Laudra's Lessons - "America's Bitter Pill" Analysis Part 1

A few years ago I read a wonderful article on the healthcare crisis in Time Magazine.  I wasn’t the only one who thought it was educational and insightful as the article won the National Magazine Award for Public Interest.  So when Steven Brill expanded his narrative to include the antics leading up to the Patient Protection Act aka Affordable Care Act aka Obamacare, I had to buy “America’s Bitter Pill,” money, politics, backroom deals, and the fight to fix our broken healthcare system.

I haven’t finished it yet so am some distance from his solution but am well into the problems that the states, the hospitals, the insurance companies, the drug companies and the lobbyists caused to keep the ACA from becoming what it could have been had everyone had the same goal – a better, less expensive health plan for the American people.

 Brill talked to all of the mentioned group. The President of the United States answered written questions submitted to him about the high cost of treatment and the abuses in our system. In 2014 we spent three TRILLION dollars on healthcare, “that’s more than the next ten biggest spenders combined: Japan, Germany, France, China, the United Kingdom, Italy, Canada, Brazil, Spain, and Australia.”  And in many cases, particularly infant mortality, our outcomes are far worse.

Healthcare has turned out to be a windfall for hospital administrators (who earn way more than doctors), drug company executives, and salespeople of medical equipment.  Apple is considered a premier American company but Medtronic, maker of all sorts of medical devices has nearly double the gross profit.   Healthcare is the only industry where technical advancement has increased costs. 

Healthcare is America’s largest industry and it is profit dominated. If the cost of healthcare is cut, incomes have to be cut as well.  Right now healthcare executives are getting wealthier and care users/patients are getting poorer.  Sixty percent of the 1,000.000 bankruptcies in the US were the outcome of high medical bills.

Stay tuned for more information as this will be my topic for the next few newsletters, or you can buy the book by clicking HERE.

All Things Equal

We are truly blessed to live in a state where ethnicities across the globe have come to settle, live, work and play on the sunny islands of Hawai’i.  The faces of the Aloha State span the ages too, with keiki to kupuna an important part of the fabric that weaves our community together.  I would hope to think that the idea of “Equal Opportunity” would be a non-issue in our very liberal and diversified state. But as all business goes, there are rules and regulations set in place to protect and advocate for equal opportunities for all classes. 

Here we briefly remind you Small Employers of your responsibilities when it pertains to regulations set by the United States EEOC – Equal Employment Opportunity Commission:

If you have at least one employee: You are covered by the law that requires employers to provide equal pay for equal work to male and female employees.

If you have 15 to 19 employees: You are covered by the laws that prohibit discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, disability and genetic information (including family medical history). You are also covered by the law that requires employers to provide equal pay for equal work.

If you have 20 or more employees: You are covered by the laws that prohibit discrimination based on race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability and genetic information (including family medical history). You are also covered by the law that requires employers to provide equal pay for equal work.

National Immunization Awareness Month

August is National Immunization Awareness Month which highlights the importance of vaccinations for people of all ages.  Vaccines are a necessary preventative measure against serious, sometimes deadly, diseases.

During National Immunization Awareness Month, we want to provide resources to ensure that employees and their families have access to this important piece of preventative care. Please read our Resources Article to learn how you can schedule a clinic at your company and other ways you can educate your employees.

As part of health care reform, most Carrier plans cover basic immunizations at 100% (with the exception of some Grandfathered/Grandmothered plans).  These include all of the Advisory Committee on Immunization Practices (ACIP) recommended Childhood and Adult immunizations with flu shots being the most common.  We here at EBC would be happy to confirm your plan status and benefit coverage for immunizations.

Each week this month we will highlight a different group of people.  The first week is for infants to make sure that all the children who are not in daycare are still getting vaccinated. Other weeks will focus on older children, adults and pregnant women.

National Immunization Resources

Educate your employees about immunizations in recognition of National Immunization Awareness Month!

