Chronic Disease Considered the Next Business Crisis

New Jersey businesses are extremely concerned about the risking cost of chronic disease. I had the pleasure of attending a breakfast meeting yesterday, an event sponsored by several prominent New Jersey business associations. These included the Chamber of Commerce of Southern New Jersey, the Commerce and Industry Association of New Jersey, the New Jersey Business and Industry Association, and the New Jersey State Chamber of Commerce. Their main message: chronic disease is costing businesses enormous amount of money and prevention, which requires investment in the beginning, has long-term cost savings benefits for the employers.

The two guest speakers, David Hom of Pitney Bowes and Dr. Steve Wolinsky of Horizon Blue Cross Blue Shield, gave a compelling argument for pro-actively addressing the issue of chronic but preventable diseases in order to reduce the cost of coverage in the long term. Their recommendation included using web-based tools to address the concerns of low-risk individuals as well as using it as a tool to conduct preliminary risk analysis to identify those in the high risk category.

While there were a number of very valid questions coming from the medical professionals and small businesses, my main concern centered around the dramatic shift that has occurred in the workforce culture. When the new generation of workers do not expect to remain in one job for more than a few years let alone till retirement, businesses will basically see a revolving door experience in their workforce. As such, businesses must be concerned that the employees that they are hiring may have received inconsistent or wholly inadequate attention to the issue of chronic diseases. Will it fall upon the more successful businesses to now pay for services that the previous employer refused to provide?

I asked both Mr. Hom if as an employer there is some concern that new employees may have received inadequate preventive care in their previous employment, and asked Dr. Wolinsky if there should be a minimum standard in addressing chronic disease as part of any insurance coverage to address that issue.

Dr. Wolinsky suggested that the market itself is setting a virtual standard for preventive care. As such, it is not necessary for any sort of formal standardization because it is in the long-term interests of businesses to provide that service.

Dr. Hom suggested that when it comes to the employee-employer relationship, it is up to the new employees to make sure that their new employers are providing the same level of preventive care as their previous employer. If an individual was receiving coverage for diabetes or asthma, they should ask for that same service from a new employer.

I do have some concerns with these recommendations. Much of it stems from the current financial crisis and at some levels I feel that the lessons learned from it are not being appreciated when it comes to addressing the health crisis. First, with a contracting economy, businesses are more likely to cut healthcare coverage to protect the bottom line. Which translates to offering health coverage that falls below the minimum standards of addressing chronic disease in relation to the general workforce. What this means in real terms is that the companies may reduce or eliminate incentive programs for health screenings, smoking ceassations, and other programs. Secondly, with increasing umemployment, there is very little leverage for individuals to ask for the level of coverage from new employers that they may have had from their previous employer. When people are more concerned with making their mortgage payments, filling their gas tanks so that they can get to work, from an individuals perspective, any health coverage is better than no coverage at all. This is a situation where the market dominated by small business with fewer than fifty employees who do not plan on being there for a long time may opt for health coverage that simply does not offer the comprehensive preventive care that is crucially needed to stop the next business crisis.