Companies like Union Pacific have different opinions. Granted they do keep
employees for 15 or 20 years compared to months or a few years for most,
but the company does realize gains from a wellness approach. They spend
$12000 per family of 3.2 (memory may be failing here though). They shape
health care in 30 states and deal with all the fun unions, population
groups, city, federal, and other regulations involved

They have a largely male population with high stress (controllers) to heavy
labor and often long hours. All employees are carefully monitored for
health and behavior as are all involved in transportation now. Diets and
smoking and diabetes and HBP are major areas. Anti-smoking campaigns
bordered on civil liberties violations in their pursuit.

The task is difficult. They also have providers in some areas that extort
them with much higher costs of care than they should be paying. UP will pay
this back by fewer jobs in the future, you can bet on this. Some medical
centers and towns never learn.

They are also rating providers in quality areas. This will be interesting,
but clearly is necessary. Whether this takes into account more of a cost
perspective or a quality perspective is unknown.

UP set up model programs involving a wide range of physical, mental,
emotional activities, changed the food types available, established various
discounts and incentives, and completely rebuilt their food services
(number 2 visited place by senior tour buses visiting Omaha, after the
world class zoo).

It is interesting what happens when systems can be planned over years
instead of months, and when long term over all costs are considered rather
than this month's bottom line.

Now should health care be in the hands of temporary employers that rarely
consider long term health, costs, or well being, or in other hands?

Robert C. Bowman, M.D.
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