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The Opioid Crisis Can Be Solved


It's happening right here in Orlando

The opioid crisis is the single greatest public health catastrophe in the last 100 years in the U.S., and the epidemic has reached epic proportions. According to the Centers for Disease Control and Prevention (CDC), more than 72,000 Americans died from drug overdoses in 2017 -- a twofold increase in drug-related deaths over the past decade, which included overdoses from both illicit and prescription narcotics. In 2016, drug overdoses killed more Americans than the entire Vietnam War. And the cost isn't just measured in human lives: the White House Council of Economic Advisers estimates that $504 billion was spent in 2015 on healthcare bills, criminal justice costs and lost productivity related to the opioid crisis.

Unfortunately, the entire U.S. healthcare system has been the biggest contributor to this catastrophe, from the doctors who overprescribe these drugs to the employers who skip out on decent primary care options within their health benefit offerings. As the largest benefits purchasers in the nation, employers in particular have become far too docile in negotiating the best deals for their workers -- regularly accepting five to 20 percent increases on their annual healthcare costs, without seeing any improvement in the treatment their employees actually receive. In other words, we're all paying more in order to get less.

And while short-term solutions can mop up the metaphorical spillage -- the overall effects of the opioid crisis -- we won't ever truly eradicate the epidemic until we "turn off the spigot" and address its root causes. That means tackling the broader challenges of healthcare in this nation.

Recently, both the Senate and the House signed a bipartisan legislation package aimed at combating the crisis. The package aims to stop the inflow of synthetic opioids while authorizing and expanding programs for addiction prevention, treatment and recovery. The package also allocates funding to the National Institute of Health for the research and development of new, potentially non-addictive painkillers. In addition, the CDC recently released new physician guidelines for prescribing and monitoring opioid use. The goal of these rules is to monitor all patients for signs of opioid tolerance or dependence in order to spot cases as soon as they begin. Some studies show that after seven days of opioid use, one in six individuals will become addicted.

While the CDC's guidelines are a step in the right direction, and this bill is a rare example of bipartisan cooperation on an important issue, this legislation alone isn't enough to stop fix the problem. To enact real change, we must look to employers that can use their market power to catalyze a watershed change in healthcare.

Fortunately, we already have a number of real-world examples to which we can turn for guidance and motivation. Hundreds of employers are charting a new course in benefits design, all in an effort to provide better care at lower costs, disincentivize opioid overprescription, fight addiction and combat misuse.

One of those employers is Orlando-based Rosen Hotels & Resorts, which was the focus of a TED talk in 2017. Rosen's story is one of our nation's finest examples of how employers can rethink the boundaries of traditional employee benefits programs, and in turn, help their employees achieve the American Dream.

In an industry with a common employee turnover rate of close to 60 percent, Rosen's turnover hovers in the low teens. Part of the reason employees stay is because of the company's commitment to fully fund in-state college tuition for all full-time employees who have worked for Rosen for five or more years. In addition, Rosen also pays for the in-state college tuition of all employees' dependents once employees have been with the company for three years.

How on earth can Rosen afford to keep such promises? The answer is simple: Rosen's benefits' design allows them to save millions on costs otherwise wasted on low-value, overpriced healthcare. Since adopting this approach, Rosen has saved approximately $315 million on healthcare costs, and their per capita spending on healthcare is half that of the average employer. By investing in proper primary care that includes physical therapy and other wise strategies, they not only have improved the health and well-being of their employees, they've kept them out of harm's way, shielding them from unnecessary levels of opioid prescriptions that are pervasive in most employer health plans. Despite physically demanding jobs, opioid prescription levels for Rosen employees are at one-sixth the level of a typical U.S. employer -- roughly the same rate as Italy or France, where they have also avoided an opioid epidemic.

And Rosen doesn't just put these savings back into employees' pockets -- they also redirect funds into the communities they serve. One of Rosen's most creative philanthropic efforts focuses on the formerly crime-ridden neighborhood of Tangelo Park. By investing in free daycare, pre-K, after-school programs and free college educations, Rosen helped to cut crime rates by 67 percent and boost high school graduation rates from 55 percent to nearly 100 percent.

Rosen continues to fund a number of different programs aimed at helping Tangelo Park's students thrive and become leaders in their community. And recently, Rosen took another move toward spreading the wealth of their healthcare savings further, now by "adopting" another underserved Orlando community, Parramore.

Rosen's efforts, and those of countless employers like him, prove that when we make an effort to tackle the root causes of the opioid crisis (i.e. our fee-for-service care model that's driving more Americans to become addicted to these substances), we can effect powerful changes in our own lives and the lives of those in the communities we serve. That change starts with employers, and it can be in their own backyard.

Dave Chase is co-founder of Health Rosetta, which aims to accelerate the adoption of simple, practical, non-partisan fixes to our health care system. He is also the author of "The Opioid Crisis Wake-up Call:Health Care is Stealing the American Dream. Here's How We Take it Back." (Health Rosetta Media, September 2018).

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