This interesting article from Health Affairs
probes how employers are grappling with rapidly rising health care costs. It concludes that the status quo is unlikely to change anytime soon:
Employers have largely been ineffective and unenthusiastic managers of the health benefits they sponsor. Typically, they view health care as a distraction from the core mission of their firms, and they are frustrated. They are "between a rock and a hard place," both unable to manage their health care costs effectively and constrained from getting out of the business of offering health benefits altogether. Employers doubt that the current round of initiatives and policy proposals will ease their situation. But finding a way out for employers is complicated and unlikely to happen quickly.
Historically, employers have offered health benefits to attract and retain labor. But because health costs have been rising rapidly, employers are now more willing to explore alternative roles for themselves and other ways of offering benefits. Today’s senior managers have more interest in finding solutions to these problems than at any time since the health reform efforts of the Clinton administration.
Since the several million firms that offer health benefits neither act nor speak in unison and, in fact, lack a mechanism to do so, it can be difficult to understand what drives them. Employers are diverse not just in size but also in their approaches to offering health benefits. Nevertheless, long experience with employers' efforts to manage health care has led us to conclude that a majority of mid-size and large firms try to satisfy the following goals:
- control costs without disadvantaging their ability to attract and retain labor
- produce immediate results while committing minimal resources
- focus on individual responsibility, competition, and market forces
- improve the health and productivity of their workforces and
- try to find a way out of offering health benefits while limiting burdensome mandates or other government interventions that bar customized solutions for their firms.
These goals, particularly the reluctance to commit resources and the shortterm focus, fall short of what is required to improve the overall value of the health care available today. However, as employers begin to look at "exit strategies," policymakers must craft alternatives that demonstrate an understanding of and address enough of these goals to be palatable to employers.