By Evan Falchuk

The National Business Group on Health (NBGH) held its Business Health Agenda in Washington, DC this week. The NBGH is one of the most influential groups in the country in terms of healthcare from the perspective of large employers. This hasn’t happened by accident – its President, Helen Darling, has long held the vision that if you provide a forum for the leaders of American healthcare to share their experiences and challenges, you can create innovative solutions to our healthcare problems. If the high level of attendance at this event (in a terribly down year for conference attendance) is any indication, it’s working.

One of the hottest topics discussed this year was electronic medical records (EMR), highlighted in the most newsworthy way by Linda Dillman, the EVP of Benefits and Risk Management at Wal-Mart Stores. Wal-Mart made news yesterday with the announcement that its Sam’s Club stores would be selling EMR systems to doctors’ offices at prices far below the current market for such things. Dillman told us that although they haven’t officially launched the program yet, they got their first call from a physician practice asking to buy the system 20 minutes after the press release hit the wire. They seem to be onto something, not even counting the nearly $20 billion in the stimulus bill targeted at EMRs.My other observation is that the healthcare discussion seems to be moving away from questions of how to get away from paying for healthcare, and instead towards ways of making sure we cover everyone. Dillman presented data showing that through efforts at Wal-Mart, they have managed to have health insurance enrollment among employees and their families that were twice as high as the national average, and with better health reported among employees and their families than comparable employers.

There was a similar discussion on the panel on which I presented, which preceded Dillman’s talk. I presented with Walter Michalski, staff representative of the American Federation of Teachers, AFL-CIO from Western Pennsylvania, and George McGregor, the administrator of the Southern California Schools VEBA Trust. Walt pointed out that in his organization, they no longer talk about “cutting” healthcare costs, but rather “cutting the increase” in healthcare costs – and pointed out that helping employees live healthy and make the right decisions when sick were key to his strategy. Walt described the terrific job they have done engaging his members, who are spread out across school districts in Pennsylvania.

George showed an NBC Nightly News clip from 1974. In that clip, John Chancellor reported, in breathless tones, on the unsustainable increases in healthcare costs, which accounted for the then-alarming figure of $100 billion. George noted the increasing concentration of big insurers and big healthcare systems and suggested that this was an important cause of continuing price inflation and quality problems. Breaking this mold, the VEBA Trust has developed its own plan designs and quality initiatives that make it possible for it to offer comprehensive insurance coverage for something like half of what members could get in the market. I’m presenting again with George next week in San Diego at the Conference Board’s Employee Healthcare Conference. If you’re there, you should go, he’s one of the most engaging speakers on this subject you’re likely to see.