Chase - CEOs guide to restoring the American dream: how to deliver world class health care to your employees at half the cost

Dedicated to the nurses, physicians, clinicians, citizens, and nonprofessional caregivers advancing the Health 3.0 movement.

Youre creating a new health ecosystem we can all be proud of. Thank you.

Table of Contents

Acknowledgments &
Authors Note

Stop! Dont Skip This!

We all skip the acknowledgments, but I encourage you to read or skim for two reasons:

1. This book wouldnt be possible without insight from the pioneering individuals here and throughout the book.

2. What youve been told about fixing health care just isnt true. Its already happening from the ground up. Any benefits purchaser can follow, no matter what excuse you hear from the status quo. Each of the more than 100 individuals and organizations in this book is doing it every day and each knows many others doing the same. Following the people below and the suggestions in this book can lead the way.

First, I want to acknowledge the employers, unions, their stellar benefits advisors, and others who have provided the substance for this book. I highlight five employers and unions, but healthrosetta.org has many other case studies. The common thread is that these leaders are problem solvers who ignore the partisan and status quo orthodoxies. They care more about enabling the American Dream.

Self-described progressives have implemented programs that many would call conservative and self-described conservatives have implemented programs that many would call progressive. Seeing this has been a breath of fresh air from the partisan bickering that dominates the health care reform conversation.

Not long ago, I knew next to nothing about health benefits. I just wanted to find (and fix) the root cause of our wildly underperforming health care system. How could we have so many smart and passionate doctors, nurses, clinicians of all types, and other professionalsand spend far more than other countriesyet have largely abysmal health outcomes? The root cause I found is that we purchase health care incredibly ineffectively. Medicare, Medicaid, private & public employers. Everywhere.

I decided to focus on employers and unions for practical reasons.

1. The overwhelming majority of non-poor, non-elderly get their benefits through their job. Theres no real evidence of this changing anytime soon.

2. As a general rule, employers and unionsincluding public sector employersare especially ineffective at purchasing high value health benefits.

3. Wise public employers and unions are already showing how to dramatically increase health care investment value. This simplifies spreading the best solutions to public programs like Medicaid and Medicare.

4. Employers and unions can innovate independently without an act of congress or top-down master plan. The best solutions can be broadly replicated, creating a self-reinforcing dynamic to get us out of this mess.

The people below have both realized this and work tirelessly to fix our health care system from the ground up. I want to highlight just a few of the people driving this grassroots movement that have most inspired me.

Benefits Experts

Forward-leaning benefits experts are the vanguard that is worth its weight in gold. Theyve left behind wasteful, obsolete approaches that plague most employers. Theyre the architects and first members of the Health Rosetta Institute. I cant thank them enough. They take what Margaret Mead once said to heart.

Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, its the only thing that ever has.

Theyve taught me virtually everything Ive learned about health benefits:

Ashley Bacot, David Balinski, Jeff Bernhard, David Contorno, Heidi Cottle, Mike Dendy, Tom Emerick, Fred Goldstein, Scott Haas, Larry Hightower, Brian Klepper, Eric Krieg, Craig Lack, Lee Lewis, Jim Millaway, Steve Miller, Andy Neary, Ron Peck, Keith Robertson, Adam Russo, Bill Rusteberg, Edward Smith, and Woody Waters.

I also want to acknowledge the first group of forward-leaning benefits advisors that weve accepted into the Health Rosetta Benefits Certification Programs:

Robson Baker, Gary Becker, Adam Berkowitz, Thomas Carey, David Contorno, Megan Cook, Dan DaCosta, Thomas DiLiegro, Eric Dreyfus, Cary Goss, John Harvey, John Humkey, Joshua Jeffries, Adam Karalius, Lee Lewis, Donnie Marcontell, Tracy McConnell, Keith McNeil, Jared Meays, Jim Millaway, Kalli Ortega, John Sbrocco, Carl Schuessler, Jr., Craig Scurato, Edward Smith, Tommy Taylor, Antione Turner, Brian Uhlig, Chris Van Buren, and Mark Weber.

Delivery System Innovators

These individuals give me hope. Theyre just a sampling of those Ive been honored to learn from. The common thread is theyre believers and doers on my favorite quote by Buckminster Fuller:

You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.

The path to success is bumpy. Each of these individuals has faced many setbacks and keeps bouncing back:

Drs. Erika & Garrison Bliss, Jeff Butler, Dr. Natasha Burgert, Dr. Christopher Crow, Dr. Rushika Fernandopulle, Jon Hernandez, Dr. Howard Luks, Dr. Sachin Jain, Dr. Jay Parkinson, Dr. Jerry Reeves, Mason Reiner, Ryan Schmid, Dr. Jordan Shlain, Dr. Prabhjot Singh, Dr. Wendy Sue Swanson, Dr. Craig Tanio, Dr. Bill Thomas, Dr. Bryan Vartabedian, Dr. Sue Woods, Dr.Sheldon Zinberg, and the late Dr. Tom Ferguson.