Brokers are concerned about the future of the U.S. health care system. They need to understand the changes coming their way so they can work with employers and carriers to design the best plans possible for their clients. Susan Blumenthal, former assistant surgeon general and a leading health expert, gave brokers a detailed overview of advances in medicine, science and technology that can improve health in the U.S. during her presentation, "How to breathe new life into the health care system," at the 15th annual BenefitsPRO Broker Expo, April 3, in Miami, Florida.

"The tectonic plates of health care are shifting," Blumenthal said, highlighting Amazon's entrance into the space with "Haven," the company's joint venture with Berkshire Hathaway and JP Morgan Chase, with the goal of improving health care for the 1.2 million employees of the three businesses. The plan is intended to shelter the employees from insurance hassles and go-betweens and to lower the costs of care while increasing transparency. "Another by-product may be developing health care models that other businesses can use in the U.S.," she said. "And while you [brokers] are not the target you could be affected."

"We need CPR to breathe new life into our health care system," Blumenthal said. In this case, CPR stands for coverage, prevention and research:

Cover all people with quality, affordable health care.

Prevention should be put first to build a culture of health.

Research causes and treatment of the most prevalent diseases and increase investment to fuel innovation.

Blumenthal would like to see a focus on improving health in all public policies and in all sectors of society. She points out that it's an issue that should be considered when setting policy in areas as varied as agriculture, foreign policy, transportation and finance. She also noted the increase in infectious diseases, with 30 new diseases that have emerged over the last 20 years, and the current pandemics that health care professionals are dealing with:

HIV/AIDS. 87 percent of people transmitting HIV infections don't know they have it.
Flu season 2018–2019. This year's flu season was milder than last year but it's lasting longer.
Anti-vax movement. This has become one of the top 10 global health threats for 2019.

Chronic conditions drive costs

Chronic conditions also remain significant drivers of health care costs, primarily smoking, obesity and the lack of physical activity at all ages. "Smoking is still the number one preventable cause of death," Blumenthal said. And switching to e-cigarettes is just as bad if not worse. The 5 percent nicotine concentration in each e-cigarette is equal to the nicotine in one pack of cigarettes, making them addictive.

Obesity is not just an adult problem. Blumenthal pointed to the skyrocketing numbers of children diagnosed with Type 2 diabetes. The prevalence of obesity has increased across all ages, racial and ethnic groups, and both genders. And it's not just a health problem; it affects national security as well. The military has found that 27 percent of eligible young people are too fat to fight.

Blumenthal also reviewed the statistics on mental illness and substance use. Indirect costs due to mental illness are estimated to be $78.6 billion and $120 billion for substance use disorders annually. "Mental health and substance abuse benefits should be key components of employer health plans. All Employers should have employee assistance plans," she said.

A related mental-health issue is that of workplace violence, which accounts for 17 percent of all workplace fatalities. Businesses pay a heavy toll for these incidents, Blumenthal said, pointing out these key statistics:

About 2 million people annually report some type of workplace violence.
About 25 percent of workplace violence goes unreported
About 500,000 employees miss an estimated 1.8 million workdays annually due to workforce violence.
The annual cost to business is now $130 billion compared to $36 billion in 1995.

Brokers can help by being strong advocates for workplace safety programs as they advise employers on policies. Workplace safety programs have been shown to reduce workers' compensation costs, making them a good investment for employers.

Move prevention to the forefront

"We have a 'sick care' system in the U.S., not a health care system," Blumenthal said, noting that only 3–5 percent of the U.S.'s $3.5 trillion health care budget is spent on prevention. Brokers can help by encouraging employers to design their benefit packages in such a way as to encourage employees and their families to adopt healthy lifestyles.

"The most productive employees are physically and emotionally healthy, which boosts productivity, reduces absenteeism, and decreases health care costs," Blumenthal said. On a positive note, according to a recent survey, 64 percent of employers have implemented a wellness or disease management program.

Invest in research

Blumenthal highlighted the recently announced "All of Us Research Program," an initiative of the National Institutes of Health, described as "a historic effort to gather data from one million or more people living in the United States to accelerate research and improve health." It's a key element of the Precision Medicine Initiative (PMI).

By taking into account individual differences in lifestyle, environment and biology, researchers aim to accelerate research and improve health through precision medicine. The goal of PMI is to enable researchers, health care providers and patients to work together to develop individualized care.

"Brokers need to stay up to date on the health service delivery, economic and regulatory landscape, and keep your customers informed," Blumenthal said. "You should become their indispensable source of information."

She recommended that brokers serve as year-round advisors to their clients, not only at renewal time. "Adopt new technologies," she said, "and use them to connect across silos. The quality of health care benefits and plans should not be sacrificed for reducing costs."

The best thing brokers can do? "Focus on your own health," Blumenthal said. "Don't smoke. Eat smart and maintain a healthy weight, and stay connected."

Read more of our Expo coverage:

Instant Insights /

Coverage, prevention and research: Health care CPR for the 21st century

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