Insurers, companies employees should form compact on good health

Open-enrollment season is here, and for millions of workers around the country, that means it’s time to choose a health plan to cover them – and in many cases their families – for the upcoming year.

For many employers and HR directors, open enrollment is the time of year when they are answering a variety of questions from employees about coverage – and, of course, costs.

The truth is, many American workers are woefully uninformed about health care costs born by employers. Surveys have shown that most believe their employers pay $2,000 or less per year, per worker. In fact, the average cost for family coverage is more than $12,000, and employees themselves pay for only about a quarter of that. Employers pay the balance.

It’s true that workers are paying more now for health coverage, but that increase has also impacted their employers in a huge way.

Open enrollment is a logical time for employers to educate their employees about the reasons health care costs are increasing – and what they can do to help control costs – but the reality is employee education should be a year-round effort.

One of the very best ways to help hold down costs is to urge that your employees find a primary care doctor who works hard to keep them healthy now so they reduce the need for a hospital stay or other expensive care later.  A single doctor they trust will get to know them medically and personally. They won’t get this bouncing from doctor to doctor, and they certainly won’t get this by going to an emergency room for primary care.

Primary care doctors should enlist patients’ help in keeping themselves healthy. And if the doctor doesn’t assign “homework,” patients should ask. Exercise programs, diet tips and classes on how to manage chronic conditions empower people to take control of their own health.

Kaiser Permanente has a long history of practicing preventive medicine, and its Web site, kp.org, offers a wide range of tools and tips for healthy living to both members and non-members.

Virtually all employer-based health plans involve out-of-pocket costs in the form of co-pays or deductibles. Experience has shown that having people bear some of the cost of care cuts down on unneeded – and expensive – doctor visits.

Keeping employees insured and healthy is more than a matter of premiums and out-of-pocket costs. Good health means lower absenteeism and higher productivity.

And if a health plan you offer provides e-mail contact with doctors and other communication tools that help avoid office visits and co-pays for routine matters, that's a plus. Kaiser Permanente's personal health record, My Health Manager, is one of the most robust in the industry, and it allows members to securely e-mail their physicians, order prescriptions, view lab test results and make, change or cancel appointments for themselves or for family members – all online and at no extra charge.

Finally, if employee wellness and lower health care costs are the goal, employers have to walk the walk.  Encourage physical activity in the workplace — perhaps a walking program — and make sure there are healthy alternatives to the usual vending machine fare.

The long-overdue efforts to reform national health care are encouraging, but change can’t be limited to Washington. The most effective health care reform comes in the home and workplace, the two places where Americans spend most of their lives.


Wade J. Overgaard is a senior vice president for Kaiser Permanente.