Michael Waterbury, Author at Real Leaders

You may not realize it, but your employees and coworkers struggle with medical debt.

The situation has become dire in the US. “About one in five Americans currently has medical debt in collections,” writes Dr. Marty Makary in The Price We Pay. “Half of patients with certain medical conditions, such as women with stage 4 breast cancer, now report being harassed by a collections agency for their medical bills.” It’s healthcare oppression.

As CEOs of companies that are investing in our employees’ healthcare, we have a responsibility to demand better. The status quo is not OK. You’re not getting a return on your healthcare investment, and some of your employees are suffering when they access the healthcare system by incurring massive debts.

If you think your health coverage is protecting your employees from medical debt, about three-quarters of medical debt is caused simply by deductibles and the patient’s out-of-pocket expenses. In addition, regardless of the industry you’re in, your company can help stamp out the leading cause of bankruptcy in the US. So not only is it the right thing to do, but it also makes business sense. Here are actions business leaders can take to address this issue.

Create a medical debt relief program for your employees

The first step is to protect your employees from medical debt. For example, say your company spends $500,000 a year on health insurance premiums. If you set aside another $50,000 per year to address medical debts incurred by your employees and their dependents, you can likely shield them from bills they can’t afford.

You’re already responsible for your employees’ health care. Why not take that further to ensure they aren’t left with a huge bill? Doing so will strengthen your connection to your employees and help them be more productive and happy.

Hold your vendors accountable

In addition to saving your employees from crushing bills, covering their medical debts will give you insight and information about the gaps in the health insurance you’re providing to your team. Then, use that information to demand better from your health plan, benefit consultants, and other vendors that supply your coverage.

For example, a company like Google spends an estimated billion dollars a year on its 100,000 employees and dependents. And they have no idea who’s suffering from medical debt. Using $10 million to fund a medical debt relief program would help suffering employees with medical debt and get them that information, which they can take directly to their health plan.

Imagine the head of benefits sitting with a health plan executive and saying, “These 100 people owed $1 million last year in medical debt for these ten reasons. I expect an answer tomorrow on why this happened.”

What’s that person going to say? They better get the answer. And if the answer isn’t good enough, this employer should take their billion dollars elsewhere. The bottom line is they’re buying a product that isn’t performing as promised.

Don’t accept excuses. Tell your health plan, “Oh, you didn’t have an anesthesiologist in the network in southern California when this person got in a car accident? How is that my problem? And it’s definitely not that person’s problem. You said you had a robust network. That’s what I pay for.”

Lower your healthcare costs

While large employers have leverage in the marketplace, smaller companies’ voices are not always heard. That should not be the case. No matter your size, you can lower your healthcare costs without compromising the quality of care and use those savings to fund a medical debt relief program for your employees.

For example, it is possible to negotiate better contracts with PBMs to lower prescription costs. In addition, there are solutions available to mitigate the massive price tag of specialty drugs for conditions like hemophilia. You can create a custom cash price network that provides a lower cost on prescriptions outside of insurance for the drug categories your employees use most.

Health plan renewals are often presented as if there are no options or flexibility. Make sure you ask the right questions and do your due diligence so that your partnership with your benefits consultants can bring costs down instead of seeing them rise every year.

Don’t accept the blame

If you get sick and go to the hospital, and you’ve been paying health insurance premiums for the last 15 or 20 years, and you end up with a bill for $10,000 because you needed care, how is that fair? How is that your fault?

Right now, business leaders and consumers are letting the players in the healthcare system blame patients for medical debt. Even the term “medical debt” implies wrongdoing. I prefer “medical oppression” or “healthcare profiteering.” This is the healthcare industry’s problem. It created it. It profits from it. Everyone in the healthcare industry needs to work together to find a solution. Employers and patients are innocent.

Changing this dynamic starts with learning the language and the system. If you’re in charge of a business, don’t let the complexity of the healthcare system scare you off. The complexity is part of the game. Those responsible for healthcare oppression count on you getting overwhelmed and giving up.

