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Supreme Smoke

Soon, we will be hearing from the U.S. Supreme Court on its’ interpretation of the health care reform law. Will it stay intact or will key features, such as the individual mandate and the expansion of Medicaid, be axed out as being unconstitutional? Or maybe the whole law will be axed?

Needless to say, watching for the Court’s upcoming decision is much like waiting for the black smoke signal to come from the Sistine Chapel at the Vatican (which means that a new pope has been elected). If we see white smoke, that means no decision has been made by the Court…causing even greater uncertainty. OK, maybe I am taking this analogy a bit too far, but hopefully you get my point.  This is a BIG decision – FOR ALL OF US!

Whatever the ruling, there will be great confusion for all employers. If the entire law is overturned, some interesting issues will most likely cause immediate alarm for employers and their employees.

One example is the $5 billion program under this law that partially reimbursed employers for the claims incurred by their early retirees (pre-Medicare eligible). This money has been distributed to employers who qualified for this reimbursement. If the law is thrown out, will those employers have to pay this money back? Don’t know. If so, this would be a very messy process.

The reform law also extended health coverage to employees’ adult children up to age 26 – generally effective on January 1, 2011. With this coverage, employees could add these newly-eligible dependents without being taxed for this additional coverage. However, if the law is overturned, this coverage may be considered taxable income to the employee – possibly requiring employers to send revised W-2 wage and income statements for 2011 to affected employees. Another messy process.

The above two examples portray a potential ugly retraction of provisions that have already been implemented since this law became effective in March of 2010. At this point, employers can only wait for the black (or white) smoke to appear.

 

The Currency of Commerce (Part 1)

Trusting Healthcare Providers in Iowa(Part 1 of a 3 Part Series)

Almost two years ago I attended a 5 day executive program at the Harvard School of Public Health in Boston.  This forward-thinking program, “Forces of Change: New Strategies for the Evolving Health Care Marketplace,” provided a very robust discussion on many salient health care topics that continue to evolve to this day. One topic in particular immediately grabbed my attention, and frankly, was THE main reason I attended this program.

The topic?  The trust crisis in healthcare.

I know, trust can be an overused word, but there is no denying the importance it has both in our personal relationships and in our commerce. I can think of nothing more sacred than the trust we place in those who provide physical and mental services to us when we become injured, sick or frail. What happens if we don’t have appropriate trust in our doctors, hospitals and other medical-related service providers?

A lot.

According to David A. Shore, the Harvard professor who organized “Forces of Change” and is the founding Director of the Trust Initiative of Harvard School of Public Health, “trust improves medical outcomes.” In fact, trust “is the #1 predictor of loyalty to a physician’s practice. Patients who trust their doctors are more likely to follow treatment protocols and are more likely to succeed in their efforts to change behavior.”

Here’s another interesting fact that comes from his books about trust, “Patients sue doctors and hospitals not so much for making a mistake – but for not being straight with them, for covering up, for refusing to acknowledge the error and apologize for it.  It is the breach of conscience that they are furious about, and that leads them to seek redress in court.”

Defining PATIENT TRUST in healthcare can sound something like this: Having trust in the clinical skills and knowledge of the physicians, the other professionals, and the service organizations with whom the patient comes into contact. It is confidence in the integrity of all these clinicians and organizations. And it is the confidence that, whatever else they may do, they will fulfill their role as the patients’ agent.

As Shore puts it, “Trust is the currency of all commerce.”

We continue in next week’s blog about the implications of having trust in healthcare.

 

 

Faith and Well-being

Iowa HealthThe Daniel Plan?

I recently read an article in TIME magazine (June 11) about how a Bible passage is impacting a mega-church in California…but in a way one would not expect. Rick Warren, Pastor of Saddleback Church in Lake Forest, CA, discovered his church members were a bit heavier (weight-wise) while he and other pastors were baptizing about 800 congregants during a four hour period (they estimated about 160,000 pounds of people were baptized that day). Warren, by the way, authored the immensely popular book, “The Purpose Driven Life”.

From this experience, Warren used a passage in the Book of Daniel describing a story of four Jewish boys who refused to “defile themselves” with meat and wine offered by King Nebuchadnezzar. Instead they chose vegetables and water and grew fitter (and apparently much healthier).

Armed with this biblical story, Warren launched the Daniel Plan – a health and fitness program for congregation members who wish to participate. The program begins with a diet of 70% unprocessed fruits and vegetables and 30% lean protein, whole grains and starchy veggies. In addition, this plan includes exercise groups, nutrition training, sports, recipe tips, small support-group meetings, and many other programs. The results since implementation (January, 2011) are very impressive. About 15,000 people have signed up to participate in this program, and it is estimated that the church has lost 260,000 pounds in this last year (Warren is shooting for 800,000 lbs). Warren intends to take this program internationally in the future.

So why am I writing about this?

For me, it’s encouraging to learn that people can collectively work together to accomplish a common goal to lead healthier lives. This particular situation stems from a faith-based community that provides the accountability and support measures needed to make this a successful endeavor. The TIME article does mention how important faith is to ones’ mental and physical well-being. In fact, various studies show that faith and health mix quite well with one another. For example, people who attend church service may be less apt to die in a given year when compared to those who don’t attend a faith-based service. People who help others tend to have a healthier profile. There are many other studies that link faith to good health.

Here in Iowa, the Iowa Healthiest State Initiative  provides a somewhat similar approach through personal connections (small groups, community involvement, etc). The spiritual component found in the Daniel Plan is very intriguing to me.