There is only one way that healthcare can really be reformed and that is through the marketplace. The World Health Organization ranks the United States as the 37th-healthiest country in the world. Not only are Americans not as healthy as the rest of the world, they are also paying way too much for the healthcare they receive.
As I have said before — and will keep saying — it’s time for U.S. business owners step up to the plate and reform healthcare. According to the Kaiser Family Foundation, employers cover 49 percent of our nation’s population and pay 83 percent of the employees’ healthcare premiums and 72 percent of the employees’ family’s healthcare premium. This is an enormous amount of money that should allow business owners to control the economics of healthcare. But they don’t.
Not only do we need to take a hard look at financial reform of healthcare, we must also reform how healthcare is delivered to patients. In a previous column, I recommended that we bring back a public hospital to Salt Lake County. The hospital should be funded with state and federal dollars. We voted on expanding Medicaid to allow the state to go after more federal funding. A better use of taxpayers’ hard-earned dollars would be to fund not only a public hospital in Salt Lake County, but also public hospitals around the state.
Lately I have been researching a new term that was unfamiliar to me: the “value equation” of healthcare. The equation is the brainchild of Harvard Business School’s Michael Porter and is used by University of Utah Health Sciences to control its costs and improve the quality of care that it delivers. The equation is a composite that gives a score of healthcare value by adding together healthcare quality plus patient satisfaction divided by the cost.
Finally, business owners have a matrix that could be incorporated into requests for proposals from healthcare providers for their companies’ healthcare services. Other provisions that should be included in the proposal are bundled pricing — like a fixed price for a hip replacement — and a guarantee of access requirement.
Another option for employees’ healthcare needs is for business owners to hire their own doctors and build their own hospitals. Alphabet, the holding company that owns Google, hired Dr. Vivien Lee, former head of the University of Utah Health Sciences, as president of its Health Platforms department. If industry does not want to own a hospital, the least it can do is start its own primary care clinics.
When I was negotiating on behalf of Utah’s small businesses with University of Utah Health Sciences, one of the first concerns they brought up was who was going to pay for the insurance. Regrettably, I said small business would. Healthcare insurance is a real bag of worms. There are two types of insurance — normal, every-day insurance and reinsurance. I had a devil of a time trying the get a handle on these costs and eventually decided that the best answer to small-business insurance needs was to eliminate everyday insurance, get the healthcare provider to cover it, and for small business to only pay for the reinsurance.
Under the new plan I am proposing, healthcare providers and businesses wouldn’t have to deal with insurance at all. This would be a boon to healthcare providers and is heck of a way for businesses to increase their productivity and improve their bottom lines. Obviously, this would lower our nation’s healthcare costs significantly.
It baffles me that business owners do not take charge of their healthcare costs and aggressively put pressure on the healthcare industry to lower costs, improve quality of care and improve access to medical providers.
But when I was trying to get small business to man the barricades to accomplish the above, all I got was blank stares. But small businesses aren’t the main culprit. Big business is by far the largest provider of healthcare in the country.
Employers-sponsored health plans are a wonderful way for businesses to guarantee high-quality healthcare for 49 percent of America’s population.
Robert Pembroke is the former chairman and CEO of Pembroke’s Inc. in Salt Lake City.