Book: CEO's Guide to Restoring the American Dream - How to deliver world class healthcare to your employees at half the cost

The American Dream has been stolen because the workforce has been shortchanged $500 billion every year due to healthcare spending. The Big Heist will awaken people to the greatest heist in American history. The key question is "How will we fix it?" Once people are awakened by the film, they must have a clear call-to-action. The great news is that since the middle class economic depression was caused by ineffective health benefits spending, if we fix this crisis, we can put an end to its massive societal consequences.

This explains why I have started to write a book targeted at CEOs and other health decision-makers (e.g., CFOs, COOs, heads of HR/benefits) entitled "CEO's Guide to Restoring the American Dream: How to deliver world class healthcare to your employees at half the cost." Every time I did a root cause analysis of some dysfunctional aspect of healthcare (e.g., why healthcare is still riddled with overpriced and outdated software to more serious issues such as high rates of preventable medical mistakes leading to serious harm or death), it always came back to the fact that we purchase healthcare very poorly in this country. For the middle class, this economic depression is significantly longer than the Great Depression. Many have expressed alarm about the rise of populism on both ends of the political spectrum. Frankly, if one studies economic depressions (e.g., 1930s Germany), it would be surprising if there wasn't a rise in populist presidential candidates in light of the economic duress the middle class has experienced.

First, I'll summarize The Big Heist movie and then I'll outline some of the topics that will be touched on in the book. The purpose of this piece is to invite input on what other topics you’d like to see addressed. This book won't be subject to the tyranny of low expectations so prevalent in health benefits spending where some celebrate merely slowing growth. Rather, it will describe how employers have shown that the best way to slash healthcare costs 20-55% is to improve benefits. [Note to PR professionals: I am only interested in publicly referenceable solutions that have sustainably achieved the Quadruple Aim over at least 2-3 years (preferably 5-10 years). Please don't pitch promises of a future state. Proven results are the focus.]

Book Summary

An inside look at how CEO’s and HR leaders can spend 30-50% less on health benefits, while significantly improving the quality of care their employees receive. The CEO’s Guide is a practical, step-by-step field guide to create change within their own organizations. It gives anyone responsible for health benefits the tools to build internal support and the blueprint to ensure change is successfully implemented, including:

• Proven strategies to cut healthcare spending while improving benefits
• When and how to pick benefits consultants
• Benefits of independent TPAs over insurance company-owned ASOs in claims administration
• How to thwart attempts to funnel profits to low value health and wellness programs
• The nature of coming fiduciary risk
• The blueprint for wisely purchasing healthcare
• The guiding principles for providing high-performance healthcare
• Strategies for the biggest cost problems
• Case studies of employers who spend 20-55% less while delivering world-class benefits
• A new definition of transparency
• Millennials: Best practices for benefits that appeal to the biggest chunk of the workforce
• Responding to and inoculating against FUD (fear, uncertainty & doubt) used by status quo preservationists

There have been many outstanding books that address various facets of healthcare. The goal of this book is to get very practical on the proven solutions to achieve what one healthcare innovator has as their tagline -- twice the healthcare at half the price and 10 times the delight. We'll go through the nuts and bolts of rolling out new approaches to a broad and diverse workforce. In the meantime, there are two must-read books for a general overview of healthcare and medical culture:

• Catastrophic Care by David Goldhill
• Unaccountable by Dr. Marty Makary 

In addition, John Torinus (Serigraph Chairman) also wrote a book entitled The Company That Solved Health Care that hit on a similar theme. We'll build off of Torinus' excellent work covering many more examples of companies of all sizes and sectors using the latest techniques.

More recently, Elisabeth Rosenthal wrote An American Sickness and Dr. Robert Pearl wrote Mistreated that go into great detail on the dysfunction from a physician perspective. My book delves into the enabling conditions that enable the nightmares that Rosenthal and Pearl outline.

A few words on politics and why I'm optimistic

One thing I know for certain is the best way to preserve an under-performing status quo, no matter what area of society, is to politicize a topic. Using FUD (fear, uncertainty and doubt) is another time-tested strategy. There is likely no other segment of our lives that is easier to politicize and use FUD than healthcare. As with the film, the goal with the book is to stay fiercely non-partisan. The heroes that have thwarted the healthcare heist have inoculated themselves from the maladies of politicization and FUD. I believe that there is no new legislation that needs to be passed to achieve a great system. The majority of Americans receive health benefits through the workplace. Of those, most are in self-insured companies. While the focus is on employers, virtually all of the examples are independent of who pays -- an individual, an employer or taxpayers through a public entity.

Further, the most overlooked role for government in healthcare is as a market accelerator. We're familiar with how the government accelerated the development and adoption of technologies such as the Internet, renewables, batteries, etc. Too often, we forget that the public sector is a major employer. While we see cities like Kirkland and Milwaukee do great things as employers, most state and federal agencies purchase health benefits just as poorly as the private sector. Policy-makers and regulators will talk about wise approaches such as re-invigorating primary care, yet their employees are still subject to the most undermined primary care system in the developed world. Fix primary care and you go a long way towards addressing the broader healthcare system.

As I've been on a 7-year quest to find the solutions that have solved healthcare, I found that tired political labels don't apply in the real world of solving healthcare. Rather, ideas that some might categorize as "bleeding heart liberal" are being implemented by staunch conservatives. Conversely, ideas that are deemed "conservative" are being implemented by former Democratic party hacks. The common thread is they are can-do people who don't care about party labels. 

Some may have the critique that these solutions would only be available for a select few who have the right employer. My feeling is that many would like to achieve a goal of universal coverage (not to be confused with single payer as universal coverage is agnostic to who pays). However, because they've only seen out-of-control healthcare costs achieving sub-par outcomes, they don't want to further bankrupt America with a system that isn't that great. Make no mistake, there are many pockets of brilliance in the American healthcare system. Unfortunately, the value delivered is widely variant by geography and income levels. Further, we wait until things are at their most dire and expensive state. The goal is to demonstrate that the richest and most innovative country in the world can easily afford outstanding healthcare if we don't needlessly squander resources.

Over the course of speaking throughout the country and talking about the adoption of the Health Rosetta, I've worked with groups representing 10's of millions of Americans. They are eager to find practical solutions that can be implement today. This is the goal of the book. Whether your organization has 5 employees or 500,000 employees, there are proven solutions. This book will share what I've uncovered;I'm excited to see these proven solutions be made available to everyone.