Health Management Research Center Blog

Population Health Management, Wellness and Health Promotion can all learn from watching the priorities play out in the Healthcare Reform discussions in Congress.  Access to healthcare, affordability and total additional costs are the key drivers, with cost seeming to be the trump card.  The lesson learned is the lesson emphasized in Zero Trends: Health Management as a Serious Economic (Business) Strategy and that continues to be, "health management as a serious economic strategy."

The current worksite wellness strategies are those of the past and they continue to be ineffective and their time has come and gone.  By any definition, the pursuing the current strategies is insanity.  Even with this knowledge the worksite wellness field has continued its singular focus of behavioral change in high risk individuals.  The commercial companies providing these strategies are financially successful and will continue to be for some time because of the corporate frustration with the current and past health (sickness) care system.  In fact continuing to pay for the current healthcare system is also insanity, given the exceptionally high cost and the mediocre results compared to the rest of the world. 

The fundamental strategies of medical and health promotion professionals are to "wait for defects and then try to fix the defects."  That strategy has been proven over and over again to be a failed strategy.  Although it is the most costly strategy, the strategy seems to capture the intuitive nature of those paying the costs only because they are framed as a health strategy.  Once those who are paying begin to apply business or economic rules against the current wellness or health promotion strategies the field will collapse.

Two shining examples of "fixing the systems that lead to the defects" are dentistry and safety.  These two fields have captured the real and the intuitive nature of business leaders.  As a result we are among the leaders in the world when examining the quality and cost outcomes of these two fields. 

The fundamental purpose of Zero Trends is to lead a revolution or a transformational approach to framing health as a serious economic strategy.  As any business knows or as any Nation in the world should know, we can't wait for defects we have to fix the systems that lead to the defects.   The five pillars in Zero Trends are the framework upon which to build the core business strategy of creating healthy and high performing workplaces and workforces.

If the politicians in Washington D.C. are telling us that economics is what drives healthcare reform then let's heed the strategies in Zero Trends and accept the transformational five-pillar approach to fixing the systems that lead to defects (health risks, unhealthy behaviors and physical and mental disease).

Director Health Management Research Center

The purpose of this blog is to comment upon the state of health status in Americans and American companies and how health status drives health, healthcare and productivity issues.  Many of the comments reflect our 30 years of research, the transformational thoughts in our new book Zero Trends: Health as a Serious Economic Strategy and our thinking related to current events.

President Obama called for our Nation to return to a common purpose in remembrance of our experience of eight years ago.  I doubt if there is anyone in America and relatively few in the World who would disagree.  Those who died or were injured on that day will remain in our memories forever.  Those who participated in the rescue attempts of those in need are clear examples of heroes and did what Americans do, "in times of need we show up."  The compassion we all felt for the victims and for the heroes are what should drive us to return to the values which drive individuals and communities to create a better and sustainable place for all of us to live and work.

There is another call to action that is necessary for America to regain our national momentum, and that is a call to regain our vitality, energy, enthusiasm, creativity and resilience.  We need those and other characteristics if we are to ever return to those values that are in our heritage.   These are the same characteristics that will allow us to regain our competitiveness in the increasingly competitive worldwide marketplace.   

This call to action is to recreate those environments and cultures that allow and encourage individuals, families, companies, communities, states and national efforts to regain the sustainable VITALITY and RESILIENCE that has characterized American society.  Our premise at the HMRC has been that companies will have to lead this renewal since they (and individuals and families) are the only entity in the America that profits from healthy and high performing individuals.   

The good news is that companies have stepped up to this challenge not only in the United States but the effort is growing throughout world.  More good news is that the challenge is being picked up by communities.  This is related to our work, as documented in Zero Trends: Health Management as a Serious Business Strategy and the work of others that the return to vitality begins within work and community environments and cultures.  The simple business case becomes obvious when one answers the question, "What is the social and economic value of a healthy and high performing workforce to a company or to a community?"

Director Health Management Research Center

University of Michigan

The purpose of this blog is to comment upon the state of health status in Americans and American companies and how health status drives health, healthcare and productivity issues.  Many of the comments reflect our 30 years of research, the transformational thoughts in our new book Zero Trends: Health as a Serious Economic Strategy and our thinking related to current events.

