Health care: We reached the Summit—now we have to climb the mountain
By Bill Settlemyer
Executive Publisher
On page 47 of this issue, you’ll find a special section about our Business Healthcare Summit held on April 28. Around 200 area business and community leaders attended the event.
I’d like to give a public “thank you” to the panelists who generously committed their time and energy to the event (see sidebar). All came well prepared to share their knowledge on the subjects addressed in each of the four sessions. In this column, I’m going to summarize some of the key points discussed at the summit, and you can turn to page 47 for more detail.
The working uninsured
In any given year, nearly 20% of South Carolinians are uninsured at some point during the year. Most of our uninsured are either working or are dependents of people who work.
Not surprisingly, smaller businesses are less likely to provide coverage. Fifty-three percent of small employers with 1-10 employees and 39% with 11-20 employees do not offer group health coverage.
The consequences
People without insurance are less likely to seek preventive care and take medications or other steps to control chronic diseases like high blood pressure and diabetes. When they eventually develop acute illnesses, they show up in the emergency room and, as required by law, receive intensive and expensive in-hospital treatment.
Who pays for that care? We all do, through our own health premiums. In 1999, area hospitals provided an estimated $55-60 million in unreimbursed care. The dollars to cover this care have to come from somewhere, and it’s estimated that the private insurance premiums we pay (individual or group) are as much as 70% higher than they would be without the need to recoup those unreimbursed dollars.
It follows that if we can help our state’s uninsured population obtain access to a minimum level of preventive care and disease management, we can help them stave off the expensive unfunded in-hospital care that we all have to pay for. That’s just what Tri-County Project Care, a local nonprofit organization, is doing with support from area hospitals. Medical director Dr. Casey Fitts showed us a remarkable chart revealing a dramatic downward trend in the cost of care based on the number of months a patient remains in the Project Care system. Prevention and basic primary care works!
Well care beats sick care
In our session on community and workplace wellness, we learned about a community initiative in Greenville led by Dr. Marcus Newberry, former dean of the College of Medicine at MUSC. In a Trident United Way initiative in which I’m involved, we hope to use Dr. Newberry’s efforts as a model for a similar effort here in our region.
We also heard about “the power of prevention” from Dr. Pam Morris of Prevecare. If you follow media reports about health care, you know our country is facing an obesity epidemic that is the precursor to an even greater epidemic of heart disease, diabetes, stroke and cancer. The good news is that with an individual and community focus on wellness and prevention, we can slow or even reverse these trends. In my view, the need to take action on this is both urgent and continuing.
Not only will wellness efforts reduce the cost of unfunded medical care; they will also help make our region more competitive and our employees more productive. Our entire health care system needs to do a better job of providing “well care” in addition to “sick care.” As I have put it to physicians, insurers and hospital executives: “I want to pay you to keep me (and my employees) well, not just treat me once I get sick.”
Business health coverage strategies
The final session addressing group health coverage showed the progress larger companies are making in honing their strategies for providing coverage to their employees. Jerry Gazes of First Federal, Craig Massey from Piggly Wiggly Carolina and Jack Hoey, Coastal Glass Distributors, described the approaches they adopted for companies ranging in size from just under 150 to several thousand employees. Piggly Wiggly, for example, has a very aggressive wellness program offering smoking cessation assistance, weight loss and disease management programs, a 24-hour nurse line to help employees make good health care decisions and a program for expectant mothers.
All three companies have worked very hard to figure out the best way to share costs with their employees, striking a balance between affordability and incentives to spend health dollars wisely and stay healthy.
Gus Gustafson from Palmer & Cay helped us look at the new Health Savings Accounts to see where they fit into the mix of possible solutions. Some issues remain to be sorted out, but at least it’s one more tool in the toolbox.
Overall, perhaps the biggest unanswered question was how to apply some of the larger company strategies to smaller businesses. Coverage provided through a properly designed association group plan may well be a part of the answer, but more study and greater innovation will be required to make this approach work.
My thanks again to all our panelists as well as those who attended the summit. There are great challenges ahead but also great opportunities. Let’s continue to work together to achieve a happier, healthier and more productive workforce in our region.
Healthcare Summit Panelists
(listed in order of presentation)
S.C. Dept. of Insurance Study
Viki L. Fox, S.C. Department of Insurance
Public Payers – The Impact of Government and Nonprofit Programs
Robert M. Kerr, State Director, S.C. Dept. of Health and Human Services
Casey Fitts, M.D., Tri-County Project Care
Deb Campeau, Trident Health System
Community and Workplace Wellness
Pam Morris, M.D., Prevecare
Marcus Newberry, M.D., Nutritional Health Center, Greenville, S.C.
First Lady Jenny Sanford
Chris Kerrigan, Trident United Way
Business Health Coverage Strategies
Jerry Gazes, First Financial Holdings Inc.
Craig Massey, Piggly Wiggly Carolina Co.
Jack Hoey, Coastal Glass Distributors
Gus Gustafson, Palmer & Cay Consulting Co.
Cathy Ferry Middleton, Executive Director, Tri-County Project Care
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