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A Bystander – No More! (Part 1 of 2)

Similar to a bystander observing something that makes them feel uneasy, such as a mugging or a car wreck, a familiar ‘spectator-feeling’ applies when watching the evolution of our health care issues – at least for me.

It began in 1984, when I worked as an account consultant at Blue Cross and Blue Shield of Iowa (Wellmark), and I consulted with Iowa employers on the health benefits they provided to their employees. For those of us old enough to remember, health insurance premium increases were exorbitant in the eighties. In fact, they were even greater than what we have observed in the twenty-first century. Premium inflation in the eighties could certainly be considered a major car wreck or a mugging over which insureds had no control – and I was both a spectator and a participant tangentially tied to the carnage.

In the early-to mid-nineties, hospital expenses and revenue increased very slowly while insurance premium inflation tapered off. However, later that decade, premiums began to move upward again. As in the eighties, my observations allowed me to conclude that rising health care costs and insurance premiums were just too pervasive to successfully solve. We were all innocent bystanders standing with mouths agape, right?

Then came 1999…

In that year, we began our first annual “Iowa Employer Benefits Study,” which is now in its 15th year. Over the years, we have been monitoring the benefits offered by Iowa employers – with health insurance being the most salient of all benefits due to sheer runaway costs and social issues. I was now becoming very intrigued (if not obsessed) with the societal issues of health care and how it impacted health insurance premiums within Iowa and beyond. In short, understanding how health care could be delivered more safely and efficiently would, ultimately, favorably impact the direction of health insurance premiums paid by employers and their employees.

Unfortunately, it was just too easy and convenient for me to remain an ‘innocent’ bystander observing the smoldering wreck that is our health care system AND reporting the results in our annual Study. Again, I unconsciously watched the buildup of these wrecks, somehow rationalizing that others who were more knowledgable and capable could ‘fix’ the underlying reasons for the undeniable malfunctions.

The health care problem is just too vast to tackle – right?

Repetition drives habits, and habits can be extremely powerful over a period of years. My ‘habit’ was to witness this wreck of a health care system, shake my head in disgust and do little or nothing to try to assist others with possible solutions to fix the underlying cause of the problem.

As time went on, a nagging question became more of a roar:  “With the inability of our health care ‘system’ to deliver safe and efficient care to our population, should I continue as a bystander and perpetuate this troubling activity or try to do something to help remedy the situation?” I needed to decide how I would focus my efforts in the future.

Finally, in October 2011, I made my choice. I would no longer continue in the role as an employee benefits consultant. Instead, I would follow my passion to help others seek new and clear initiatives to pursue the core problems within our truly dysfunctional health care system.

As mentioned in a recent blog, we developed an infographic describing ‘Our Health Care River.’  The downstream portion of this infographic illustrates the rising health insurance premiums paid by Iowa employers and their employees, which is derived from our annual Study. That work will certainly continue. However, I will now focus more of my attention upstream. The landscape upstream shows two primary root causes for our health care cost problems:

  1. Fragmented Delivery System
  2. Unhealthy Lifestyles

You may have noticed the “Heartland Health Research Institute” (HHRI) logo within the infographics. HHRI is our new company that will begin to address some of these root causes upstream.

More about HHRI’s mission and vision in next week’s blog. My goal is to put our wreck of a health care system in the rearview mirror and concentrate my efforts on being a part of the solution…because we have to start somewhere.

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  1. David,
    Glad to hear you are becoming more involved in this. We need independent leaders like yourself with the knowledge to sort out the complexities involved here. I think this is becoming a larger problem and my sense in the marketplace is that it may be holding back hiring. Federal Health Care system is creating uncertainty.

    Is there low-hanging fruit that you are going to be trying to impact first?

    • David Lind says

      You ask a very good and important question. As you can imagine, because we have an abundance of low-hanging fruit to pursue, it will be a big challenge to determine WHICH tree to pick from (i.e. apples, oranges, pears or some other fruit!). I think it will be important to ask Iowa employers what they consider to be critical for their employees and family members. I do plan to provide a vision of what HHRI will be doing in the next few months…so please stay tuned! Thank you for your insightful comments, Maurie!

  2. Great blog David. I look forward to the next blog as well as the new benchmarking tool I’ve heard great things about.

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