
Employers play a vital role in the creation of healthy communities. They
provide the means by which people in the community earn a living, pursue
their dreams, and make a difference in the world. As the primary provider
of health care coverage for working people and their families, employers
also shape overall community health in three important ways:
- Offering health insurance benefits, wellness programs, and other direct
workforce interventions
- Partnering with local providers to improve health and wellness throughout
the community
- Aligning strategic and corporate purchasing practices with broader public
health priorities
That’s a pretty tall order. But especially now—a time of unprecedented
uncertainty about the future of American health care – I urge Orange
County employers to embrace this responsibility with renewed vigor. The
community needs employers’ pragmatism, wisdom, and ingenuity.
A good place to start is your company’s values. Employers should
ask themselves: What is our corporate philosophy regarding the health
and well-being of our employees? What is our responsibility for providing
health care services—and at what cost? Obviously, you want a healthy,
motivated, productive workforce. In a dynamic market like Orange County,
competition for top talent is stiff. How do these factors impact the structure
and generosity of your health benefits package?
Businesses value stability, efficiency, and predictability—especially
financial predictability. Savvy business leaders also understand and embrace
their role as community leaders. In that dual role, how do you structure
a health care system that is equitable and inclusive while maintaining
fiscal discipline in a time of escalating costs and scarce resources?
These are hugely important and incredibly complex questions—but,
again, the community needs your pragmatism, wisdom, and ingenuity.
National Trends with Local Significance
It is often said that all politics is local. Health care is the same. Of
course, there are national trends, norms, and regulations that apply throughout
the nation. But it is how those national trends and practices impact us
on a local level —in community hospitals, employer facilities, and
peoples’ homes—that really matters. Orange County—which
comprises nearly 10% of California and 1% of the United States –
is both a driver and a reflection of dominant national trends.
It’s worth examining how key themes in the nation and California
are likely to play out in our communities.
1) Repeal and Replace vs. Single-payer
California’s business community will be impacted by however the winds
of political change tend to blow. If you’ve been following the efforts
to repeal and replace the Affordable Care Act (ACA), you probably know
that California risks large losses to its Medi-Cal program, which serves
one-third of the state’s population. It is estimated that the state
would lose $114.6 billion in federal funds within a decade. Also likely
impacted will be the one million small business employees and over half
a million self-employed Californians who benefited from the health insurance
options provided by the ACA.
Alternatively, some people are calling for a “single-payer”
solution. This is where the government replaces private insurance companies
by paying physicians and hospitals directly for services rendered—much
like Canada and the UK. California has its own single-payer bill—the
Healthy California Act—which is currently stalled in Sacramento
and is estimated to cost California $400 billion in additional funds.
Even if Healthy California doesn’t pass, there are new proposals
on the horizon for state-run health services—especially as the federal
government appears to be moving in the opposite direction. We can’t
predict the specifics of these new proposals right now, but we do know
that employers will be challenged to help fund these state-run services.
2) Innovation
So, with so much occurring in the political arena, where do we go from
here? Regardless of how the health law debates turn out, it’s clear
that we all must be more innovative about health care than ever before.
With innovation our best medicine for tomorrow’s care, it’s
heartening to know there are many Fortune 1000 companies here in Orange
County, along with a growing cluster of technology start-ups of all shapes
and sizes. As local leaders, we need to harness all that brainpower and
invent some innovative, homegrown ways to deliver better, more equitable
health care at a much lower cost.
3) Collaboration
We all have a role to play—health care providers, community organizations,
employers,
and employees, throughout Orange County. If we really want a healthy, happy,
productive workforce, a climate conducive to business success, and an
inclusive, equitable health care system, we must create a vision for a
healthier community together. In these times, it has never been more certain
that we must collaborate to make our vision a reality.
For more information on how St. Joseph Hoag Health is partnering with Orange
County employers to build healthier communities, call 949-381-4777.