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The Caucus ‘Wake’

The votes are in and Iowans have, yet again, spoken. For the past year, presidential candidates have made Iowa their new home, intent on connecting with us ‘common folk’ who strangely have both the power and privilege to make a difference on charting the future for this country.

Let’s face it, most Midwest states may not have the ‘sexy’ appeal that many other states have, such as ocean views or majestic mountains. When attracting people and businesses to relocate to their ‘paradise,’ or to entice visitors, these states use this natural ‘territorial privilege’ to their advantage.

As in real estate, it’s all about LOCATION. By default, for many states fortunate to have oceans and/or mountains, they are a natural destination. The economic and social value of having this resource for residents and visitors is assuredly real, and for many, priceless. But what can Iowa tout – other than being and having charmingly NICE people?

The Iowa CAUCUS!

Every four years, Iowa serves both an important and unique role in our country. And, an awesome role too, I might add! Yes, we may personally pay a ‘price’ by receiving pesky campaign phone solicitations all hours of the day. The television and radio ads can be particularly irksome, although, in some strange sort of way, entertaining. Did I just say that?

It is also worth noting that Iowa has the best pollster in the business, J. Ann Selzer. Ann magically finds the right methods to make the Iowa Poll (released by the Des Moines Register) the most relevant poll for Iowa and national pundits during this critical time. This past Saturday, I was fascinated by just how anxious/excited the national news organizations (CNN, FOX, ABC, CBS and NBC, among many others) were to learn of Ann’s final poll – just two days before Monday’s caucus.

Regardless of the candidates we have (or have not) chosen in the past or the present, this North Dakota native is proud to call myself – an Iowan!

As we enjoy the caucus ‘wake,’ we need to brace for the turbulent waters ahead. Even though we have no oceans or mountains to tout, Iowans will continue to make a difference on important matters that await our country.

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An ‘Oreo’ May Make You Healthier

Oreo and Emma

Daughter, Emma, with our 10-year-old family pet, Oreo.

Did you know that you have a better chance of living healthier without having to see your doctor as often just by being a pet owner? That’s right, your pet can actually lower your healthcare costs!

Thanks to a recent report, I now look at our family Shih-Poo canine, Oreo, a bit differently than before. Oreo, it appears, may not only be our beloved family pet, but may also enhance our health while keeping our health costs lower.

The health benefits to pet owners are diverse and have been well-known for some time:

  • Decreased blood pressure
  • Elevated mood
  • Reduced feelings of stress or anxiety – even for those recovering from post-traumatic stress disorder

According to the new report by the Human Animal Bond Research Initiative (HABRI) Foundation, pet ownership has now been quantified (in real dollars and economic impact) as to the national healthcare savings resulting from having pets. Of course, beyond the money, the bond between pets and owners can be powerful and emotional.

The report found two main benefits of pet ownership:

  1. A relationship between pet ownership and decreased medical appointments as compared to non-owners. HABRI conservatively estimated that reduced physician office visits produces savings of about $11.4 billion per year as compared to non-pet-owners.
  2. Lower obesity rates among dog owners who frequently walk their pets. Research shows one-fifth of pet owners (23 percent) walk their dogs five or more times per week. The incidence of obesity among people who regularly walk their dogs is five percent lower than non-pet owners, which decreases U.S. healthcare spending by $419 million per year.

Pet allergies aside, this combined total annual savings of $12 billion is nothing to sneeze at!

A Purdue University study found that animal therapy for Alzheimer’s patients residing in long-term care facilities can have positive outcomes – such as boosting food intake and reducing the need (and costs) for nutritional supplementation. Additionally, clinical trials are revealing that animal-assisted therapy significantly impacts the treatment of children with cancer. Pet owners might even become more compliant patients when medical providers inquire about their pets.

While in Minnesota this past Sunday, the thermometer read a balmy 10 below as the daytime high! I needed to remind myself that taking Oreo outside in this frigid weather to do ‘his thing’ may actually benefit my physical wellbeing. I suppose this is yet another way to keep me active during the winter doldrums!

