In the days since the U.S. Supreme Court’s legal affirmation of the Affordable Care Act (aka Obamacare), we have witnessed a cacophany of celebratory victory laps and ongoing bloviating about impending doom, loss of freedom, and death panels. Whether you are an employer, an individual citizen, legislator, or health care worker we would offer two words of advice that can usually be found this time of year on signs carried by course marshals at the FedEx St. Jude Golf Tournament – Hush Y’all! It is time to stop our national food fight on this issue.

Simply put, we have neither the time nor economic margin for grandstanding or political theater. We’ve got important work to do. Health care spending amounts to 17% of the nation’s GDP, and is growing at an unaffordable rate. Health outcomes are increasingly second rate, and certainly don’t match the expenditure, or our stature on the world stage. Too many of our fellow citizens are being marginalized because they lack access to quality care, take too little responsibility for their own wellness, or both. Our businesses are being rendered less competitive in world markets because of the cost overhang of a job-based funding model. It is only a matter of time before the relative health of our workforce becomes yet another competitive headwind.

As proposed in our new book, Contented Cows STILL Give Better Milk, those of us who are leaders and employers have important considerations to make right now, and “right now” means just that.

1. We must decide thoughtfully whether to begin (or continue) participating in an employer-provided health insurance plan.  Some might posit that this decision comes down to simply choosing between employer and employee interests, or the least costly option. We would submit that it’s not that simple.
2. Each of us should be taking steps to become informed (really informed) about the finer points of health care services and economics. It’s time to turn off the TV and do your own homework.
3. Let’s use our influence wisely, rather than getting into yet one more “Tastes Great vs. Less Filling” debate. One good place to start would be in encouraging tort reform as pertains to health care. For so long as health care professionals are required to practice defensive medicine to prevent unnecessary lawsuits, our system will never be as efficient or effective as it needs to be. Second, we must proceed apace with implementation of a robust, integrated electronic health record (EHR). We’re told that the Veteran’s Administration already has such a system in place. It’s paid for. Why don’t we use it?
4. It is past time to initiate an ongoing grown-up conversation with our employees about health care – its costs, complexities, options, and responsibilities. And that’s not an easy conversation to have because, for openers, our workforce is anything but monolithic. And, let’s face it, most of us couldn’t care less about health insurance until there is a serious diagnosis pending, or we’re staring down the barrel of a big fat hospital bill.

Our hope is that we can use this challenge as a vehicle to move the nation forward in a positive direction, and perhaps regain some of the credibility and trust that we, as business leaders, have lost over the last decade.

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A pathfinder in the arena of leadership and employee engagement, Bill Catlette is a seminar leader, keynote speaker, and executive coach. He helps individuals and organizations improve business outcomes by having a focused, engaged, capably led workforce. He is co-author of the Contented Cows leadership book series, the newest edition of which is now on sale. For more information about Bill, his partner Richard Hadden, and their work, please visit their website, or follow him on Twitter at http://twitter.com/ContentedCows

In his best-selling book, “Beating the Street”, famed investment fund manager, Peter Lynch opined that people ought not invest in anything which “cannot be explained with a crayon.” His reasoning was that, if you can’t explain with something as blunt and simple as a crayon what a company does and how it makes money, then you don’t understand it well enough to own it. I’ve tried very hard over the years to obey this iron law, and it has served me well, particularly on those days when the market is in free fall.

Mr. Lynch’s advice is equally appropos outside the financial world. It holds true, for example, for us manager-types. If we can’t credibly explain with that same crayon what our business/department/team does, then people aren’t going to buy into it, and we can be assured of half-hearted effort at best, and lots of empty seats on our bus. It’s not because people are stupid – not at all, but because they’re rightfully cynical, owing to all the hype, noise, and spinning directed our way as we go thru life.

Our president is finding more empty seats than he would like on the health care reform bus of late, not because reforming our health care system (correction, we have NO health care system) is a bad idea, but because he and those around him have thus far been unable to credibly articulate the problem and the proposed solutions. Granted, it’s not easy being heard above the din of competing interests, but he does have a pretty big microphone.

