Last week, Richard Thaler was awarded the Nobel Prize in economics for pointing out that individual behavior, with respect to investing for the future, is not rational. As someone said in a recent WSJ article on Thaler’s accomplishment, “We’re a nation of procrastinators, not a nation of portfolio managers.” Thaler taught us that we need to nudge people in the right direction by doing things like 401(k) auto-enrollment, auto-increases, and auto-diversification. These moves have helped millions of people better prepare for retirement.
Likewise, people aren’t rational consumers of healthcare services. The system is just too complex, information too lopsided, and emotions too charged to decide if or when or where to get complex care. Employers need to help their plan members with these decisions. It may seem heavy-handed and paternalistic, but denying kids the freedom to play in the street is too.
Tom Emerick and Sally Welborn of Walmart took the lead and said we are tired of our people figuratively getting hit by cars. They gave them a big nudge to get out of the street and have their hips, knees, backs, hearts, and more treated by carefully vetted, multi-disciplinary teams. The result – better care and lower costs. And other organizations, like Lowe’s, have followed suit.
More employers need to tilt the field (nudge employees) in the right direction. Plan members can’t do this on their own, and the big health networks can’t do it either (they are too tied-up in their existing contracts with brand-building regional health systems). Joint replacements and back surgeries are a great place to start, but there are a number of other opportunities to make a big and positive impact.