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The health insurance companies, including Blue Cross, Aetna and others, have two primary goals. These health insurance companies want to keep as much of your premium payments as possible and they want you to be healthy and not bother them by requesting they spend the money on treatment. Those companies have joined the legions of American big businesses who pray daily in the direction of Wall Street and whose mantra is “raising the stock price.”
My television production business is small by just about any standard, having a maximum of six employees at various times. Insurance has always been a sharing arrangement for me, with employees paying 50 percent of the cost of a plan chosen by them. A quick look at the financial records let me know that what we spent on health insurance seven years ago for four people doesn’t cover today’s premiums for just one person. Whether you are a small operation or a Wall Street darling, some new attitudes are due. The joys of big benefit packages are being replaced by the realization that benefit #1 is the fact that you have a job.
How did health insurance packages become a part of so many employment agreements? Back in the war years of the mid 1940s, Congress tried to keep inflation under control by imposing a freeze on worker’s wages. Companies who were competing hard to recruit workers in a very tight marketplace were offering a menu of perks, including medical coverage for workers and their families. My father was a common laborer at the Vanadium Corporation plant in Niagara Falls, and those extras even reached his low wrung on the ladder.
In the 1950s Walter Reuther, head of the UAW union pushed for universal coverage to become the law of the land. The General Motors president at the time, Charlie Wilson felt that each company should look after its own workers as well as it could. Voila! In the span of one decade, our present system had been put into place. General Motors isn’t the only one. 51% of large unionized companies in the U.S. offer health care benefits for retirees. Fifty years later, the costs are crippling and if left alone, they will bankrupt businesses and governments. Since rule number one in business is “survive,” a lot of enterprises will be looking at the new GM model on how to unload or diminish those punishing obligations.
Small business owners have always enjoyed much more flexibility than the giants in deciding how to handle health insurance for employees. Even the mandatory insurance mandates being contemplated by some states skip over very small (under 10 or 20 people) businesses. But any entrepreneur will tell you that offering some level of benefits is important to recruiting and keeping the best people. It is a useful if expensive business tool.
I lived and worked in Canada for several years and saw their often admired universal system up close. Regardless of its flaws, their approach certainly does make basic services available to everyone so that you don’t worry about going broke from a serious injury. However, they’ve lost many MDs to the United States and you better have money or supplemental coverage for traveling outside the country or if you need priority treatment for serious and prolonged illnesses. There is no perfect system, and we can see in Canada, France, Britain and other countries that you can never build enough facilities or have enough doctors to meet the demand.
Nothing can replace being responsible for your own health and well-being with education and best practices. Despite the billions of dollars spent on diagnostics and treatments in our pretty sophisticated system, Americans are among the sickest and fattest people in the world. The underlying reasons for this would keep a stadium full of psychiatrists busy for a lifetime! Just watching the pharmaceutical company television commercials lets me know that we’ve created diseases and syndromes where there were none before. I guess that is called business development!
Small business owners are becoming more familiar with health plan products such as “Bare-Bones Coverage” and “High Deductible” plans. They realize that things get better only when employees have an investment in their health. My point of view is colored by the fact that I haven’t missed a day of work due to illness in more than 18 years. Part of that is the realization that lifting a giant bag of Doritos can’t be considered exercise or healthy eating. Many doctors say that stress is a major cause of illness, and since work can provide an ample supply of that, stress management must be an important wellness tool. No matter what the politicians and insurance companies do with the treatment systems, being healthy will always begin with you.
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