Peggy Noonan spelled it out as only she can in a recent WSJ piece . “The president’s health-care plan is not clear, and I mean that not only in the sense of “he hasn’t told us his plan.” I mean it in terms of the voodoo phrases, this gobbledygook, this secret language of government that no one understands—”single payer,” “public option,” “insurance marketplace exchange.” No one understands what this stuff means, nobody normal.” And, while I vehemently disagree with Mr. Noonan’s solution (pull the plug – not on grandma, but the whole shebang), she’s dead right about the explaining part.

Mr. President, it’s time for Congress to shut up and for you to find your voice, ‘er crayons. Now.

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A thought leader in the arena of leadership and employee engagement, Bill Catlette is a seminar leader, keynote speaker, and executive coach. He helps individuals and organizations improve business outcomes by having a focused, engaged, capably led workforce. For more information about Bill, his partner Richard Hadden, and their work, please visit their website at www.contentedcows.com, or follow him on Twitter at http://twitter.com/ContentedCows

Yesterday, at the conclusion of a routine office visit with my primary care physician, I asked for his opinion on the most important aspects of fixing our health care system. Actually, use of the word “system” is off the mark, because we really don’t have a health care system at all, just a bunch of component parts that don’t work together especially well. I digress.

The doctor’s eyes lit up when he realized that I was seriously interested in the topic, and what he had to say. Owing to the doctor’s kindness, love of his work, and a surprisingly slow Monday in his office, he talked and I listened for the next forty (that’s right) minutes. Here’s what he said…

Dr. J (that’s what the folks in his office call him) suggested that in order to sufficiently bend the cost curve while expanding coverage, we need to do at least three things:

1. Make patients accountable for questioning, being economically involved in, and then acting on the medical advice and treatment they are getting. He recounted a litany of instances where patients were needlessly tying up valuable health care resources (e.g., pharmaceuticals, breathing treatments for COPD, and recurring office/hospital visits) simply because they refused to quit smoking, lay down their fork, etc. He also suggested that there is a powerful link between a patient’s actually having paid something for a drug, as little as $1, and the likelihood of them taking that medicine as prescribed. He recommends a scenario whereby patients who don’t properly use the advice or treatment lose the ability to be reimbursed for it.
2. Institute tort reform as a means of reducing the tendency of medical service providers to over-test. Surprisingly, he was not in favor of capping liability awards. Rather, he suggested a pre-trial medical panel review in which a dispassionate group of docs would review the facts and issue a finding to the court as to whether or not malpractice occurred. He cited good results from a handful of states where such a policy already exists.
3. Finally, he suggested that we need to do something to prevent (as occurs presently) pharmaceutical R&D and marketing costs from being sequestered in this country due to price controls everywhere else around the globe.

I don’t know what the answers are, but I’m confident that if we all take the time and initiative to become better informed, to read and chat up our own “Dr. J’s”, make our voices heard, and demand that our elected representatives at least read any proposed legislation before voting, we’ll be miles ahead.

Godspeed!

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A thought leader in the arena of leadership and employee engagement, Bill Catlette is a seminar leader, keynote speaker, and executive coach. He helps individuals and organizations improve business outcomes by having a focused, engaged, capably led workforce. For more information about Bill, his partner Richard Hadden, and their work, please visit their website at www.contentedcows.com, or follow him on Twitter at http://twitter.com/ContentedCows

Our 1998 book, Contented Cows Give Better Milk, called attention to the substantial advantage in business outcomes achieved by companies with sensible leadership and employee relations practices. In it, we compared the difference in business results for a group of 6 companies with reputations for being great places to work (Contented Cows) versus a half dozen of their direct competitors with not quite the same workplace reputation (Common Cows). One of the companies profiled as an exemplar was Wal-Mart.

Despite very good business results, in the intervening years Wal-Mart has suffered more than its share of reputational black eyes inflicted by competitors who’ve endured countless beatings at the hands of the beast from Bentonville, labor unions that have grown weary of the company’s strident union-free posture, and yes, some mis-steps of its own.

