Business forum: Health care needs new treatment

Guy goes to the doctor and says, "Doc, it hurts when I do this."

Doctor says, "Don't do that."

It's an old joke -- but sound advice for those of us hoping to transform our disjointed, dysfunctional health care "system" into a functioning market that serves us all equally well.

Everyone is worried sick about health care, including employers. More than half the employers responding to a Minnesota Chamber of Commerce survey last year identified access to affordable health care as the most- or second-most-important issue facing the state.

That's not surprising. Nearly two-thirds of Minnesotans receive health coverage through employers -- the second-highest rate in the nation. On average, those employers pay about 80 percent of the premium, which is a financial benefit most of us don't appreciate until we have to buy insurance on our own.

The financial burden is getting heavier for everyone. Insurance premiums rose 68 percent in the past six years, according to the Minnesota Department of Health, making health care the fastest-growing cost of doing business for many employers. With premium costs rising 4.5 times faster than inflation, some smaller employers have stopped offering health benefits. Others are shifting costs to employees. Understandably, some employees aren't happy, and some are forgoing insurance.

The Minnesota Business Partnership and the Minnesota Chamber of Commerce view health care as a broken market that -- despite the best intentions of many stakeholders -- isn't geared toward controlling costs or improving overall health. The standard treatment -- minor tweaks followed by congratulations all around -- won't cure what ails us.

That is why we have outlined a "Business Plan for Health Care Reform" that offers a basic framework for transforming health care into a responsive, functioning marketplace that delivers optimal outcomes at affordable prices. Simple, but not easy. We recommend that we stop doing a few things that hurt:

•Doctor, it hurts when we make people fill out the same paper forms time and again for someone else to enter into a computer. Beyond clerical costs and patient inconvenience, this fragmented system prevents health care -- despite amazing technological advances -- from fully using data to improve the overall quality of care and drive down overall costs.

We can improve quality and reduce costs by making health records portable and by adopting a statewide standard for information sharing. Legitimate concerns about data privacy must be addressed. But we should stop limiting the potential that technology offers to make care better and more affordable.

•It hurts when we make it hard for people to be savvy health care consumers. People are very interested in the quality of their care and understand that they have a role in controlling costs. To help people be smart consumers, providers should offer transparent price and quality information. Innovative programs such as the Minnesota Community Measurement and Carol.com are showing that this is possible for routine procedures and disease management services.

•It hurts when our system rewards process over outcomes. Office visits, tests, procedures -- the more expensive they are, the more rewarding for the provider. Yet better management of chronic illnesses such as diabetes or hypertension, which could improve overall health while dramatically reducing overall costs -- isn't paid for. We can improve people's health and reduce health care costs by shifting skewed financial incentives to reward the value of care, not the volume of services.

•It hurts when we pile on rules and regulations that add to the cost of insurance. The list here is long and space is short. One example: Employers can deduct the cost of insurance premiums, but individuals can't. Health insurance is expensive because health care is expensive. Regulation is needed, but shouldn't be counterproductive.

•It hurts when we don't take care of ourselves. This isn't health care, it's health. Behaviors that affect health are individual choices. But we can reduce health care costs -- individually and in total -- by improving our health. The Chamber and the Partnership have adopted simple programs to help our employees improve their health. We don't need or want mandates for healthy lifestyles. But all institutions can create incentives for, and reduce barriers to, healthy choices.

•Finally, it hurts when we, as employers, sit in the waiting room and complain about what happens at the Capitol. We have an opportunity to advance a market-based health care reform plan that will better serve both employers and employees.

Our plan is consistent with proposals put forward by the Legislative Commission on Health Care Access and the Governor's Transformation Task Force. But we need your support.