Employers have the power to fix the U.S. health care system

Whenever I ask a U.S. employer what’s wrong with health care in America, I get the same response: it costs too much and delivers too little.

Employers are positioned to know this better than anyone. About 158 million Americans get health insurance through their employers. This is just under half of the total U.S. population and more than three and a half times the number served by Medicare, the second largest source of U.S. health care coverage.

During my 24 years in Congress, I spent countless hours in meetings about what is wrong with health care in America. It is unacceptable, that one of the richest and most innovative nations in the world has such a poorly functioning health care system and a population with mediocre health outcomes compared to other developed countries. After all those meetings, I know why: the U.S. health care system operates on a set of incentives that too rarely align with improving the health and well-being of Americans.

I also now understand that, in a country where transparent markets are highly valued and understood as beneficial to everyone involved, health care is one of the least transparent markets of all. This is revealed in many ways, among them:

• Patients know little to nothing about the services being provided to them and have little opportunity to become informed consumers
• Health care services are paid for by third parties, so the cost of care is often hidden from patients and even individual providers
• Prices of services are buried in multiple contracts across many providers and intermediaries, making it difficult to estimate costs in advance or even after the fact, even for those who pay the bills
• Pricing is considered proprietary information by many providers and insurers
• Perhaps most egregious, too many of these middlemen believe that the data about pricing and usage of services belongs to them—not to the people who receive those services or pay for them

The ray of hope in this picture is that employers have the power to change the health care system in America. I know this because I now have the opportunity to lead a cooperative of large U.S. employers working together to provide better health care to their employees, retirees, and their families. I see every day how employers can play a pivotal role in solving seemingly intractable problems by joining forces, sharing best practices, and aggregating data.

However, I also see every day that taking on the U.S. health care system takes courage—especially from the men and women who lead and operate health benefits plans for employees and their families, Change is always disruptive and rarely without risk. Informing your employees you’re going to change some things about how they get health care sounds great in theory. But if people are used to a certain card in their wallet or accessing care in certain ways, they might not like it. In addition, when you set out to transform the health care system, you risk damaging relationships you might have with companies in the health care field. Given that health care now accounts for 20% of the U.S. economy, most large companies are bound to have health care companies as customers.

There is also the reality that there is no silver bullet for transforming the U.S. health care system. Instead, the focus must be on solutions for the most broken parts. One example is providing your employees with safety and quality data so they can choose the safest hospital or surgery center for their need. This has the added benefit of incentivizing providers to make improvements.

Another example is using insights gleaned from data that insurers have and would prefer you don’t have. For that, we need more employers working together, aligned in a common vision that armed with data—about commercial claims, safety, and quality and aggregated from millions of people—employers can negotiate and enforce payment strategies and contracts that reward providers for the best outcomes for patients. Not only does this help save lives; it saves billions of dollars in health care costs.

Working together, with powerful data about what patients need most and a laser-like focus on what is best for them and for the organizations that are paying the bills, employers can and will succeed at transforming the U.S. health care system at scale.

Robert Andrews is chief executive officer of the Health Transformation Alliance (HTA), a cooperative America’s leading employers that have come together to fix our broken health care system. Prior to the HTA, he served as a Member of the United States House of Representatives for nearly 24 years.