Posts Tagged ‘President Obama’

Ed Koch: Don’t Mess With My Employee Benefits

Tuesday, August 11th, 2009

By Evan Falchuk

I’ve been making the point that health reform’s troubles are due to a fundamental failure of reformers to understand that health care is all about employee benefits.

At Real Clear Politics, former New York City Mayor Ed Koch shows you what I mean.  He recently had bypass surgery:

I speak from personal experience. I have been told that the cost of my hospital care, including the services of 20 doctors and 72 nurses and medical technicians over a six-week period may ultimately cost a million dollars. My private insurance policy is paid for by my law firm, Bryan Cave LLP, and because I still work full-time, that insurance policy is my primary one, not Medicare, even though I am 84 years old. Will that continue to be the case under any law signed by President Obama or will I be denied the right to spend my own money and my law firm’s for such unlimited coverage?

Koch says he think the answer is probably “yes,” but he’s very unsure.  In fact, he points to quotes from Administration officials along these lines that he says are “alarming.”

So, is the problem with health care reform politics?  Of course there is politics, but I don’t think Ed Koch is motivated by that.

No, Koch’s article illustrates something else.

If someone as sophisticated as Ed Koch is left wondering about the answer to fundamental questions about reform, how can you expect others, paying much less attention, to feel otherwise?

What in the World is Steven Pearlstein Talking About, Ctd.

Sunday, August 9th, 2009

By Evan Falchuk

Steven Pearlstein wants to know:

Are you with him, or are you with the terrorists?

He’s serious.  And it’s part of the continuing, thoughtful debate on health care.

(more…)

Why Reform Is Going So Badly

Thursday, August 6th, 2009

By Evan Falchuk

Another day, another round of disastrous town hall meetings for congressional representatives.

Why is it going so badly?

As I noted yesterday, angry resistance to change in health benefits is totally predictable.

The RAND Corporation and Watson Wyatt did a survey of 42 large U.S. employers that implemented major changes to their benefits plans in recent years.  They found that employees were normally “wary,” “confused,” “apprehensive” and “risk averse” about changes.  Employees assume – rightly or wrongly – that when management talks about “controlling costs,” it is just a nice way of saying, “we want to spend less money on you.“  No one likes to hear that.

So what does work?

Clear, direct, honest communication.  Companies that spent 6 months or more talking about their plans were far more successful than those that didn’t.  What worked were real, specific examples of what change means for an employee and their family.  How much will my take home pay be affected?  How much more will I have to pay for care?  Can I still pick my own doctors?

There was no replacement for concrete, simple, real illustrations done over and over again.

It’s very much the opposite of what’s happening in health care reform.

Sure, we have been talking about it for months, but mostly about the need to cut costs.  People think – I’ve heard this story before at my job.  What it means is that my health care is about to get cut.  So they get anxious.

But unlike a company trying to implement a benefits change, representatives returning to their districts have no plan to explain.  Instead, they have multiple bills, and no idea of what may become law.  They can’t give real, practical examples of what reform may mean, and don’t seem to be trying.  It’s a very bad combination given how delicate the question of health care is.

And it also makes the statements by some of our representatives all the more bizarre.  There’s nothing at all helpful about trying to dismiss skeptical citizens as swastika-carrying agents of the insurance lobby.

So think about the angry people at town halls like employees at a company who are being told that their jobs are being eliminated, or their benefits are being cut.  And think when you watch our representatives talking about this how they are missing real, honest reaction, and making it worse.

Oh, Good, a Thoughtful Debate on Health Care

Wednesday, August 5th, 2009

By Evan Falchuk

If you were hoping for a thoughtful discussion on the reform of our health care system, I have bad, bad news.

It turns out that health insurers are “villians.”  Public anger over the massive, mostly unread, reform bills is “manufactured,” and anxiety created by the expectation of unknown changes to people’s most valued benefits is the result of disinformation and “fishy” stories.

It’s like an employee benefits roll-out gone horribly awry.

The protests and disastrous town halls look to me just like the kinds of angry protests that happen all the time when employers make important changes to a benefit plan and the employees either don’t understand them or don’t agree.

Blaming the people who don’t follow what you’re doing and why is a big mistake.  Sure, there is politics.  But health care is a serious, emotional issue, and it should be no surprise that people react badly when they think something to do with it may be taken away.

Dreaming up ideas of how health care ought to work is relatively easy.  But figuring out how to implement it is hard, and there are no short cuts.  The people who actually run benefits plans – employers, benefits consultants, HR professionals – can tell you:  there is no replacement for communication, engagement and respect for opposing views.

