A copy of this post first appeared on Google Plus. Lets just say my interest in high school physics greatly outpaced my ability. I was pretty good with the Mr. Wizard stuff, but that's about as deep as I get. One of the things I remember is about the death of a star, a super nova. After a star has used up it's main fuel, it begins to basically burn itself. Come to think of it, I wasn't a scholar in health class either; but I remember when we eat too little, our bodies will actually consume muscle. In starvation mode, like a super nova, we eat ourselves. A recent study reported by Thomson Reuters confirms the unsurprising truth, healthcare workers consume more healthcare than the average public. Are we just taking advantage of industry perks or are we consuming ourselves for nourishment?
I'm willing to guess, although that's all it is, folks who work for airlines fly more than the general public. Makes sense, right? You get cheap or free standby tickets, you know how the system works, it's in your favor. Healthcare workers probably have an easier time getting appointments. We are certainly bombarded with information about disease risks and wellness benefits. It's logical to think we're just taking advantage of working in the proverbial right place at the right time.
The airlines are also experts at understanding data about travel. Which is the least expensive path from A to B? They know. If they are going to send their mechanics across the country to work on a jet, I bet they know the best routing to optimize the cost associated with taking up an otherwise for-sale seat. In other words, they manage the risk associated with travel costs very well. It would stand to reason the healthcare industry has the same advantages when it comes to employee health benefit risks. The Wall Street Journal makes that very assertion in reviewing the Thomson Reuters study. The healthcare industry was one of the few industries to add jobs in the most rent reporting period. We are large employers. We should be good at managing our own health cost risks.
But here's the thing, while as an industry we are consuming more healthcare, we are not, on the whole, healthier than other industries. Likewise, our benefits costs are not any lower. What is all this consumtion getting us? I bet people who work in restaurants eat more restaurant food. Restaurant owners always say, "you have to watch what goes out the back door." What they mean is, all that free food eaten by employees is cost. (an arguably justifiable expense for a group work works hard for very little pay)
The slightly perverse economics make these potential costs a double whammy. Most large provider organizations (hospitals, integrated systems, etc) are self insured. They may pay an insurance company to manage a plan, but they are footing the medical expenses out of their own coffers. When we consume our own product (health care) we are not only generating cost to the system, we are also moving money from one pocket to another. Is it really profit if you are paying yourself? Even if it's not recorded as such on a financial statement, doctors still get RVUs for visits, nurses get paid for working the shift, and the suppliers still get paid for the supplies used.
Now, I'm all for healthy employees, and I believe wellness and health benefits go a long way. I'm in no way suggesting we we abandon caring for our own people (hey, I work in a hospital, I'm healthy and I go to the doctor more than my peers). I am more concerned with the false economy inherent in our proportionally high utilization of health services.
This week, The Healthcare Advisory Board Comapny reported the Patient Protection and Affordable Care Act (Obamacare for the pop culture inclined) will advesly affect healthcare jobs. Not much of a surprise, is it? We're going to increase the number of people with access to care while decreasing the reimbursement from the largest payor, Medicare. Let's not forget, the commercial payors (and employers they represent) are getting kind of tired of footing the bill for our margins; how much longer will they pay a premium over Medicare? We're going to treat more people and get paid less. We have two options: more revenue or cut costs. Providers might reduce some staff, along with other cost cutting efforts, and then what? The way to bolster revenue is to bring in more patients….like, say, our own employees. So I ask again, are we taking worthwhile advantage of working amongst to doctors, or are we eating our own tails to stay alive?