In the midst of the health care debate, the CEO of Safeway Inc., described the kind of reform that has a track record of success. Steven Burd began by noting that 70 percent of health care costs are the direct result of behavior, and that 74 percent of health care dollars go to just four conditions -- cardiovascular disease, cancer, diabetes, and obesity. Eighty percent of cardiovascular disease and diabetes is preventable, as are 60 percent of cancers and more than 90 percent of obesity. His company, which self-insures and thus makes its own rules, offers employees tests for those four conditions, which include questions about tobacco use, weight, blood pressure, and cholesterol levels. Safeway then provides discounts for those who achieve good scores. If, a year after receiving a bad test result, the employee is able to reverse it through good habits, the company offers a refund equal to the premium difference.
The results, as Burd described it in the Wall Street Journal, were arresting. Between 2005 and 2009, Safeway's per capita health spending remained flat while health spending in the rest of the economy increased by 38 percent. A survey of employees found that 76 percent wanted more incentives for healthy behaviors, and 78 percent rated the program as good, very good, or excellent.
Whole Foods, another supermarket player, adopted its own form of health savings accounts that allow employees to keep and roll over any unused portion from year to year.
Each of these companies adopted programs that rewarded individual responsibility. There was no coercion, but rather incentives for healthy choices and careful consumption of health care. Not only did Obamacare fail to take account of these excellent models, it will very likely force these companies to abandon them.
Another sad report: As of Nov. 1, 111 labor unions and politically well-connected businesses had secured waivers from the Secretary of HHS from complying with the onerous taxes, fees, and requirements of Obamacare. This cronyism is brought to you by the same kind of people who banned Happy Meals. "What works" is completely irrelevant to them. The important thing is that government decides.