Health Care - What If We Play the Games Differently?

Twenty-plus years ago I worked for an attorney who said that whatever didn't require his law degree to do, could-and should-be done by someone else. He trained his staff as paralegals. I started my professional career learning to think strategically and ask different kinds of questions--about a lot of things. Today that includes health care, health insurance, and the increasing costs to both employers and consumers.

I'm a business and human resource professional, a consumer, educator, and wellness coach. I know that people behave and act based on motivators and rewards. In general, wherever the incentives are placed, and or monitoring is done, action will take place and the monitored results will be achieved. Parents know this; teachers know this. It's a basic principle of education.

The answers will not come out of one essay. The subject is complex and as individualized as its participants. And it's unrealistic to think one solution will fit all contingencies. My objective here is simply to tap the interests, experience, and expertise of the players, and get all of us thinking outside the "rules" a bit. Like pieces of a giant jigsaw puzzle, we all have important pieces of information and experience to contribute.

In childhood, we learned the value of playing outside the rules once in awhile to achieve the objectives we wanted. I did. Our family version of Monopoly included IOU sheets. Mom invented them so she and all of my siblings could stay in the game and play as long as we wanted (allowing her to keep us occupied and together where she could see us)-her desired objective at the time.

Asking questions is key. Different questions get you different answers. Knowledge is interesting and empowering. Here are some questions I'd start with:

Health Care

What requires a doctor's medical degree? What doesn't? What medical, health, or wellness practitioner has the expertise needed and is the most practical (and cost-effective?) resource to address your condition?

What is the best utilization of RNs, for example, and other health and wellness practitioners? Now? In the future?

What is our definition of Health Care? Is it too broad? Or too limited? What benefits can alternative, integrative, and or experimental approaches offer to the consumer? To the employer? Consider costs, including lost time away from work, effectiveness, and incentives for use-or non-use.

Health Insurance

What are the cost / pricing factors? How does health insurance compare with auto insurance, for example? Is your rate affected by your claims, or lack thereof? In other words, is there a monetary incentive for consumers to stay healthy and make healthy life-style choices? What are the cost drivers? What's covered by health insurance plans? What is excluded? Should health insurance be employer provided? Or is it time for portable consumer-owned programs/policies? Are there other options? Now? In the future? What exactly do we want health insurance to insure us against? Normal maintenance expenses? Or major events and expenses?

Laws - Tax incentives

Who benefits? Are there tax incentives to reduce consumer medical expenses? To invest in wellness and health? Or are there dis-incentives?

Section 125 - Flexible Spending Accounts, Medical Savings Accounts, Health Reimbursement Accounts. What are the allowable expenses? What expenses are excluded?