FAQs

1. I know there is a health care crisis but how bad is it?
Health care costs are swelling out of control with tremendous impact on American business—large and small, citizens, and the U.S. economy. According to the Kaiser Family Foundation/Health Research and Educational Trust 2007 Annual Employer Health Benefits Survey (Kaiser/HRET), premiums for employer-sponsored health coverage rose an average 6.1 percent in 2007, a slower rate than the 7.7 percent increase in 2006. This is the fourth consecutive year with a lower rate of growth than the previous year, and the lowest rate of growth since 1999, when premiums increased 5.3 percent. Even as premium growth moderates, the rate of increase continues to be higher than the growth in workers’ earnings (3.7 percent) and inflation (2.6 percent). Family health coverage now costs an average $12,106 annually, with workers paying an average of $3,281 toward those premiums, about $1,662 more than in 2000. Other key findings include:

• In 2007, only 45 percent of businesses with three to nine workers offered health insurance to employees. Only 59 percent of firms with three to 199 workers offered health insurance, versus all large firms (200 or more employees) where 99 percent of workers had health insurance coverage.
• Workers at small firms (with three to 199 employees) on average contribute significantly more to their premiums ($4,236 for family coverage) than workers at larger companies ($2,831 for family coverage).

According to HealthMarkets, Opinion Research Corp., November 2006, rising medical costs make health insurance unaffordable for the average American, with 47 million (16 percent of Americans) uninsured.

The statistics and associated long-term business implications are staggering. For example, if your business attracts the most talent or the best employees because health care coverage is a benefit today, then who will you be able to attract and retain tomorrow, should those plan costs not continue to be affordable by your organization? COSE is looking at these and other situations on behalf of its members.

2. How is COSE responding to this health care crisis facing business?
COSE took a lead role by undertaking an intensive two-part health care scenario planning process. COSE brought together some of the top thinkers in health care to place a spotlight on the health care crisis and plot a course into the future.

3. What was the COSE Health Care Scenario Planning process?
The COSE Health Care Scenario Planning initiative was comprised of two conferences. The first session took place November 28 and 29, 2006 in Cleveland, Ohio, where industry observers identified five main areas of uncertainty about the future of health care: defining health and wellness; identifying the players and their roles in the health care system; assessing the impact of technology and innovation; considering the impact of consumer empowerment; and evaluating the various sources and the nature of health care funding.

The first scenario planning session gave COSE and its stakeholders a deeper understanding of the world in which COSE operates. COSE leaders will use this understanding to make smarter decisions now and in the years to come as it relates to health insurance and other COSE products.

Following the completion of the second Scenario Planning conference in March 2007, distinct scenarios were published to share with key government officials and the media to represent the organization’s perspective as a serious discussion on the direction of health care reform gets underway. COSE is certain the scenario planning process has yielded some groundbreaking insights, so they have planned to share findings with local and national media as well as health care industry journals.

4. What are Scenarios?
Scenarios are stories about how the future might unfold. For COSE, they are stories about how the health care issue may play out and the subsequent implications for members, small business, and our country. These scenarios are not predictions. Rather, they are positioned as provocative and plausible stories about diverse ways in which relevant issues outside the organization might evolve, such as the future political environment, social attitudes, regulation, and the strength of the economy.

5. What are the scenarios that COSE has identified?
After completion of facilitated discussions at two major conferences, COSE, in collaboration with Global Business Network (GBN), reached consensus on the four most likely scenarios for the future of health care in the United States. The key forces at work in each scenario set the urgency for change that exists among the stakeholders of the health care system and which institutional or individual players will lead reform of the system.

Scenario 1 – Where’s the traction?
The first or “status quo” scenario envisions health care insiders as having no incentive to reform the system, leading to continued erosion of benefits and functioning of the system. Cost shifting to those left in the system provides “band-aid solutions” while the number of uninsured continues to grow.

Scenario 2 – Don’t just stand there – do something!
The second scenario sees popular demand (the pinch of high health care costs) forcing powerful players such as the federal government to make quick but far reaching decisions about health care. Employer mandates and price controls are more prevalent and the system evolves into a minimally federally subsidized program.

Scenario 3 – No news … good news?
Evolutionary change characterizes the third scenario as the urgency for health care reform takes a backseat to other domestic and international political issues. In this scenario, consumers take more control of their own health and health care and market forces slowly bring change to the industry. Individuals and small business are caught up in a rapidly changing, confusing policy and benefits environment.

Scenario 4 – New powers, new systems.
In the fourth scenario, in the midst of intolerable costs and a system in need of reform, new players and organizations step in to offer a different take on health care and its financing. New alliances emerge and significant changes in practices cut medical costs. Health information systems arise to become agents of change.

The details of each scenario, including “stories” of how they might impact individual small business owners, are included in the 31-page final report to provide policymakers with the means to reach informed decisions about which scenario provides the best conditions for their constituencies.

6. How will COSE members benefit from this Health Care Scenario Planning process?
As a result of the scenario planning process, COSE can offer its stakeholders, including members:

•A deepened understanding of the driving forces at work in the external environment to make better decisions in the interests of its membership;
•Expert insight into what the future of health care may look like, how COSE and small business can prepare for this future, and how it will impact access, affordability and quality of health care;
•The experience in working with a compelling structure around which to converse with some of the most influential thinkers in the areas of health care and small business; and
•A tool for refining COSE activities, products and services, ensuring that its strategy is more robust against possible outcomes.

7. Who facilitated the COSE Health Care Scenario Planning process?
COSE selected Global Business Network (GBN), the world’s foremost scenario consulting group, to lead the scenario planning exercise. GBN is a network of organizations, scenario practitioners, and futurists from a variety of disciplines and industries. GBN codified the scenario thinking process and was among the first companies to offer public training courses for strategists from across sectors. Since that time, they have collaborated with hundreds of corporate, non-profit and government agencies across the globe.

8. Who participated in COSE’s Health Care Scenario Planning exercise?
Working closely with Global Business Network (GBN), COSE selected a diverse group of more than 35 local and national health care experts—including physicians, respected health care trend watchers, journalists, authors and executives from numerous small business and political organizations. Additional information on COSE Scenario Planning participants can be found at www.cose.org/heathcare2015/participants.asp

9. Why COSE?
Since its founding in 1971, COSE has been the voice of small business and is nationally recognized as an authority on small business health care. COSE’s membership is comprised of more than 17,000 Northeast Ohio small businesses and COSE’s health insurance plans cover more than 178,000 individuals.

Historically, COSE has been an advocate and leader for small businesses. Over the years, COSE has crafted and lobbied for legislation to allow for group purchasing of health insurance for small businesses that keeps operating costs down while providing access to quality and affordable coverage for their employees.

10. Where can I find more information?
The following links can connect you with additional information and resources:

COSE Health Care Scenario Planning dedicated micro site via: www.cose.org/healthcare2015

Global Business Network www.gbn.com

Kaiser Family Foundation www.kff.org