Graham-Cassidy And Health Care Outside The Beltway

While congressional Republicans take yet another, and apparently last, shot at health care with the new Graham-Cassidy bill, American business has already forged ahead to better understand and address the 21st-century health needs brought about by the aging of our society. That’s the focus of two new reports released recently by Bank of America Merrill Lynch (BAML) and Transamerica, which provide important new findings about financial wellness and elder caregiving that should guide both public- and private-sector health care solutions.

BAML’s 2017 Workplace Benefits Report finds that two-thirds of those surveyed are planning for out-of-pocket cost as the most challenging and stressful aspect of managing their health care; a full 50 percent admit they don’t know how to predict current or future out-of-pocket health care costs or determine the appropriate savings vehicle or rate; 23 percent admit they don’t save beyond a year and the majority under-fund their health care savings; and a whopping 75 percent acknowledge fear regarding their health care finances.

The real news here, which won’t be solved by “inside the Beltway” health insurance approaches, is that the financial concerns of health care – financial wellness – has a serious impact both on our mental and emotional health and our workplace productivity. The Merrill Lynch Report finds that well over half of those surveyed – 56 percent – are stressed about their financial situation. And, an incredible 53 percent of those are willing to admit that this stress interferes with their ability to focus on work and be productive. They’re also spending less on other goods and services as a result of their health care concerns.

Indeed, it is the impact of all this health care stuff on workplace productivity that is the dirty little secret – including the dramatic work impacts of elder caregiving, which is the focus of another report released today by The Transamerica Institute, a research arm of the global insurance company, Aegon. That report, The Many Faces of Caregivers: A Close-Up Look at Caregiving and Its Impacts, dramatically highlights the stress and productivity effects of health concerns and caregiving, much like the BAML report. According to the Transamerica report: “Many caregivers are holding down jobs in addition to their caregiving duties, which requires a daily balancing act. More than half of caregivers (52 percent) are employed either full-time (39 percent) or part-time (13 percent).” And among these employee-caregivers, 76 percent made an adjustment to their employment as a result of caregiving, including 30 percent using sick and vacation days, 26 percent taking on fewer hours and responsibilities, and 14 percent quitting their jobs or retiring.

The harsh reality is that caregiving duties often – in fact, usually – conflict with job responsibilities, which, in turn, may impact performance and put a strain on a caregiver’s relationship with their supervisor or employer. The Transamerica report finds that 28 percent of employee-caregivers “have experienced adverse actions taken by their employers as a result of their caregiving responsibilities.”

So what is to be done?

First, while we can welcome a more rational approach to health care spending than has been thought up in D.C., the real fix must be greater emphasis on prevention and wellness, including reducing the mental and emotional stress that has considerable impacts on our health as we age. And since the 55+ demographic is exploding, both the Bank of America Merrill Lynch and Transamerica reports provide insights to pathways for better health through financial wellness and elder caregiving solutions across a life course that is now expected to routinely reach 100.

Second, while it is understandable that such studies come from financial service companies who are in the business of providing employee workplace benefits, more of this attention would be welcome across all sectors so that employers can seize their potential to help employees address their health needs, particularly workplace-related.

Third, the recognition that the aging of today’s society – longevity combined with the greater proportion of old to young as a consequence of stunning reductions in birthrates – will result in these trends becoming steeper and more dramatic. Public policy solutions for Medicare, Medicaid, and Social Security must be put through a strategic screen of population aging, which will surely lead to the recognition that outdated 20th century approaches simply will not work in our 21st century.