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East Bay Business Times

Public Health System Needs the Help of Employers

by Jamie Court & Kay McVay
Nov 09, 2001

The recent anthrax scare should send a 911 to employers that they must now grab the extended hand of the medical community in order to fix a broken public health care system that undeniably affects us all.

It has never been more obvious that our society needs greater public oversight over the private health system in order to guarantee that resources go not just to HMOs that cut corners but to preserving facilities, people and programs that save lives.

In a society subject to the spread of anthrax or smallpox, there can be no distinction between public and private health care. Distinguishing between sick people deserving of health care and those not becomes irrelevant when everyone is at risk. Nor does it seem right to deny health coverage to the families of heroic Americans who perished in the World Trade Centers or the bombing survivors who lost their jobs simply because they cannot pay.

Society needs a new way of thinking that prevents the demands of the private health care system from diminishing the needs of the public's health. As a key political stakeholder in determining the shape of the health care system, employers must be at the forefront of change.

Employers hired HMOs to get the cheapest care possible in the private health care system. This resulted in the massive closure of emergency rooms, the dismantling of trauma care facilities, and in the closure of hospitals. In the hospitals that remain, chronic understaffing has driven experienced registered nurses out of the profession. Such lost infrastructure is needed precisely during a bombing, anthrax scare or smallpox epidemic.

Employers believed that HMO control over medicine would reduce costs. Instead, employers have been bedeviled by the twin vices of double-digit premium increases and increasing gripes from employees about obstacles to medical care. Employers concerned about the welfare of their employees face a market that allows them diminishing options for coverage all gravitating to the lowest common denominator and ever increasing costs with no end in sight.

In a deepening recession, businesses have been forced either to shift more or all of the payment burdens to their employees, making their companies less competitive and their employees more vulnerable, or have health care costs eat up their profits. Those businesses that cannot afford coverage will have far more concern for their workers' health in the post-Sept. 11 world than ever before.

The time has come for employers to join physicians, nurses, hospitals and patient advocates in creating a model for health care that does not pit the private health care system against the public health system, but brings them together in a more rational way.

If any good in health care is to come from the rubble of Sept. 11, it will only happen when employers, doctors, nurses, patients and hospitals come together to make it happen.