Health care today represents 18.5 percent of the U.S. economy — a staggering number to be sure and one reason it is so difficult to figure out how to fix what’s wrong.
Every day we are asking more of our providers and more of the payment systems created to protect individuals from financial ruin after being diagnosed with a major illness.
In a nutshell, the cost of health care has become so expensive that many Americans, even those with health care benefits, are not going in for treatment because they cannot afford it.
In recent articles, I have talked about bringing stakeholders together to address cost and quality issues to make health care more affordable.
For that to work, there needs to be a structure to support these efforts. To that end, the Lancaster County Business Group on Health — created in 1984 by a group of area employers concerned about the cost and quality of care in our community — has announced an expanded reach and a new name: Central Penn Business Group on Health.
The organization’s board of directors decided to expand operations because many health care decisions are no longer made locally and area employees are more mobile than ever. They commute across Central Pennsylvania to get to jobs better suited to their skills and interests.
Although this expansion is a big challenge, it is an exciting time for our organization and the communities that we serve.
By bringing together a larger contingent of buyers and suppliers, we believe we can address health care cost and quality issues and impact positively health care in our region.
The invitation from our organization is clear: We want you to join the conversation and be part of the solution rather than another symptom of the problem.
As we successfully influence this larger sphere, we will be creating a model for improving health care that can be replicated in other regions.
Of course, it is not as simple as it sounds, and many will have to make concessions to make things work.
Affordable health care means people can not only get the care they need, but they can afford to pay the bill. If people can afford to pay their bills, they will do the things they need to do to maintain their health.
Since experts estimate that approximately 80 percent of today’s health care spending is for conditions that are preventable, fixing this will go a long way toward curing what ails the system.
We know that people are paying more for their health care than ever before. So understanding what care costs is important to them.
Unfortunately, understanding health care costs is difficult under the current system. Insurance carriers have contracted directly with providers for payment schedules that are not shared with patients until the bill needs to be paid. Increased price transparency will make it easier for individuals to make informed decisions.
Additionally, much of the care delivered seems to be based on what individuals’ insurance will pay and not on what is truly in their best interest.
Consumers need to probe so they clearly understand their treatment options and the costs of each one before beginning care. It may be easier to pop a pill each morning than lose 15 pounds, but at what cost?
Since much of health care is provided through employer-sponsored plans, health suppliers must be willing to reach out to employers, to understand their struggles and to develop ways to work together to address health care concerns.
As we develop market data that can demonstrate clearly what is happening in our community from a cost and quality perspective, will outliers be willing to rethink their pricing and delivery structures? We hope so.
As an organization created to support employers and their covered employees and dependents, we realize there is much to be done. We look forward to the challenge.
• Diane Hess is executive director of the Central Penn Business Group on Health, an affiliate of The Lancaster Chamber of Commerce & Industry.