Unlike past public health crises where a primarily government-led effort has been effective, the opioid crisis can’t be solved without employers fundamentally changing their approach to health benefits. Thus, mayors and other civic leaders must enlist the business leaders who employ the bulk of the community.
In many realms, the public sector has been a great second-wave customer after an industry has proven the commercial market viability of a product or service. New and better building practices are an example; private developers were the early adopters of LEED-certified buildings, followed by many cities and states that required new public-sector buildings to follow LEED standards. Public-sector employers as market accelerators may be the biggest missed opportunity in health policy. Use your bully pulpit to demand change!
Put simply, the opioid crisis can’t be solved without a rebuilt primary care system that gets rid of the fundamentally flawed fee-for-service model. Already overburdened primary care doctors who are spending an hour or two on bureaucracy for every hour of patient time have understandably taken a “check the box” approach to care. For public employees, you have the opportunity to ditch the currently flawed model and find something that works better.
It seems every local, state, and federal government is struggling with budget challenges – largely the result of health benefits taking up an ever-larger share of funds. If governments are early adopters of higher-performing health benefits for their employees, they can free up public funds for improving the “social determinants of health” that drive 80% of health outcomes, compared with just 20% for clinical care. Make this part of your next annual budget discussion.
There are now literally hundreds of lawsuits against all the perceived villains in this crisis. If we are to satisfy our desire to help – not just achieve retribution – then any grand settlement must do more than just hit the right pocketbooks. It must ensure these massive payouts are spent in a way that will address the root causes of the crisis. Any comprehensive settlement should guarantee that opioid overuse sufferers can receive a high standard of value-based primary care. See Chapter 20 of The Opioid Crisis Wake-up Call for a recommendation on the necessary elements of a settlement that gets at the root drivers of the crisis