Instead, find an ally. Find people that will talk to you in straightforward, plain language and who will be transparent and clear. If you’re not getting that today, you can assume you’re not getting a good value on your healthcare investment, which is an investment in your employees and business.

Suppose you’re a CEO and don’t know how many of your employees suffer from medical debt. In that case, you have a significant blind spot on their well-being and the social determinants of health for your organization. I would challenge you to be proactive about gathering information and addressing this issue. If business leaders continue to ignore it, it will only get worse.

Most professionals have at least one concrete idea about how their industry could work better. The world is full of imperfect systems — the American healthcare system is clearly one of them — and the people who work in them day in and day out for years begin to see opportunities for improvement.

The trouble is, by the time these insights appear people are pretty far along their career paths. It’s daunting to leave the stability you’ve become accustomed to for the risky life of the entrepreneur. But without someone like you with deep industry knowledge and an eye for change, your field will never move forward.

One of my passions is to free and amplify talent locked in bureaucratic systems because I felt trapped for so much of my corporate career. Here are some of the common places people transitioning from the workforce to entrepreneurship tend to get stuck — and some tips for finding freedom.

Step 0.1

Professionals may hold on to a great business idea for years without acting on it because they can’t identify the first step. There’s no way for them to implement their idea in their current position and they would need something concrete to transition to if they were going to leave their job.

Often, the first step is smaller than you think. It can be as simple as informal conversations. I have a long list of people in the healthcare field who I think are very smart and who I like to check in with regularly. These chats have led to several successful businesses.

Discussing your idea with your former colleagues, customers, mentors and friends can help you fine-tune it and start to visualize putting it into action. It may also lead to partners or relationships critical to getting the idea off the ground.

If you’re worried about sharing the full extent of your idea too early, you can focus on the problem you’re solving. If others experience the same problem you do, you’re probably on to something. Listening to how others articulate the problem will get you to an even better solution.

Infrastructure insecurity

When you come from the corporate world, it’s hard to imagine life without HR, IT and other acronyms of supporting cast helping you focus on your job. New entrepreneurs often assume they’d have to build all of this infrastructure themselves; calculating the cost stops them in their tracks.

The business world is more flexible than it used to be. Starting out with freelance or fractional members of your team can give you some runway.

Another route is to find a partner who will provide the infrastructure you need. Your company could launch as a division or subsidiary of another company. Or an investor or co-founder could share resources with you from another project.

I really wouldn’t advise taking on the nuts and bolts of running a business unless you have to or really want to. Part of my free-and-amplify philosophy is making sure the entrepreneur isn’t bogged down with minutia and can focus on the big picture in order to get the company on the right trajectory from the jump.

Be down to scale up

This is the hardest part. Many entrepreneurs can imagine the first steps of a new business and land a few clients. They may even put together a small team. But getting from 5 people to 50, that’s where you really start to reap rewards, and for most people, it’s not obvious how to do it.

Once your business is up and running, I recommend joining groups of other entrepreneurs and talking to them specifically about scale. Did they hire a sales team? Form strategic partnerships? What got them to the next level? Hearing others’ stories will help you see your own unfold.

Part of achieving scale is overcoming a mental block as well. When you own a business, you live with a certain undercurrent of anxiety. Don’t let that keep you from dreaming big. Write down where you want to go and the steps it would take to get there even if it seems too bold and daring as you’re doing it. Run the plan by others in your circle to pull yourself out of your emotions and get perspective on the opportunity that exists for you.

Goliath got you down

Starting a business in a field like healthcare that’s dominated by giants can be particularly intimidating. Assuming you’ve already worked at one of those giants, think about how inflexible and unresponsive they are to market forces. You can cover a lot of ground before they take notice.

Also remember that you have something incredibly rare and valuable: years of experience that has led you to imagine a better system. Since 99.9 percent of people don’t understand your industry in the detailed way you do, they have no way of seeing the opportunity you see. That’s a competitive advantage.

It’s also a calling. If you don’t implement that idea, no one will. Can you live with that?

4 Actions Business Leaders Can Take Today to Stop Medical Debt