I have had several dealings with the benefits managers/HR managers of large corporations and other large organizations over my career. I have one over-arching conclusion about what motivates these people: They will never be a source of disruptive innovation in health care.
I find them to be passive people. They are fundamentally people pleasers. They derive joy from helping their employees navigate their insurance plans, figure out deductibles and co-pays, explain benefits packages, etc. I find their knowledge of health care costs, outcomes, and alternatives to be little greater than the general public. When one talks about pushing back against insurance company or hospital system excesses, their eyes get wide and their pulses quicken. (I assume. I confess I’ve never actually measured their pulses.) For them to think about ANY attempt to make any major changes in their typical annual offerings, they see hordes of angry employees lining up outside their doors, and they refuse to consider major changes.
A lot of them work under the CFO, who could turn to them and order them to find innovative solutions. But when challenged to do this, all the CFOs I’ve talked to throw up their hands and say, ”We have a great HR/benefits team who manage all this. Talk to them.”
Every few years, the CFO gets upset at the annual rate of inflation for health insurance. They turn to the HR people and ask why it’s so bad. The HR people then apply their universal dodge to protect their emotional flank, “We’ve hired new consultants who come with great new analytics and cost-containment programs.” Those consultants stick around two to four years, then new consultants are hired, and the cycle repeats itself. I’m also convinced that the health insurance consultants profit from making sure that the exorbitantly expensive dysfunctional health care system stays dysfunctional.
It doesn’t have to be this way. Here is a story about a brave HR person in Montana. She was a former insurance company employee who knew of its excesses. She negotiated for better and more transparent rates and got what she asked for.
The moral of this story is that it is possible for payers to push back against the excesses of insurance companies, hospital systems, drug companies, and ologists. It just takes a little knowledge and a lot of moxie. This is in woefully short supply in American business and governments.
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