healthcare Matters is a business guide.  It helps corporate leaders clearly understand the range and depth of the crisis from a business perspective, providing best practice and lessons learned from progressive companies whose actions are leading the transformation.  Specific and detailed recommendations illustrate how they can latch on to the promising trend of healthcare consumerism and implement powerful new concepts strategies to lower overall costs and improve health outcomes at their companies.

The book’s core idea is that the essence of the solution lies in personal responsibility, that the main catalyst for change is healthcare consumerism, and that the main engine for popularizing this is the business community acting as employers.

Why Healthcare Matters is a practical guide for employers to help address one of the great macroeconomic challenges of our time: the US healthcare crisis.  Employers have leverage to initiate real market change by encouraging greater personal responsibility from their workforce.   Healthcare consumerism can influence the markets toward greater economic efficiency, better quality of care, and improved outcomes overall. 

The heart of Why Healthcare Matters is the Seven Step Guide to Transformational Change for Employers. This strategic template has recommendations that can lead to substantial positive change for healthcare in their company.  Collectively, American business can lead the nation to substantial improvements in the cost, quality and outcomes of the US healthcare system. 

Corporate executives are an audience primed to do something about this problem with the power to make a difference. Essential to this solution is to shift the emphasis from the supply side to the demand side, to put the power in the hands of the people.  Why Healthcare Matters is a manifesto for change and provides the information, insight and ideas for how corporate leaders can make this happen. 

Order it now from Amazon, and read how free-market solutions can really drive effective change for healthcare.


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For the second day in a row this week, President Obama spent time at The White House with key stakeholders in healthcare.  During today's meeting, the focus was on company leaders who have been early adopting employers of healthcare consumerism as a way to address employee health.  

Yesterday, he got everyone's attention by getting executives that represent three-quarters of the Medical Marketing Model (Pharma, healthcare professionals and insurers - the FDA did not attend) to pledge to lower their costs over the next several years.  This was a big win for the administration because out-of-control costs have a chokehold on reform efforts.  

But the real excitement for advocates of free-market strategies and demand-driven solutions came today when the main topic related to behavior change.  By meeting with employers who have had the direct experience of reducing their healthcare costs, and improving their worker productivity and company profitability through employee health initiatives, the president has signaled the importance of encouraging wellness and prevention through appropriate employer interventions.

With representatives from Johnson& Johnson, Pitney-Bowes, Safeway, Microsoft, REI, as well as the State of Ohio and the Hotel and Restaurant Employees International Union, President Obama listened to their stories and came through with a clear message to the nation:

"So what we've done here today is to gather together some of these stories and best practices to make sure that they are going to be informing the health care reform discussions that take place here in Washington.  There's no quick fix, there's no silver bullet.  When you hear what Safeway or Johnson & Johnson or any of these other companies have done, what you've seen is sustained experimentation over many years and a shift in incentive structures so that employees see concrete benefits as a consequence of them stopping smoking or losing weight or getting exercise, working with providers -- the provider incentives are aligned with the employee incentives as well, and changing the culture of a company."

This is precisely the sort of thinking that we need to be focused on as the Congress works through health reform planning.  Employers must be centrally involved, healthcare consumerism and consumer power needs to be recognized, personal responsibility should be leveraged, and in the end, a better between supply-side refinements and demand-side efforts can bring about new efficiencies and a healthier nation.

Frank Hone
Author, Why Healthcare Matters

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With the news on health reform starting to pick up, it was certainly encouraging to open the Sunday newspaper and read that Congress has taken up a position reflecting demand-side solutions for employee health.  

 The article in the NY Times says the plan is to give employers more of a say in helping to drive health behavior change through efforts delivered at the workplace.  Senator Tom Harkin, a Democratic voice of reason when it comes to healthcare, notes that “prevention and wellness should be a centerpiece of health reform.”  His advocacy in this area is long and well-documented.  But he seems to have gotten others from his party to come around as well.

What’s refreshing about this view is that it is giving focus to driving health behavior change among consumers so that they can delay or avoid accessing the healthcare system about lifestyle-related diseases or problems. 

This concept is similar to the strategy of Nixon’s “War on Drugs”, which was designed to tackle the problem at the source of drug importation.  By emphasizing consumer interventions with health improvement incentives and rewards, there is a fantastic opportunity to drive more “health” into the culture and begin to reduce the reliance on “sickness treatment” that exemplifies our healthcare system. 

Wellness has unfortunately been on the fringes of the healthcare system for far too long.  It had been viewed as soft and fuzzy and unscientific, but over the years the data have shown positive outoomes, and today many companies are already committed to using as way to address employee health. 

Look for even more innovations from companies like Healthways, SHPS, Alere, Health Dialog, Meritain and others that have proven programs in this space.  They have been given a golden opportunity to be at the center of health reform, and allow healthcare consumerism to really deliver effective solutions with measurable results for employee health. 

Frank Hone
Author, Why Healthcare Matters

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In the course of working with clients and talking with other experts in employee health, we continue to experience a wide variation in knowledge, experience and motivation toward health behavior change in the workplace.  Most believe that working to develop strategies that improve employee health and reduce overall cost is a good thing, but many aren't sure where to start. 

For that reason, were excited to announce of a new webinar on the topic, entitled Help Your Employees Get Healthy, While Reducing Costs and Increasing Profits:Employee Health Strategies That Impact Your Bottom Line.   effective strategies to address employee health as a means of reducing costs and increasing productivity and profits.  The webinar will take place on Thursday, May 7 at 1pm, hosted by Business Expert Webinars.  Frank Hone will be the featured presenter of this educational and insightful one hour event. 

"There must be something I can do to address the rise in healthcare costs…" Like all business owners and leaders, you’re searching for solutions to help rescue your company from the economic crunch. But you can only cut staff and spending so far. In the end, a healthier workforce will actually save money and deliver better results. To truly grow the bottom line, you must do something to improve employee health as a way to lower costs.

Frank Hone, author of Why Healthcare Matters: How Business Leaders Can Drive Transformational Change, teaches business leaders how to reduce company healthcare costs by improving employee health. You’ll learn a process for creating a culture of health among your employees so they willingly take personal responsibility and action to improve their health. As a result of their active participation, you’ll not only reduce health care costs, you’ll also increase productivity and reduce absenteeism.  You can learn more and register for the event by clicking here.

In this webinar, you will learn how to:

• Design a culture of health founded on employee accountability
• Develop a communication strategy to fully engage your workforce
• Create strategies to address lifestyle-related conditions and diseases
• Employ health screenings and interventions for positive change
• Formulate strategies and tactics to promote personal responsibility for health

About the Presenter: 
 
 Frank Hone is a consultant, author and advocate for free-market healthcare solutions. His book, Why Healthcare Matters: How Business Leaders Can Drive Transformational Change, offers perspectives on the US healthcare crisis, proposes that business has a major role to play in transforming consumer health attitudes and behavior, and provides a blueprint for change that incorporates creating a culture of health, fostering personal responsibility and leveraging healthcare consumerism. As Founder and CEO of Healthcentric Partners, he leads engagements supportive of employer ambitions to promote better health in the workplace as a way to lower cost and increase productivity. 

Go to Business Expert Webinars to register.
 
Frank Hone
Author, Why Healthcare Matters

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