Are We Asking the Right Question?

Obviously, one of the big mistakes that people make when they are trying to solve a problem is to ask the wrong question.  I was thinking about this on the plane and wondered if we think about healthcare wrong.

In a fully-insured world, managed care companies make the most money when patients are healthy.  In an ASO (employer self-insured) world, employers save the most money when employees are healthy.

In both cases, prevention and wellness are drivers of business value.  Obviously, retention and turnover impacts companies ability to capitalize on their investments in these areas.  But, I don’t hear people asking how can I drive wellness and preventative activities to maximize savings and profits simultaneously.  All I hear people asking about is how to fix our confusing and broken system.

Maybe we need to find a way for insurance to stay with the individual (not a new scenario but not one I hear much about right now) – aka portability.  In that case, the company would want to drive satisfaction and minimize costs to retain the members and keep them healthy.  A win-win??

It’s certainly not that easy, but a quick thought on the topic.

Certainly someone can figure out tax incentives and a framework for crediting companies that invest and the member is no longer associated with them…As long as they have done something to improve the condition…