Column: Universal coverage, courtesy of the corporate world? It’s possible
Took ’em long enough.
After decades of government leaders fumbling efforts to introduce some rational thinking to the over $3-trillion U.S. healthcare system, the corporate world has finally stepped in with an initiative that, in the best of all possible worlds, could provide a breakthrough that shows the way to universal coverage.
Details of Tuesday’s proposal from Amazon, Berkshire Hathaway and JPMorgan Chase are scant, so I don’t want to get too far ahead of things. But the players involved, and their track record for clear thinking, suggest that there’s potential for a corporate-led overhaul of how insurance and treatment are provided to Americans.
“The healthcare system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” Amazon Chief Executive Jeff Bezos said in a statement. “Hard as it might be, reducing healthcare’s burden on the economy while improving outcomes for employees and their families would be worth the effort. Success is going to require talented experts, a beginner’s mind and a long-term orientation.”
Berkshire’s Warren Buffett put his finger on the key problem that needs to be addressed.
“The ballooning costs of healthcare act as a hungry tapeworm on the American economy,” he said. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.”
In unveiling their partnership, the three companies, which collectively employ about 1 million people domestically, said they would use their combined workforce as a laboratory for healthcare innovation.
If they come up with ideas and efficiencies that improve things for the companies’ workers, they said, this could demonstrate changes that other private and public employers may want to follow.
The key language in the announcement is that Amazon, Berkshire and JPMorgan will create “an independent company that is free from profit-making incentives and constraints.”
“The initial focus of the new company will be on technology solutions that will provide U.S. employees and their families with simplified, high-quality and transparent healthcare at a reasonable cost,” the companies said.
This is potentially huge. Any healthcare-related entity that eliminates profit-making from its priority list is already well on the way toward the sort of systems in other developed nations that guarantee affordable coverage and treatment to everyone.
“Everyone talks about tipping points,” Dana Goldman, director of USC’s Schaeffer Center for Health Policy and Economics, told me. “This could be one of those moments.”
He said rising healthcare costs have forced all employers to reexamine their insurance plans and to rethink how to look after the welfare of workers.
“I think these companies understand that by making workers healthier, they’re making them happier and more productive,” Goldman said. “It’s a way of making a long-term investment in future gains.”
Former President Obama’s Affordable Care Act was intended to provide a sweeping reprioritization of the healthcare system, with the goal being to keep Americans healthy rather than spend gobs of money on healing them.
That intent got lost amid the horse trading of various stakeholders — politicians, insurers, hospitals, drugmakers — that were looking out for their own interests. What we ended up with instead were half-measures that significantly reduced the number of uninsured but pleased almost no one.
With Bezos, Buffett and JPMorgan CEO Jamie Dimon spearheading this new effort, political considerations, and those of entrenched healthcare interests, get thrown out the window.
Instead, the focus will be on what works, with the ruthless willingness of the business world to ignore naysayers.
“Our people want transparency, knowledge and control when it comes to managing their healthcare,” Dimon said. “The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans.”
This isn’t the business world’s first stab at healthcare reform. Dozens of companies already are part of something called the Health Transformation Alliance, which seeks to come up with broad changes.
But it might require a trio of high-achievers to pull it off.
Amazon already has signaled an interest in getting into healthcare. Though the company hasn’t announced specific endeavors, an online drugstore is widely rumored, as well as the sort of data-crunching that Amazon does best in search of ways to cut costs.
The Seattle e-commerce giant also is said to have made a number of recent healthcare-related hires, suggesting a more than passing interest in the medical marketplace.
One wildcard: America’s businessman-in-chief, President Trump, has waffled on healthcare over the years, but he did say during the election that he favored a healthcare system that covered everyone at an affordable price.
He may be particularly amenable to a solution that emerges with a corporate seal of approval.
There’s also a historical aspect to all this. One of the most far-reaching changes to the U.S. healthcare system — employer-based insurance — came not as a government initiative but from the business world.
A wage freeze during World War II forced employers to find other ways to attract talented workers. Health insurance was an effective benefit. And it never went away, even after the wage freeze was lifted.
Employer-based coverage hasn’t worked out well for workers in recent years. Premiums, co-pays and deductibles keep rising, leaving employees with a greater share of medical costs. But the original idea was a good one.
“It took Medicare 40 years to figure out that we have to cover prescription drugs,” USC’s Goldman said. “The private sector is more nimble and more able to maneuver. They can move much faster.”
That’s why I’m hopeful the Three Musketeers of Bezos, Buffett and Dimon can be similarly influential. Perhaps they could even lead the way toward a Medicare-for-all system, with the federal government adopting the business world’s advances to make U.S. healthcare more patient-focused and more effective.
Maybe that’s a pipe dream.
But let’s face it: These guys could do what no U.S. lawmaker could pull off: genuine reform.
That’s reason for optimism.
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