Through it all, we’ve defied popular sentiment, maintaining instead that Wal-Mart is still a pretty good place to work, not to mention a convenient place to shop for a huge assortment of items at relatively low prices. Is it sexy? Nope, not one bit. Though I’ve never worked for the company, I get the distinct impression, gained from hundreds of store visits, interviews, and talking with acquaintances who do work their, that the work can be taxing (think long hours, hard floors), not especially lucrative, and, with  2.1 million people on the payroll (fully 50% larger than the active U.S. military), not particularly flexible. Moreover, consistent with lessons learned from other high performance workplaces, evidence abounds that employment at Wal-Mart is not for everybody. But it is right for a lot of people, and if you’re currently looking, you might give it some consideration.

What Wal-Mart lacks in “sexy” it makes up for in “steady”, something a lot of us are finding renewed appreciation for as the economy continues to quake and quiver. To wit…

• Unlike employees at 3 of the 6 designated “Common Cow” companies (Consolidated Freightways, United Airlines, and General Motors) and a long list of others that have gone through bankruptcy since the book was published , Wal-Mart employees have enjoyed growth, relative prosperity, and job security.
• Despite all the carping from organized labor about the company’s conservative approach to pay and benefits, Wal-Mart is now among the retail industry leaders in workforce health care insurance coverage. Indeed, the industry’s largest trade group, the National Retail Federation is apoplectic that Wal-Mart has endorsed congressional proposals that would require employers to provide health insurance for their employees
• And, they actually are doing some exciting stuff on the environmental front. The company is currently working with environmentalist and entrepreneur  Yvon Chouinard (Patagonia) to develop and produce recyclable clothing

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A thought leader in the arena of leadership and employee engagement, Bill Catlette is a seminar leader, keynote speaker, and executive coach. He helps individuals and organizations improve business outcomes by having a focused, engaged, capably led workforce. For more information about Bill, his partner Richard Hadden, and their work, please visit their website at www.contentedcows.com, or follow him on Twitter at http://twitter.com/ContentedCows

P.S. Bill Catlette does not currently own Wal-Mart stock, nor has he ever taken a dime from the company.

There is a compelling piece in today’s WSJ by Dana Mattioli about the frequency with which small businesses are finding it necessary to cancel employer-sponsored health care coverage for their employees.

Citing data from the National Small Business Association, the article mentions that:

1. “About 10% of small businesses are considering eliminating coverage over the next year, up from 3% in 2005, and

2. “Just 38% of small businesses provided health insurance last year compared to 61% in 1993.”

The obvious cause – the continued run-up in health care coverage premiums in the face of a declining economy. Contrary to the way these decisions are often portrayed in the media, Ms. Mattioli takes pains to establish that in reality, these are extremely painful moves for a business owner or CEO to make.

Aside from trading more job cuts for health insurance, or raising employee premiums and co-pays, there are things that employers can do to hold the lid on health care costs. Here’s but one example, based on simple human greed, and the notion that each and every one of us needs to become a better health care consumer:

On the premise that many (most?) medical bills, particularly hospital bills contain billing errors, not necessarily in the payor’s favor, organizations would be well advised to adopt incentives that cause patients to audit their bills, and reward them for catching/reporting errors.

More specifically, adopt a program that encourages employees to obtain and carefully review all of their health care bills, and rebates to them fully 50% of any recovered over-billing. As a case in point, when our daughter was born, while looking over the bill, I noticed that we (my company) had been charged for use of a delivery room and for anesthesia. The only problem was that my wife never went to a delivery room, and didn’t take so much as an aspirin in the birthing process (one strong lady!) As the company’s HR director, I dutifully made sure the billing error was corrected, saving the organization several hundred dollars.

By providing a reasonable, self-funded incentive, you are able to achieve goal congruence with your insured employees, and save a lot of money in the process. Try it, I think you’ll like the results.

A thought leader in the arena of leadership and employee engagement, Bill Catlette is a seminar leader, keynote speaker, and executive coach. He helps individuals and organizations improve business outcomes by having a focused, engaged, capably led workforce. For more information about Bill, his partner Richard Hadden, and their work, please visit their website at www.contentedcows.com, or follow him on Twitter at http://twitter.com/ContentedCows