By Evan Falchuk

Over at the Daily Diversion, Kelley Butler blogs about the study released by Watson Wyatt and the National Business Group on Health on employers’ view of the future of health benefits.   The press release accompanying the study says “Employers Remain Confident in the Future of Health Benefits,” while Butler leads with “Employer confidence in future of health benefits slips.”  Who’s right?

Well, technically speaking they both are.  The study showed that a majority of employers expected to still provide health benefits 10 years from now, but the number was lower than the last time the survey was done.  The more interesting question is whether this is a trend, or just two different data points?

From my experience talking to employers of really all shapes and sizes across the country these last several months, I have yet to find one that is considering dropping health benefits entirely.  So while employers may be responding to these surveys by saying they’re not sure what things will look like in 10 years, it may well be that the survey is picking up general economic anxiety, and that these numbers will turn around when the economy starts to.

But I think there is something more.  There is a sense out there that we are in the midst of a time of major change.  The organizers of the Employee Health Care Conference in San Diego made a “health dividend” the theme of this event (I’m still not sure what that means), but the most popular word that has emerged among presenters is “disruption.”  There seems to be a hunger — and a need — to start anew, discard the old ways of thinking about health care, and create new ways of doing things.

We are nearing the end of the paternalistic model of health care.  You rely on your employer to give you good coverage, on your doctor to take good care of you, while you have little responsibility for cost or living a healthy life or how your care is provided.  In its place is coming a new concept: personal responsibility.  You have to pick the plan that makes sense for you.  You pay for the cost of your care and figure out where and how you get it.  You are responsible for the consequences of smoking, or being overweight, or otherwise not taking care of yourself.  This is extremely disruptive to the old ways of doing things, old business models, old job responsibilities.  To the extent this big shift implicates how employers think about their role, and where they will be in the next decade, I think that is what is being seen in this study.