A few weeks ago, I was invited to participate in a focus group hosted by a local hospital organization to identify improvement opportunities in the delivery of occupational health services.

The attendees represented a cross-section of small and midsized employers from manufacturing and service industries that were using some or all of the services offered by the hospital group.

I expected to hear the company representatives discuss obstacles they face in managing the cost of delivering health care benefits to employees. Instead, I spent 90 minutes listening to much more tactical issues, such as inconsistent procedural approaches in emergency rooms, after-hours availability of drug screenings, the merits of return-to-work programs and a few comments about wellness initiatives.

It was enlightening, but I was disappointed that I didn't have the opportunity to engage the attendees in a discussion about my favorite subject: integrated health improvement programs as a means of managing health care cost.

However, I realized that what I was witnessing was "reality" for the majority of HR folks in small and midsized businesses. These committed HR/benefits professionals are going to work every day to put out fires. They're tasked with ensuring employees undergo required physical testing, that they participate in drug screenings and provide the correct doctor's notes after sickness.

They're also the primary go-to people for arranging physician evaluations for work-related injuries and ensuring that employees get back to work as soon as possible after a workers' compensation or short-term disability case. These duties are additional to the hundreds of other tasks that eat away at their days and prevent them from addressing the big picture.

These dedicated professionals unfortunately are so busy that they can only deal with the crisis of the moment. In effect, they spend most of their time fishing people out of the river rather than preventing people from jumping in, in the first place.

Fundamentally flawed

Unfortunately, that analogy serves well to highlight the standard method of health care delivery in this country, a fact that many of those HR professionals in that focus group understand because they work so closely with health-related matters.

It's a sad state of affairs that professor Dee Edington of the University of Michigan illustrates in his book, "Zero Trends."

"In many communities," writes Edington, "the largest employers are hospitals . . . Their success depends upon full occupancy of hospital beds, operating rooms, and clinics. The health care system has no economic incentive to help people avoid illness. It's to their advantage to wait for sickness to strike and then make money by treating it."

He expands this theory to show that this do-nothing strategy is by no means limited to hospitals and physicians. Medical and pharmaceutical research in this country is so focused on treatment and cures that it, for the most part, ignores prevention.

Simply put, focusing on treatments rather than prevention is an inefficient model for the delivery of health care.

Sickness does not usually just happen to people. The majority of illnesses develop over time and frequently stem from existing health risks. Research conducted by the University of Michigan has repeatedly documented that the cost of health care is directly related to the number of health risks an individual has.

An increase in health risks increases the burden on the health care system and, therefore, the cost of treating them and the illnesses they create. If health risks are eliminated or reduced, costs go down (although at a much slower rate than at which it went up.)

However, with the exception of body mass index, many health risks are effectively invisible without screening procedures. There is no visible red flag which pops up when somebody develops another health risk.

This makes it more difficult to apply effective preventative care on a large scale because companies and health care providers are often unwilling to actively go looking for those silent killers. The medical system, as it exists, is over-tasked already, leaving little time or resources for folks who "just" want to stay fit.

Health equals money

For companies, this is bad news. Keeping healthy people healthy is the most effective way to reap the financial benefits of cost- avoidance. The positive results gained from health care plans that focus on prevention cannot be duplicated by practicing reactive health management.

Many companies and individuals overlook the fact that not only does prevention of illness drastically reduce the health care cost of chronic conditions and catastrophic claims, it also directly impacts an employee's ability to remain productive. Loss of productivity negatively impacts profits. Health equals money.

For the last several decades, it has been the automation of the workplace that allowed companies to distinguish themselves from their competitors.

Fast forward to 2010, and attitudes have taken a 180-degree turn. Automation, the Internet and worldwide connectivity have homogenized most industries to the point where companies are struggling to differentiate themselves from their competition.

With a few exceptions, products and services have grown more and more similar, markets have become flooded with competitors, revenues have dropped due to ineffective price wars, corporations once thought invincible have fallen and been replaced by relatively young upstarts.

So how does a modern company propel itself into the future? What single component can increase a company's efficiency, define its brand and literally revolutionize the general public's opinion of it? Human capital.

Unfortunately, that same human capital is currently locked in to an ineffective health care delivery system that is, by necessity of its own creation, almost exclusively focusing on the treatment of the sick rather than preventative self-care. In such a system, how can those healthy employees hope to maintain their well-being and high levels of productivity?

The good health of our employees has become, unannounced to many, a competitive advantage for individual companies. On a larger scale, this could be a life-saver for the U.S. economy at large if enough companies look out for their own best interest and take responsibility for effectively managing the health and well-being of their employees.

Contributing Editor Michael Puck, SPHR, is the Benefits Practice Leader for 33,500 employees of a global defense, security and aerospace company, author of "Healthcare Cost Management - The High Road" and founder of www.8020wellness.com.

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