Is Healthcare An Investment Or A Cost?

As I’ve been looking at the employer view of healthcare, it strikes me that there are two different fundamental approaches.

1. Healthcare expenses are a cost.  We want to drive down the costs as much as possible.
2. Healthcare is an investment in our human capital.  We want to optimize our spend with the best outcomes.

Unfortunately, this likely means that the most vulnerable population is disadvantaged in this model (i.e., the hourly worker who is in a job where they are easily interchanged with another employee).

But, for companies where their biggest asset is their people (e.g., Microsoft), it seems clear that they would want to focus on healthcare as an investment.

This might drive you to make different decisions.

• What if you looked at your formulary (for medications) based on side effects not necessarily costs?
• What if you were willing to pay more for drugs with a clear impact on productivity (e.g., no drowsiness)?
• Would you pay more for facilities that were better able to get people back to work?
• Would you really push people into high deductible plans when this forces them to spend more time figuring out the system and navigating it?
• Would you provide them all with devices to help them manage their healthcare?
• Would you hire health advocates to help them navigate the system?
• Would you provide them all with second opinions for major diseases (e.g., cancer) at no additional out-of-pocket costs?
• Would you make sure to implement a telehealth solution so they weren’t away from the office as much?
• Would you provide them with an onsite gym?
• Would you provide them with healthy food onsite?

It seems like you would look at these types of decisions differently.  It wouldn’t be about the lowest healthcare premium.  It wouldn’t be about pushing them to a limited network.  It wouldn’t be about limiting their choice.  It wouldn’t be about shifting costs.  It would be about guiding them to make choices that kept them happy, productive, and engaged so that they could do the best work for you.

This would involve addressing stress.  It would involve addressing sleep patterns.  It would involve helping them create a work-life balance.