National Immunization Awareness Month (NIAM) is sponsored by the National Public Health Information Coalition (NPHIC). NPHIC, in collaboration with CDC’s National Center for Immunization and Respiratory Diseases, developed communication toolkits to help you educate people of all ages about vaccines recommended for them.  For more information on the observance and to download the communication toolkits, visit NPHIC’s NIAM website.

During flu season, September through February, Carriers offer free vaccinations to their members at participating pharmacy locations, and also offer worksite clinics.  Worksite clinics often require a minimum number of participants and will even cover employees who are non-members of the hosting Carrier. To get more information about hosting a worksite flu clinic, please EMAIL us and we can help facilitate an event with your insurance carrier.

Why Immunizations are Important

• Diseases are becoming rare as more people are vaccinated against them

• Protect against preventable diseases

• Protect against vaccine-preventable diseases that are still are threat like measles and whooping cough

• Protect against illnesses that can cause serious complications, even death

• Protect those around you that are sensitive to illnesses like newborns and the elderly

• Some countries don’t require vaccines which leaves those without immunizations susceptible

• Immunizations protect against future illnesses that could result in high healthcare costs

• Vaccines are safe and effective

This week, please go to the following sites for more detailed information on vaccines; particularly infant vaccinations:

http://www.immunize.org/importance-of-vaccines/

https://www.vaccines.gov/getting/for_parents/five_reasons/index.html

https://www.cdc.gov/vaccines/parents/travel-vaccines.html      

https://www.cdc.gov/vaccines/parents/infographics/strengthen-baby-immune-system.html

Combat Diabetes at Work; Save Employees & Health Costs

In Hawaii, the percentage of the population that is diagnosed with diabetes is 13%.  A somewhat manageable sounding number, no? Well, there is another 41% that are categorized as pre-diabetic.  Meaning, if these people do not take steps toward managing and controlling this disease, it will turn in to a more serious Type 2. That means an astonishing 50% of our local population is diabetic or pre-diabetic!  Chances are, one of these two people are working for you.

As an Employer, what does this have to do with me?

For starters, diabetes is the second highest cost driver of medical and insurance costs only preceding cancer.  Studies have determined that for someone with managed, controlled diabetes the yearly cost for care is $45,000. As such an employee’s health plan sponsor, this directly impacts your group plan.  This number also does not account for the indirect costs associated with time off, absenteeism, TDI, FMLA and other aspects of chronic conditions that may affect your employee and their productivity.

As an Employer, how can I help my employees manage this condition?

There are many different risk factors that can be associated with developing diabetes.  Some may be genetics (highly prone to Asians, Pacific Islanders, men) however many of the risk factors fall into the  lifestyle category such as nutrition, weight management, physical activity, and compliance for pre-diabetics and diabetics to make subtle changes in their behaviors and prescribed plan of treatment.  Aside from the patient taking the initiative to want to change their risky behaviors and manage their diabetes, employers can be an environmental influence to help lead the patient down the path of behavior change. Swap out the soda machine for a filtered water dispenser, provide fruit and wraps at your next lunch meeting instead of bentos and chips.  Yes, employees may gripe at these unfamiliar changes at first, but if you make your intention clear that you care about them and they are an important aspect to your company, they will come around. Provide opportunities to be active. When appropriate, a standing or walking meeting not only gets you out of the office but it gets the blood flowing. Prop open that dingy stairwell door to encourage employees to take the stairs. There are even exercises that employees can do at their desk.  Any small change is a change in the right direction.

1/3 of adults lack the sufficient health literacy to effectively manage their diabetes.  While not an employers responsibility, here in Hawaii we do imbody a “work ohana” type atmosphere.  By providing a nurturing environment that fosters awareness and education with resources for your employees, it shows them how much you care.  You do not need to re-invent the wheel. There are many resources that are available to employers for your use and distribution. Click on the links below for specific programs and collateral:

National Diabetes Prevention Program

American Diabetes Association    

Department of Health    

HMSA Diabetes 101 Workshop

HMAA Gestational Diabetes Management Program  

UHA Diabetes Management Program  

Kaiser Stop Diabetes Class Schedule

HDS Diabetes and Gum Disease Connection

20 Exercises to Do at Your Desk