Recently released survey results confirm what anecdotal conversations have been hinting at for some time: business executives’ attitudes related to health care spending and the role of government in providing coverage and lowering costs have changed. The survey report, How Corporate Executives View Rising Health Care Costs and the Role of Government, taps into the thinking of more than 300 business leaders from diverse industries, each with more than 5,000 employees. The research was a collaborative effort of the Kaiser Family Foundation and the Purchaser Business Group on Health and was funded by the Gary and Mary West Health Institute.  

Significant concern for health care spending and cost growth is widespread among employers. While organizations believe that they have some ability to control costs, such as with plan and payment design, they recognize that many solutions are outside of their control. Uncertain of how much longer they will be able to shoulder the growing financial burden without government intervention, business executives did not assign one factor as the predominant driver of excessive cost or identify a “silver bullet” solution. The survey asked the executives to rate four contributing factors to high costs: fee-for-service payments, provider consolidation, drug costs, and unhealthy behaviors. Provider consolidation is an area where the government has clearly failed the American public over the past several decades. Ninety-four percent of respondents felt it was a very large, considerable, or moderate factor in driving high health care costs.  

Historically, business executives have been believed to prefer market-based solutions in order to transform health care, and they likely still do. Yet, health care industry insiders have held significant power over the regulatory and other mechanisms that enable markets to work effectively. As a result, Americans pay between two to four times more for prescription drugs than citizens of other countries and reimbursements from businesses and their workers are two to three times above those of Medicare. These recognitions may be the financial sense behind changing employer attitudes. In some way, those higher prices have been a hidden tax imposed by health systems and other suppliers on American workers, while policymakers pretended not to notice.  

The survey is important because little research has attempted to identify and quantify the attitudes of business executives on the cost of providing health benefits. Even with these results, much remains to be understood about businesses’ health policy preferences, although it cannot be ignored that a surprising 83% of respondents reported that a greater government role in providing coverage and containing costs would benefit their business. 

These results come in conjunction with the end of the Biden Administration’s first 100 days in office, turning attention to its social and health care policy agendas. Although not included in the President’s American Families Plan announced last week, it is expected that initiatives, such as those to lower the eligibility age for Medicare, expand the range of covered health services, and empower the government to negotiate prescription drug prices are in the wings. So buckle up for a fierce debate of ideas before the November 2022 mid-term election when all 435 seats in the United States House of Representatives and 34 of the 100 seats in the United States Senate will be contested.

Warm Regards,

Louise Y. Probst

BHC Executive Director