I often find myself conflicted between my two jobs. During the day I am an account executive for a major health insurance carrier. My job involves working with large employers in my community to create a benefit plan that is affordable and provides appropriate coverage for their employees. This often encourages the use of pharmacy benefits and getting an annual physical so that you can get on the maintenance drugs you need to control the high blood pressure you just found out you had.
My other job, as a holistic health coach, has me working one-on-one with clients to meet their individual needs. I often find myself talking about how to incorporate new foods, how our relationships and careers impact our food choices and how no matter how healthy you eat, you need physical activity in your life if you want to maintain a healthy weight. I coach people to make lifestyle changes so that they get off of the drugs they are on and can go to the doctor less.
Interesting choice of careers, huh?
With healthcare reform moving full steam ahead, I often get asked my feelings on the bill and what it will mean for everyone. Like many of you, I feel there are positives and negatives to the bill (to most bills, for that matter). First, politicians are not doctors, they don't understand our insurance programs and often don't understand our healthcare system the way they think they do. This is mainly because they don't use the healthcare system the way we do and aren't insured the same. However, they do recognize the statistics - that there are too many uninsured Americans and that the cost of care is much higher than it needs to be. Both of which I agree with.
The bill has already done some good things: it has provided coverage for preventive care, eliminated pre-existing conditions for children and provided birth control for members. While these things are great, they still cost money. Either your employer or the insurance company are paying for them at the time of service, but then at your renewal, the claims experience causes your rates to go up and the premium increase gets passed on to you.
What about the doctors?
I was fortunate to attend a seminar this week where a panel of hospital Presidents and CEOs talked about how healthcare reform was changing the way they did business. I was happy to hear them admit that physicians have missed the boat in the past and that needs to change. One of the panelists, from a very large hospital system here in town said this, "There are 5 things that we know are driving healthcare costs. They aren't easy to change but we know what they are. 1. Unhealthy Eating 2. Unhealthy Weight 3. Unhealthy Exercise 4. We drink too much 5. We smoke too much." He went on to say, "It's not about magic pills or fancy operating rooms. It's about these 5 things, and all providers know that." The panelists went on to talk about how you would think these things would be at the top of a providers mind, but they aren't. That's not how they were trained to diagnose.
Some other points they made were that they needed to find new ways to deliver care, especially with non-compliant patients. It's important to look at the member holistically and begin to involve resources like health coaches (yah!) to work with patients and families - and the physician - on a treatment plan that will work.
Sounds good, as long as it happens, right?
Keep in mind that with healthcare reform providers will experience major cuts in reimbursements. They are expected to do more with less - as we all are. The good thing is that they (at least the panelists I heard) viewed the bill as an opportunity - with challenges, yes - but an opportunity to look at the resources they already have and how they can use them differently, rather than recreating the wheel.
When it comes down to it YOU, as the consumer, are going to have more power than you've ever had before - which is a good thing. However, you'll have power in a world of insurance that you've probably never understood....EVER - which is a challenge. Insurance companies and provider groups recognize that there will be challenges, but these companies are finding ways to be more resourceful and utilize people and products in new ways - to benefit you. Employers are beginning to recognize that wellness programs need to change. Employees need to be incented to make better choices around their healthcare. You will probably see companies requiring health questionnaires or biometric screens - these are good things. They are engaging you in your health.
If you think that they don't have a right or that it's intrusive, you need to remind yourself who is footing most of the bill. Like everyone else, we need to shift our focus. Right or left, Democrat or Republican, rich or poor - the world of healthcare is changing and you are in the middle of it. Literally. You need to start thinking about how you can take control of your health. Today.
It's really up to all of us to determine how we maximize wellness rather than maximize disease. Are you ready?
My other job, as a holistic health coach, has me working one-on-one with clients to meet their individual needs. I often find myself talking about how to incorporate new foods, how our relationships and careers impact our food choices and how no matter how healthy you eat, you need physical activity in your life if you want to maintain a healthy weight. I coach people to make lifestyle changes so that they get off of the drugs they are on and can go to the doctor less.
Interesting choice of careers, huh?
With healthcare reform moving full steam ahead, I often get asked my feelings on the bill and what it will mean for everyone. Like many of you, I feel there are positives and negatives to the bill (to most bills, for that matter). First, politicians are not doctors, they don't understand our insurance programs and often don't understand our healthcare system the way they think they do. This is mainly because they don't use the healthcare system the way we do and aren't insured the same. However, they do recognize the statistics - that there are too many uninsured Americans and that the cost of care is much higher than it needs to be. Both of which I agree with.
The bill has already done some good things: it has provided coverage for preventive care, eliminated pre-existing conditions for children and provided birth control for members. While these things are great, they still cost money. Either your employer or the insurance company are paying for them at the time of service, but then at your renewal, the claims experience causes your rates to go up and the premium increase gets passed on to you.
What about the doctors?
I was fortunate to attend a seminar this week where a panel of hospital Presidents and CEOs talked about how healthcare reform was changing the way they did business. I was happy to hear them admit that physicians have missed the boat in the past and that needs to change. One of the panelists, from a very large hospital system here in town said this, "There are 5 things that we know are driving healthcare costs. They aren't easy to change but we know what they are. 1. Unhealthy Eating 2. Unhealthy Weight 3. Unhealthy Exercise 4. We drink too much 5. We smoke too much." He went on to say, "It's not about magic pills or fancy operating rooms. It's about these 5 things, and all providers know that." The panelists went on to talk about how you would think these things would be at the top of a providers mind, but they aren't. That's not how they were trained to diagnose.
Some other points they made were that they needed to find new ways to deliver care, especially with non-compliant patients. It's important to look at the member holistically and begin to involve resources like health coaches (yah!) to work with patients and families - and the physician - on a treatment plan that will work.
Sounds good, as long as it happens, right?
Keep in mind that with healthcare reform providers will experience major cuts in reimbursements. They are expected to do more with less - as we all are. The good thing is that they (at least the panelists I heard) viewed the bill as an opportunity - with challenges, yes - but an opportunity to look at the resources they already have and how they can use them differently, rather than recreating the wheel.
When it comes down to it YOU, as the consumer, are going to have more power than you've ever had before - which is a good thing. However, you'll have power in a world of insurance that you've probably never understood....EVER - which is a challenge. Insurance companies and provider groups recognize that there will be challenges, but these companies are finding ways to be more resourceful and utilize people and products in new ways - to benefit you. Employers are beginning to recognize that wellness programs need to change. Employees need to be incented to make better choices around their healthcare. You will probably see companies requiring health questionnaires or biometric screens - these are good things. They are engaging you in your health.
If you think that they don't have a right or that it's intrusive, you need to remind yourself who is footing most of the bill. Like everyone else, we need to shift our focus. Right or left, Democrat or Republican, rich or poor - the world of healthcare is changing and you are in the middle of it. Literally. You need to start thinking about how you can take control of your health. Today.
It's really up to all of us to determine how we maximize wellness rather than maximize disease. Are you ready?
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