employer based health care

Here we stand on the precipice of returning to work with everyone wondering what that will actually entail and how we’re going to stay productive and healthy in our work environments.  In that context, I couldn’t help but think about something we continue to hold on to in America, which is a system we call “employer based health care.”  It strikes me that the intersection of health and employment has taken on entirely new dimensions and I think that our current situation gives us the opportunity to explore what best practices really mean when it comes to wellness and work.  

At the risk of sounding like I’m ranting (OK, that’s not really a risk with me, but an inevitability), I first of all need to say that in my opinion we do not really have a health care system in America.  What we have is a disease management system, something that we normally utilize after symptoms have manifested themselves and which in far too many cases addresses those symptoms rather than their causes, usually with pills and procedures.  Einstein reminded us that “in every crisis is an opportunity,” and it seems to me that what Covid-19 has done for us is to put on the table in a more robust way the topic of prevention, something that is absolutely necessary if we are ever to move away from just disease management and into actual health care.  Although some of the conversation is certainly about treatment, the vast majority of it seems to me to be all about how to keep from contracting this disease as well as how to keep others from doing so.  Social distancing, face coverings, hand washing, cleaning and disinfecting surfaces… those are all preventative measures, and things that employers will have to decide how and when and whether to implement.  We are awash, if you’ll excuse the expression, with information and opinions about those things, but I rarely hear talk about the most powerful weapon we have in our arsenal to prevent this disease, or most others for that matter:  our own immune systems. 
 
I certainly believe that an actual health care system can and should be individual, as well as based in family and community structures.  But in addition to the other measures we take I also believe that the work environment has an important role to play in making sure we have at our disposal the most powerful tool we have, which is our immune system.  For one thing, we know that at least 70% of our immune function resides in our gut, the health of which is determined by what we eat.  An increasing number of employers are offering food as a convenience for their employees, but it can be so much more than that.  Our addiction to the kinds of foods that can make us sick is a huge part of why this pandemic is so harmful.  But if a company focuses on helping access the kinds of nutrition that actually support a robust immune response then to that extent they really are part of an employer based health care system.  In our current situation, that comes close in my mind to being a moral imperative for an employer. 

In my years of exposure to this topic I have come to see the other two aspects of the “three legged stool of wellness” as fitness and stress management, both of which materially affect the ability of our immune response to repel unwanted invaders.  The ability of an employer to encourage daily movement varies, but I’m sure there is always something that can be done as a company culture to affirm the value of that.  But let’s face it: nobody needs to debate whether our work life can be a source of stress.  As the context in which we push ourselves to fully utilize our skills and gifts and education to make our contribution, there should always be some of that. And some stress is good for us.  But toxic amounts, especially if they become chronic, will destroy our ability to keep from getting ill even if we do everything else right.  It could be that for some business leaders our experience with sheltering in place will afford an opportunity to consider more deeply what a healthy work life balance looks like and how that can be supported for their employees.   I also note that the concept of mindfulness has emerged from the world of weirdness and woo-woo and into the mainstream, and many companies are helping their employees understand how to employ basic techniques of Mindfulness Based Stress Reduction (MBSR).  These are simple and easily applied to keep the inevitable stressful situations we face at work (and elsewhere) from being something that undermines our body’s immune function.  
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Yes, we need and deserve the best disease management system we can create, because clearly stuff happens.  But If this pandemic has taught us anything, it should be that we absolutely need a good healthcare system as well: something that fully supports our own natural abilities to prevent the diseases that from time to time wander through our world, or are simply always around to some degree, attempting to wreak havoc.  They will always cause some trouble, but havoc is optional.  I have my own opinions about whether our employers are the best or most efficient way of providing resources to manage our diseases, but I absolutely believe they can and should play a critical role in our health care.  And that’s good for business.  Lockdowns can be expensive, and employees who know that their company is supportive of their health will surely be the kind that will help a company reach its objectives.  Also, we are now more aware than ever of the importance of having a healthy work environment, and that is going to start with the employees themselves coming to work with the ultimate weapon of immune support fully locked and loaded.