Do communities with higher pet ownership have healthier residents? Hmm, the findings from this study may give us paws (sorry for the pun!) – but there certainly appears to be many benefits and implications of pet ownership.

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A New Employer Mindset Needed
Avoid Repeating Healthcare ‘Time Loop’

Time LoopIn the 1993 movie, “Groundhog Day,” actor Bill Murray plays a Pittsburgh TV weatherman who finds himself in a comical time loop while covering the annual Groundhog Day event in Punxsutawney, PA. Murray’s character wakes up each day to relive February 2 and eventually learns how to use his prior-day experiences to make a difference within Punxsutawney. But it takes him many, many attempts and frustrations before he realizes he must re-examine his life and priorities before he can make desired progress.

I was recently approached by a very large Iowa organization interested to know my ‘take’ on the next phase of employer-based health coverage. Specifically, I was asked how to break the endless cycle of doing the same things over and over again to control health costs – as current attempts seemingly do not move the cost needle.

This particular organization assuredly represents most employers when it comes to the frustration of offering health coverage to their workforce. Much like the Murray character, employers continue to relive their renewals, year-after-year, only to repeat past practices that invariably result in a similar and familiar fate. A handful of these annual activities typically include the following:

  • Changing insurance companies or third-party vendors, including pharmacy benefit managers, wellness vendors, insurance brokers, etc.
  • Increasing employee cost-sharing components, such as deductibles, co-payments and out-of-pocket maximums
  • Limiting (or expanding) provider networks
  • Embracing consumer-driven health plans
  • Converting to a new financial mechanism to pay for coverage, such as self-funding, partial self-funding and a host of other hybrid funding arrangements

To avoid repeating similar (and predictable) results from these practices, employers should take a page from Murray and re-examine their priorities. Here are three ‘takes’ that I shared with this particular organization:

  1. Employers Must Recognize and Accept that Preventable Medical Mistakes is a HUGE Problem

    Employers should not assume employees and their family members will consistently receive safe and appropriate care from the local provider community. Even the best and most prestigious hospitals are not immune from committing these errors. Preventable mistakes are VERY costly, both in lives and in money. According to the Robert Wood Johnson Foundation, poor quality-of-care costs employers at least a third of the single-health premium. In Iowa, this would conservatively amount to $1,850 per employee each year. The social costs due to preventable medical errors dwarf this amount.* Just as importantly, eliminating preventable mistakes will also result in employees and family members living healthier and more productive lives.

  2. Insist that Patient Safety becomes a PRIORITY

    In the past, employers have relied on healthcare providers and insurance companies to control costs and quality, assuming that patient safety was naturally baked into the services we purchase. Yet, employers unknowingly pay for medical errors – albeit at the lower-negotiated fee available through insurers – but such discounted ‘savings’ are eventually negated due to paying for undocumented preventable mistakes. Employers and employees (not insurers) are the ultimate payers for this wasteful and unnecessary cost through higher insurance premiums. And, because of this, they must insist that new health plans deny payment for preventable medical errors. At the very least, this should be a minimum requirement. Few private plans attempt to do this, primarily because they have scant metrics to detect these errors. How would they know?

  3. Require public TRANSPARENCY from local providers

    The word ‘transparency’ has become an overused word – especially within healthcare. But for the ultimate payers of healthcare (employers and employees) to determine the value they receive from the ‘investment’ they make, the provider community must enter the 21st Century and demonstrate their value by publicly reporting comparable and usable safety information. This should also be a minimum requirement.

Offering and paying for expensive health insurance coverage year-after-year is the ‘Groundhog Day’ confronting frustrated employers. Unless a new mindset takes hold in the employer community that can forever alter our perpetual ‘Groundhog Day,’ very little will change in our ‘town’ of Punxsutawney.

*Additional details to follow over the next month.

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