The strategy of demonizing those who aren’t on board is a mistake, and is as likely to set back the cause of reform as it is to further inflame an already volatile audience.

Is Health Care the New Third Rail of American Politics?

Monday, August 3rd, 2009

By Evan Falchuk

Judging by the angry reactions Congressional and administration officials are running into as they return to their districts to talk about health care reform, maybe it is.

But does it have to be?

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Don’t Mess with My Health Care

Thursday, July 30th, 2009

By Evan Falchuk

The news is full of stories about the President’s declining poll numbers.

Analysts struggle to explain the politics of what is wrong.  But anyone in the business of employee benefits shouldn’t be surprised at all.

You don’t mess with people’s health care.

Benefits professionals could tell you all about situations where companies have tried to make important — or even minor — changes to their employees’ health plans, only to run into strong resistance.  It’s one of the reasons they work so hard to communicate and engage with employees on this subject.  Smart companies don’t change health benefits without spending a lot of time explaining things to their employees and incorporating their views.  It’s hard work, and it takes time.  But it’s necessary if you want to make effective change.

A survey by the National Business Group on Health in a couple of years ago is still one of the best on this problem.  Helen Darling, President of the NBGH said at the time: “Overall, no aspect of a job is more important to workers of large companies than having good benefits, and our survey results clearly show that the benefit most important for most workers is the health plan.”

Here’s what she is talking about.  The NBGH survey of American workers found that:

  • 75% said they would forgo a pay raise if it meant they had to buy health insurance on their own
  • 60% would not trade a drop in health benefits for a better retirement plan
  • 83% said that if their company had to cut total compensation costs, they would rather have their pay or retirement plans cut than give up any of their benefits

And yet here is the President, proposing national insurance exchanges where it sounds like employees may be encouraged to buy their own coverage.  Saying that we need to control health care costs because the government won’t be able to afford retirement plans like Social Security and Medicare.  Telling us that the government needs to save money and so has to think of ways to cut spending on health care — and raise their taxes.

It’s the perfect combination of the worst buttons to push on health care.

Imagine a CEO who told his workers, good news, we need to save money for our retirees, so I’m going to cut your health benefits in ways that are very complicated and hard to explain.  Also, I’m going to cut your pay.  And, by the way, I don’t want to talk about this for very long, we need to do this right now.

He’d be awfully unpopular.  And that’s pretty much what we’re seeing now.

Of course there’s plenty of polling data that show that, in theory, most Americans support all kinds of changes to health care.  But when you are talking about their health care, well, it’s pretty simple.  Don’t mess with it.

We Have No Consensus on Health Care Reform

Thursday, July 16th, 2009

By Evan Falchuk

I belong to a terrific organization that brings together C-level executives, once a month, to discuss issues each of us face.  It’s called Vistage.  One of the subjects we talked about yesterday was health care.  It was like a focus group made up of seasoned, senior executives from many different industries.

The discussion revealed the tremendous divide between what ordinary Americans think about health care and what policy makers in Washington are doing.  It’s a combination that is almost certain to ensure that whatever reform passes may make our problems worse, rather than better.

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Cadillac….or Edsel?

Saturday, July 4th, 2009

By Evan Falchuk

The Boston Globe reports on a battle brewing in New Hampshire over the state’s health care plan for its employees.  The story focuses on the possibility the plan might end up being taxed under the new reform legislation being debated in Washington.

But it begs the question: how much of our country’s health care expense burden is created by plans like the one employees of the state of New Hampshire enjoy?

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Reform Has to Mean Change, Not Just Coverage

Tuesday, June 23rd, 2009

By Evan Falchuk

The New York Times has been running a series on its Economix blog about health care reform.

Today, they post answers to following the questson from three health care experts:  “What should our priorities for health care reform be?”

You should read them all, but you should think about two things.

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The McAllenization of Health Care Reform

Monday, June 22nd, 2009

By Evan Falchuk

Everything is McAllen, Texas.

It’s all part of our “uniquely American” approach to many issues: oversimplify the problem, so we can solve it. Ideally, on an artificially short time line.

In the case of health care reform, let’s say we get ‘er done by August 1.

(more…)

  • "Medicine is learned by the bedside and not in the class room. Let not your conception of manifestations of disease come from work heard in the lecture room or read from the book: see and then research, compare and control. But see first."
    - Sir William Osler, MD
    The Father of Modern Medicine
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