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Not all have worked, but many of them have proved effective. They have driven down the cost enough that co-workers at Serigraph have seen only three small premium increases in the last seven years. 8 percent per year, far below the national average of 7 percent. Serigraph co-workers deserve that premium relief because they have been full-fledged partners in making the company’s new strategy work. Indeed, no human organization can succeed without the full engagement of the people in the system. Therein lies the philosophical gulf between ObamaCare and Serigraph.
PRIME ROLE FOR PRIMARY CARE The third reform platform is a model that centers on primary care, a little like it was in the good old days when doctors and patients had a personal relationship, both for care and for the economics of care. A large swath of costs can be cut by re-establishing the role of primary care. Big, complex medical systems have homed in on the higher reimbursements offered by the government and insurance companies for specialty care. They put high-priced specialists at center stage.
It is because the actuaries at Blue Cross know that behaviors change remarkably when people have “skin in the game,” even if the personal health accounts were given to them. It becomes the employee’s money. Primarily, it is intelligent self-rationing that kicks in. That is the initial behavior improvement, but it is quickly followed by better purchasing behaviors, improved lifestyles, and regimens to keep chronic diseases under control. Ziegelbauer got non-union employees and six of the seven units to go along and then shared about half of the savings with the employees.