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"The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet, and in the cause and prevention of disease."

-- Thomas A. Edison

I believe the benefits broker of the future will bring innovation to the market or be absent from it. Brokers won't be paid commissions or fees but will receive a share of the efficiencies created or the efficacy of results delivered. Think contingency bonuses.

One broker a few weeks ago acknowledged that his commissions will be reduced by healthcare reform. He said that he was not shrinking his infrastructure in anticipation of this change in revenue stream.

"I'll just add a fee," was his solution.

He doesn't understand that healthcare reform is being driven by folks who are unwilling or unable to pay more. If brokers are to be relevant in the future, they must "innovate process" to come in under the price that the market is willing to pay.

Yet most brokers are naïve about their future and are "blinded" (or delusional) as to the value they bring to the new system.

Our current healthcare systems are bankrupt--ripe with waste, fraud and inefficiency. The good news is that there is more than enough money in the current system to address all our needs. We are 308 million individuals consisting of mind, body and spirit and aspiring toward "wellness," yet our healthcare system is built nearly exclusively for "body" and "illness." Don't believe me? Review the ICD 9 codes.

Stress and obesity are at epidemic levels, but most doctors are not prepared to teach us what to "eat" or treat the stress that "eats us." Taxpayers and the chronically well are paying more dollars than they can afford and the chronically ill are consuming far more dollars than they contribute. Generation Xers and millennials will soon rebel over the cost of caring for the boomers and the Greatest Generation.

The hope for our future and the secret to our success and prosperity is true innovation. (No, casual Friday isn't innovation.) The difficulty in changing was explained by Mr. Machiavelli centuries ago:

"There is no more delicate a matter to take in hand, nor more dangerous to conduct, nor more doubtful to success, than to step up as a leader in the introduction of changes. For he who innovates will have for his enemies all those well off under the existing order of things, and only lukewarm supporters in those who might be better off under the new."

In spite of the incessant complaining about healthcare, most current stakeholders (patients, providers, carriers and brokers) have been "well off under the existing order of things," so we can't expect them to be great innovators.

JFK was the innovator; Neil Armstrong was his change agent.

Below are examples of "small steps" being taken by some friends. They work, and this is just the beginning. To survive in the future, we'll need "giant steps for mankind." Before you say "no way," remember we've already walked on the moon.

Dale Dauten has packaged the process of innovation readiness for organizations. He believes that there is an unlimited supply of new ideas but a limited demand to implement these because this requires individuals to change. Dale reminds us that "different isn't always better but better is always different."

Peter Ranzino unleashes the power of distance learning to ensure that the process of change and innovation can be delivered to any audience, ensure (and measure) their involvement, and monitor results to determine when their commitment becomes the rule, not the exception.

Jane Cooper provides advocacy service for patients that use healthcare and employers and employees who fund the care. This ensures efficiency and efficacy when consumers maneuver around the "landmines" of healthcare and its financing. Information on cost and quality (outcomes) on selected medical procedures is also provided to facilitate decision making. The range of cost for one procedure in one locale was between $4,000 and $14,000.

Tommy Canterbury has moved past education and awareness about a more active lifestyle to deliver proven, fun and healthy programs and oversight to groups, schools and communities.

Dr. Larry Hollier, chancellor at Louisiana State University Health Sciences Center, understands the shortage of physicians and the importance of easy access to primary care. His telemedicine model allows doctors in New Orleans to work through the caring touch of a nurse practitioner in a community clinic in Anywhere, Louisiana. It's better to bring care to the people than people to the care.

Dr. David Schleich and all the naturopathic physicians (NDs) in this country are having a real impact on the health and wellness of populations served. NDs possess nutritional training and behavioral modification expertise that can have incredible impact. This is especially true in communities overridden by obesity, sedentary lifestyle, diabetic and addicted patients.

Joseph Lockwood is a community leader in the early stages of aligning the appropriate parties to transition his community from a reactive population with unmet healthcare needs, limited funding and poor outcomes into a proactive healthy community that will be served by a wellness center, which will address the mind, body and spirit of each resident.

The organizations and programs mentioned above are not being endorsed by Risk & Insurance® and are only provided as an example of simple innovations that are working, and to encourage benefits brokers to innovate their operations and offerings to reduce costs and enhance outcomes.

"It's not the same to talk of bulls as to be in the bullring," according to an old Spanish axiom.

To paraphrase that, I'd suggest we quit talking "bull" about healthcare reform and get in the bullring to reform it!

MICHAEL G. MANES is owner of Square One Consulting, a New Iberia, La.- based consulting business focusing on planning, sales and operations, and change management and architecture. He has over 37 years of insurance industry experience, including serving as an instructor of risk and insurance at Louisiana State University.

March 9, 2011

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