On January 1, 2014 the affordable Care Act—Obamacare—will be in full effect. This is one of the biggest national “Who Moved My Cheese” moments ever. Even though the purpose of the act is break the cycle of spiraling costs and increase access to health care (which are good things), there is no doubt that before all the dust settles, everyone is going to get pissed off about something.
This blog calls out the fact 58.9% of the frustration associated with Obamacare will have more to do with change management than it will with health care administration.
OK, I made that number up. But the point is that this transformative moment in our history demands active leadership and clear-eyed communication. Leaders will be made and broken by the way they guide their businesses and their employees through the upcoming rapids of health care changes. Here are do’s and don’ts to help along the way.
Don’t make this political. If you want to destroy morale and business focus, start talking about the ACA in the derisive terms of AM talk radio. Go ahead and proliferate bumper-sticker screed about socialism, government intervention, and conspiracy theories and watch your business go down the toilet. You can blame everyone who is left of right for that too.
Do the right thing for your people. This isn’t liberal softy entitlement stuff; it is about good business. No matter what you make, do, or sell, you depend on quality people. Quality people stay and work hard in companies that offer support. Ensuring that people have reasonable and affordable access to health care is a good thing. Figure it out and make it happen because it is the right thing to do; connect this effort to the overall value proposition you are offering your employees.
Don’t panic. The Kaiser family Foundation points out that 94% of companies with 50 to 199 employees already offer benefits that comply with the ACA guidelines. That’s a real number. It means most people won’t have to do anything. Those companies are paying 76% of their employees’ health costs—well above the 60% mandated by the law. This doesn’t mean that premiums aren’t going to increase. In fact we are sure they will—but that is not news. Premiums have gone up 97% (another real number from Towers Watson Group) since 2002.
Do provide education and be transparent with employees. When I started my companies (both small), health care was a central part of the value proposition. I had the misfortune of having some tough medical challenges in my early 30’s. I saw how vulnerable we all are and was frankly lucky to have great health care coverage. We have always offered top tier serviced to our employees. But even in our little company, we are going to have to make some changes. We can offer more options; we can allow employees to opt in and out of services, we can look at new options for dental, vision, even pet insurance. Yeah it’s all fun and games until you get the vet bill after Trixie eats a box of panty hose! (That really happened…)
Don’t try to game the system. No you are not allowed to break your 80 person company into two companies with forty people each so you can limbo under the employee limits; if you have two half time employees—that equals one FTE for the purposes of ACA calculations. Americans think about working the system as a professional sport—just look at how we tango with the tax codes. Don’t be foolish, inattentive, or pay a penny more than you have to—but don’t waste your energy trying to scam your way through. This is one of those situations where everyone is facing the same threats and opportunities. As Napoleon said, “The weather is not a problem for the army because we know it is raining on both sides of the battlefield.”
Do use experts. There is no way you can get through this without help. After returning from a long road trip my CFO told me I was going to meet with our health insurance expert. I would rather eat bugs, count BB’s, or go through a TSA shakedown than talk with insurance people. Her name was Shannon and it turns out she is awesome. She was smart, thorough, as clear as she could be and honest about what none of us know–yet. It was clear that she lives and breathes this stuff—and she made a good effort to get to know us as well to make sure that we made smart choices. My anxiety level went way down and I am actually pleased about the decisions we made.
Don’t shy away from wellness efforts. Any viable vision of the future includes all kinds of efforts for people to take more control of their health. Bike to work? You bet. Partnering with gym? Why not. Yoga and nutrition classes? Sounds like fun. There are gobs of studies that confirm that healthy employees mean good business. The long term play here is to get control of the chronic disease management issues that are causing the huge spikes in medical costs. This means Type II Diabetes, cardiovascular disease, and behavioral health issues. Think about the changes in smoking behavior in this country. I remember you could buy a “smoking seat” on airplanes back in the day! Now that just seems insane.
Do demand your employees have some skin in the game. Health care is crazy expensive. We have tried to offer our employees the best plans possible and we will continue to do so; but now I am sharing with my employees just how much that costs. We are also making some changes that will demand the employees pony-up a little more than in the past. We all need to be aware that there is no free lunch here.
And the Changes Will Continue
Changes in health care are going to continue to change our worlds. In a few short years DNA and molecular testing will be a part of every doctor visit. Pharmaceuticals will be manufactured to your specific needs and biochemistry. Regenerative treatment regimens will be commonplace. In other words, this is not one of those things where we will be done in a couple of years. These changes are a classic first world problem; the only thing worse than dealing with these issues would be not having a health care system in the first place.
So in summary, do the right thing, offer education, use experts, and have employees contribute ideas and income to their own health care plans. This is a leadership challenge! Treat it as such.