Over the course of the past 30 years we have been witness to the rise and sometimes fall of wellness intervention companies.  The nearly universal clinical model of these companies has been to administer a Health Risk Appraisal with screening, indentify the high risks and then try to contact those individuals, typically through telephone or internet or e-mail and encourage them to participate in behavior change programs. The results have been terribly discouraging. 

1. One cannot practice behavior change and then put anyone that does happen to change back into the same environment.  Yet that is what wellness professionals have been doing for 30 years.

2. One cannot wait for defects and then try to fix the defects to get to a defect free society. Yet that is what the healthcare industry has been trying to do for the past several decades.

3. One cannot control healthcare costs by trying to control costs. Yet that is what companies and the government has been trying to do for the past several decades.

4. One cannot expect the healthcare industry, whose economical model depends upon sickness, to be innovators in lowering healthcare costs.  Yet that is what they and the government and politicians have been doing even to this day.

It is time to say ENOUGH and here is what we can do. 

To get to sustainable behavior change we have to fix the environment and culture in our companies and communities before we engage in behavior change.

To get to defect free society we have to fix the systems that lead to the defects.  Safety learned that lesson nearly 80 years ago as did manufacturing 15 years ago.  We need Six-Sigma thinking.

To get to lower costs we need to get the root causes of high costs and one of those is health status.  We need to stop from getting worse in terms of health status and then we may start getting better.

To get to lower costs we need new levels of thinking, to follow the words of Einstein.

Dee W. Edington, Director

Health Management Research Center

University of Michigan

The purpose of this blog is to comment upon the state of health status in Americans and American companies and how health status drives health, healthcare and productivity issues.  Many of the comments reflect our 30 years of research, the transformational thoughts in our new book Zero Trends: Health as a Serious Economic Strategy and our thinking related to current events.

It is fitting that this first entry coincides with the publication of an article that I co-authored with Ken Blanchard.  The title of the article, found in the Summer 2009 issue of Leader to Leader, is "Averting the Collision between Rising Healthcare Costs and Corporate Survival."   The message of the article is that CEO's have to recognize that health and healthcare are core survival issues in these times of global competition.  If CEOs do not recognize it and create environments where we grow health and high performing companies, someone else in the world will and we will lose our competitive advantage as well as our overall way of life.

The theme as President Obama said in his July 23^rd 2009 address to the nation was that the "do-nothing" healthcare strategy is not an economic option.  This is true for America, Americans and American companies.  I am sure everyone respects the President for even addressing healthcare in front of a nationwide audience.  He certainly touched upon many critical issues, but let me address just one of the central themes from his address, and that is that the do-nothing strategy is economically unsustainable.

The President is clearly correct; however, what he missed in my opinion is the more fundamental issue of the "do-nothing" healthcare strategy: wait for people to get sick.  Ninety-five percent of the economic incentive in healthcare is focused on sickness.  This strategy has been unchallenged for several decades and it has now proven to be unsustainable, as everyone agrees.  Moreover, it is tragic that the large magnitude of the healthcare industry in many of our cities and states has only exacerbated the unsustainable situation. Clearly, procrastinating until sickness will only create emergency situations for both life and business sustainability. The final conclusion to all of this is that waiting for sick Americans is a failed economic, health and quality-of-life strategy.

The solution is, as Einstein said, "...the level of thinking that got us into this situation is not the level of thinking that will get us out of the situation..." If one believes the logic of the Einstein quote, then it is clearly time to find a new and transformational way to manage health in America.  The major opportunity for America is to intervene in the current sickness strategy by addressing the systems that lead to sickness.  The strategy of "don't get worse" and "helping the healthy and high performing people stay healthy" is a strategy that begins to change the incentives.  The safety industry learned this lesson several decades ago, while the manufacturing industry learned the same lesson a few years ago.

The outcome of this proposed solution is that we create healthy environments, avoid excessive high costs while maintaining high levels of performance and quality of life, which is good for individuals and good for companies and good for American competitiveness throughout the world.

Dee W. Edington, Director

Health Management Research Center

University of Michigan

The purpose of this blog is to comment upon the state of health status in Americans and American companies and how health status drives health, healthcare and productivity issues.  Many of the comments reflect our 30 years of research, the transformational thoughts in our new book Zero Trends: Health as a Serious Economic Strategy and our thinking related to current events.

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