Employers take long view on health and costs

There are several eminently good reasons why private companies are leading the charge in the United States on prevention, wellness, chronic disease management delivered in on-site primary care.

Unlike health care providers and insurers, employers have a long-term relationship with employees, a career long relationship on many cases. That includes a long-term commitment to paying the lion’s share of health costs for each employee. That price tag could run as high as a half million dollars per employee over a long career.

With companies picking up 70% to 75% of the health care bill, they obviously have a lot at stake in each employee’s long term health.

In contrast, health care delivery is for the most part reactive. The big hospital systems fix you when you are broken. They usually do a good but expensive job of it. It’s a short-term relationship – in and out. Routine office visits in the big systems, when overall health is dealt with, last a brusque six to eight minutes.

Hence, big medical providers in America largely do a superficial job of tending to long-term health.

In his book, “Younger Next Year,” Dr. Henry Lodge said, “Most modern medicine is what lawyers and bankers call transactional; a one shot deal.

“You blow out your knee, you have a heart attack, and you see a specialist. A short, intensive period of repair or cure follows, and the parties go their separate ways, probably forever.”

Dr. Lodge says it’s an outrage that medicine does so little to deal with lifestyle mistakes that cause half of the diseases in men and women.

He is one of the few primary care providers have take seriously a long-term relationship with patient, just as employers do. Therefore, it is a perfectly logical outcome that large employers are hiring their own primary care providers in their own on-site clinics.

Health insurers also take a more short term view. That is probably because Insurers are often swapped out as employers bid out their business and shop for better discounts. Their prevention and wellness programs are more token than real.

The third party that should have a long-term view that health is a precious asset is the individual. Employers, primary care providers and the employee should have the same long term interest in staying healthy and staying out of the hospital.

The rewards from a continuous focus on health are many. Pro-active primary care delivered on-site can cut costs by 30% to 40%. That’s proven, audited stuff. The reductions come through serious management of the chronic diseases that cause most of the costs.

Serigraph, for example, has cut its hospital admissions by more than half to 34 per 1000 lives per year. Employers and employees both save a ton of money when that is accomplished.

It’s obvious why private sector corporations are stampeding toward hiring their own doctors, nurse practitioners and nurses, often in on-site clinics.


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