In the political and policy debate over health care costs, employers have more muscle than they want to flex — at least for the time being. But a growing number of experts, from both parties, would like to see businesses step it up.
When we talk about health care stakeholders, we too often focus solely on the industry, and sleep on employers.
- That's nuts — more Americans have employer-based insurance than any other form of coverage, and it bears the brunt of cost increases.
- But to some extent it's employers' own doing. For years, they've responded to rising costs simply by pushing more of those costs onto workers, through higher deductibles and other out-of-pocket spending.
Between the lines: Employers are the core of the health care system, but health care is generally not their core focus.
- A manufacturing company, a tech company and a small business, for example, may all have the same structural incentives, but they aren't organized around those priorities as a collective.
- And they have generally been content to let their insurers handle health care while they focus on their actual products or services.
That may change. It may have to. As prices keep rising, and as insurers keep complaining that a lack of competition among hospitals and drugmakers is thwarting their ability to negotiate, the calls for state or federal intervention keep getting louder.
The big question: Will employers reach a tipping point and join that chorus? They'd be awfully persuasive if they do.
What they're saying: "I think you're going to see more and more pressure, and even openness to public policy interventions that take advantage of negotiations," Democratic health care strategist Chris Jennings told me.
- It's not just Democrats: Former Trump administration health official John Bardis said in a speech this week that employers need to take more aggressive stances toward cost containment.