This article is adapted from a talk given by Dr. Crimmins at a January 17 gathering organized by Twin Cities North Chamber in Mounds View. Crimmins spoke to a group of small business owners about how General Mills promotes health and wellness in the workplace in an effort to keep health care costs down.
I spent most of my life in an emergency department. The ER taught me a lot about the medical care system. And I recognized then that we have some dysfunctional aspects of the care system. I would see behaviors that I was concerned about 25 years ago, and it was tragic. I felt strongly enough that I got very involved in seat belt legislation. Then I became devoted to trying to improve the systems the doctors and hospitals used. (I was deputy medical director of a hospital at the time.)
No one can get up in the morning without reading in the paper that health care spending is out of control. I can remember when the percent of people who were obese was only 8 or 9 percent. We thought, “Oh my gosh! One day it’s going to be in the double digits.” Now we’re near 16 percent obese adults moving up to 20 percent.
We still have 47 million people who don’t have access to health insurance. More and more of you are seeing personal spending on health care go up. Today, I want to talk specifically about work site wellness.
When I ask myself, “What’s wrong with our health care system?” I just think of my days in the ER. Whenever you’re taking care of somebody, the family of the patient says, “Doc, do whatever it takes—whatever the costs.” It’s inherently irrational. It doesn’t fit a rational consumer model.
The other thing I found was, people would say, “Doc, do what you think is best.” So as a physician, you lean toward more information, more hospitalization, more treatment, and you’re a little worried about malpractice, so maybe you had better over-test, over-treat, over-manage. Often I find that patients leave it up to their doctors to make decisions, which again develops a certain way to behave.
At every hospital or clinic I’ve worked for throughout my career, they’d say, “You’ve got to raise more money or this clinic is going to close.” There’s this constant business pressure . . . to continually raise your prices to generate more income. And there aren’t the usual market mechanisms to keep those costs in check.
