Managed Care - November 2008 - (Page 40)

health. It also means that we want to ensure our SEPULVEDA: Our investment in this goes back policies are implemented around the world. For many decades — when you walk into this cominstance, in China the prevalence of hepatitis B pany, health awareness is all around you. You see virus infection is enormous, so we address the your leaders doing things that are healthy and issue of HBV infection in China to ensure that you see your coworkers doing things that are from a workplace policy standpoint this is not a healthy, and it’s an environment that advances factor in whether or not we choose to employ an you along the path of change. But we have had individual. In China employers can discriminate to transition from the notion that an employee in hiring people in that way, but we came into could be safe and healthy at work and then go that market and we said, “No. We’re not doing home and not wear his seatbelt, not get his imthat.” We hire people because of their talents, munizations, buy a pack of cigarettes, and eat untheir commitment, their enthusihealthy food. Those things are more asm, their flexibility, and their cre- The indiscriminate important than being safe at work. ativity, and we take these individ- provision of health MC: Have wellness efforts failed in uals with whatever else they come care services — absent any important way? to the table with, including chronic efforts to help SEPULVEDA: Two things worry me diseases. about wellness efforts. One is that people understand health promotion doesn’t really reach MC: Has it been easier to make those the disenfranchised, and second, deideals such as prevention and ac- how to use those services — will lead to spite the best efforts by employers of countability stick in developing all sorts, behavior change associated health care systems? Turning the voracious appetites for with wellness programs in the best Queen Mary around quickly in the consumption. case scenario is about 30 percent to United States and European countries seems like a very tough task. 40 percent. So when people ask, “What’s the single biggest challenge to better health status and SEPULVEDA: It took us a while, but we have made better health outcomes for the population?” Getthe transition in places like the United States, ting care in an environment where relationships France, Spain, and Italy by convincing employees with providers are deep and very trusting would that it is far more valuable for us to provide adult make the biggest difference, because it’s in that immunizations and to talk with people about dicontext that people can be motivated to change. abetes or asthma than it is to give them free access to health care for whatever reason and whenMC: But you haven’t given up on wellness in the ever they wanted. That was a big cultural change. workplace? We’ve gone into other parts of the world without SEPULVEDA: No. It’s very important, but is also a a lot of that baggage, because they’ve never had long-term investment and it has to be sustained that kind of access to services. Yet things were over time. Health promotion has become a big evolving rapidly in those countries, and we could business in our nation, and I’m worried that it see that all other things being equal and left unhas been oversold in terms of what can be extouched, those environments were going to end pected over time. I worry that if a salesperson up in the same place that we are at today in the walks in and makes promises to a small-business United States, which is not a good place. Because or a medium-business owner who may not see we are a larger purchaser, we were able to work the results, or if the changes a company makes with partners to help us achieve our objectives. In work and are taken for granted, then the investIndia and China, we were very successful in drivment will stop and the problems will recur with ing marketplace reform. We have seen phenoma vengeance. We have to be forever mindful that enal traction around the ideas of prevention, acthe reason we don’t have a problem anymore is countability, and partnership with your employer that we have successfully addressed it to a level in places like Brazil, China, India, and Hungary. that we’re all quite comfortable with and we don’t let up on the investment. MC: But you said you have made that transition in the United States, too? MC: In creating a culture of health at IBM, how im- 40 MANAGED CARE / NOVEMBER 2008

Table of Contents Feed for the Digital Edition of Managed Care - November 2008

Managed Care - November 2008 Editor’s Memo Contents News and Commentary Legislation & Regulation Letters Medication Management Compensation Monitor Do It Yourself for Less Biomarkers Promise, but Do They Deliver? Oncologists Complain About Drug Payment Consider Blood Pressure Self-Monitoring Q&A: Keep Industry in the Game Formulary Files Plan Watch Tomorrow’s Medicine Outlook Respiratory Syncytial Virus Managed Care Considerations Contents Continuing Education Objectives RSV Disease in the Pediatric Population In the Trenches RSV Infection in the Adult Population Health Plan Medical Director Health Plan Pharmacy Director RSV Issues and Solutions Assessment/Evaluation/Certificate Request Post-Test

Managed Care - November 2008

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