To say the future of health care policy in the United States is uncertain is like predicting the Kardashians might soon make the news, fake or otherwise.
The repeal of Obamacare is nigh, agree Republican leaders in Congress, but there’s plenty of dissent in the ranks over a repeal-and-replace strategy. Those same GOP leaders are in the dark about President Trump’s vow to substitute a plan that offers “insurance for everybody” — which pretty much describes how Obamacare was supposed to work all along.
Not to be overlooked in the unpredictable debate over health care coverage and costs is the need to preserve quality of care. That’s true nationally but more so in states such as Wisconsin.
Wisconsin stands among the nation’s best states when it comes to health care quality. The federal Agency for Healthcare Research and Quality has ranked Wisconsin among its top four states in nine of the past 10 years, including a No. 3 ranking in the latest year based on about 200 evaluation measures. Wisconsin also scores well in a number of private rankings.
In a national free-for-all over health care, Wisconsin patients, providers and policy-makers have good reason to worry that high-quality care states will be penalized in the rush to reform. So do business owners and managers.
It’s the Law of the Lowest Common Denominator: States that are mediocre to poor in terms of delivering quality health care don’t have much to lose if Obamacare is jettisoned for an unclear strategy. Those states may not have changed how they did business, anyway.
On the other hand, states that innovated in the face of health care upheavals — keeping quality care in mind as they did so — could find themselves unofficially penalized if quality of care is devalued by a replacement strategy.
“Wisconsin’s enviable record of access to high-quality care underscores how much we have achieved and how much we have at stake in the coming months as the nation debates the repeal and replacement of Obamacare,” said Eric Borgerding, president of the Wisconsin Hospital Association.
For employers in Wisconsin, health care costs are usually top of mind. Health care quality should be a concern, as well, because it’s an issue that also goes straight to the bottom line.
The often-asked question, “How much does this health plan cost?” can be answered in ways that go far beyond insurance premiums. It also includes sick days, sick wages and worker productivity. Consider these findings from the National Committee for Quality Assurance and others:
- In 2006, the failure to routinely follow recommended guidelines for evidence-based care for just five conditions — asthma, depression, diabetes, heart disease and hypertension — cost U.S. employers $7.4 billion in lost productivity.
- The same suboptimal care resulted in 45 million unnecessary sick days in 2006. That’s the equivalent of 180,000 full-time employees — or all of Salt Lake City — calling in sick every day for a year.
- Unhealthy lifestyle choices contribute to the loss in workforce productivity, as well, but those costs can be mitigated by participation in high-quality wellness programs.
Low-quality health care leads to lower productivity and increases in health care costs that business and society can ill afford.
In health care, the failure to prevent serious complications, such as a hospital-acquired infection, may cost the patient his or her life, prolonged disability and thousands of dollars in treatment. Avoidable surgical complications may prolong hospitalization, result in disability or death, and cause great expense and repeated procedures.
More than 30 studies have been conducted over time on the links between health risks, medical costs and workplace productivity. The studies provide compelling evidence that investing in employees’ good health pays off in measurable ways.
High-quality health care is also a business advantage worth touting. At a time when everyone from Gov. Scott Walker on down is worried about workforce development, Wisconsin businesses can point to health care quality metrics, either statewide or through specific delivery systems, as a way to attract and retain workers.
“You can go anywhere in the state, from the most-urban areas to rural. … If you have access to good quality health care, people will want to come and do business in your community,” Walker told a health care advocacy crowd last year.
Wisconsin needs all the business and workforce development advantages it can get. As the national debate over health care unfolds, the state would do well to guard its reputation for quality.