This is the first installment of a two-part series on the role of complementary and alternative medicine (CAM) in health-benefits plans. This article covers what’s likely the most extensive CAM program in Corporate America. Part 2 will present viewpoints from others in the corporate, medical, and insurance communities.
You should eat fruits and vegetables, exercise, drink moderately at most, and smoke not at all. And you definitely should try to avoid saturating your system with mercury.
Don Washkewicz, chief executive officer of the $13 billion manufacturer Parker Hannifin, had no clue mercury was a likely culprit behind his chronic intestinal discomfort and overall low energy until he underwent a full medical screening. There appeared to be no source for the condition other than his mouthful of “silver” fillings — which, like everybody’s, were about half mercury.
The American Dental Association and the mainstream medical community generally hold that there is virtually no risk of mercury intoxication from silver fillings. But Washkewicz’s mercury score was high, so he underwent a process called chelation therapy, in which an injected enzyme cleanses one’s system of toxic heavy metals like mercury and lead. Before long he started to feel better.
As CEO of a Fortune 500 company — this year it’s ranked 216th — Washkewicz could afford to have his old fillings replaced with nonmetallic composite ones and to undergo chelation. That was a good thing, because neither procedure was covered under Parker Hannifin’s health plan.
His next move was to check how many of the 35,000 fillings Parker Hannifin had paid for under its benefit plan the previous year were mercury-laden. The answer: 70%.
“I said, this is insane,” says Washkewicz, eight years later. “We’re poisoning our workforce, paying for it up front, then paying again later for the chronic conditions that result from being poisoned.” Parker Hannifin instituted a policy under which it covered less and less of the costs for silver fillings over the next few years. Now it pays nothing for silver, but 100% for composites.
More notably, Washkewicz’s experience was the genesis of a complete review of Parker Hannifin’s health benefits. The result of that has been a steady expansion since 2004 of procedures, treatments, and therapies covered under the plan (see a partial list, left). Many, unlike the CEO’s treatment of an existing condition, are preventive in nature. And most of the list consists of complementary and alternative (CAM) practices that are rarely covered by health plans.
That’s because, according to much of the medical community, the health-insurance industry, and most employers, they are untested and unproven.
A tug of war between conventional medicine and CAM medicine — much of which is aimed at preventing or treating illness and injury without drugs or invasive approaches — has been going on for decades. While CAM continues to grow in popularity among individuals, the corporate mainstream remains committed to covering only what’s been proven by evidence obtained through large, multiple, and rigorous clinical trials.
“Parker Hannifin is a big outlier, and in fact probably unique in its breadth of coverage,” says Ken Pelletier. A cardiologist by trade, he has been running The Corporate Health Improvement Program for 25 years. Now affiliated with the University of Arizona School of Medicine, the program helps large companies (though not Parker Hannifin) design customized health and wellness initiatives, often using a variety of CAM methods. But that doesn’t mean he offers a blanket approval of Parker Hannifin’s health strategy. (His objections, and other views on the subject of CAM versus traditional medicine, will be addressed in Part 2 of this series.)
Washkewicz, who reads extensively about CAM and regularly meets with CAM practitioners around the world, is undeterred by detractors.
“I’m 100% positive we’re doing the right thing,” says Washkewicz, who is not a doctor but whose passion for CAM is driving much of the company’s approach to health care. “Allopathic [i.e., traditional] medicine doesn’t work very well. It treats symptoms instead of getting to the underlying problem. If the problem is high blood pressure, the solution is not a blood-pressure drug. The solution comes from finding out what is causing the high blood pressure. Maybe the person is low on magnesium or some other natural substance. But he or she surely is not low on this pharmaceutical drug.”
He stresses that he’s not bashing doctors. Instead, he says, they were trained to do things in a certain way, which is to “go to the Physician’s Desk Reference and find a drug to give you that matches up with your symptoms. But that’s a stupid way to approach it.” Nor does he mean to imply that every drug is useless: some pain medications, antibiotics, and thyroid drugs do have merit, the CEO thinks.
Although Parker Hannifin’s program has been developing for eight years, the company has not talked about it much publicly. That’s changing now, with employee utilization of CAM having grown from 27,000 services performed in fiscal 2009 to 46,000 in 2010, 78,000 in 2011, and 102,000 in 2012, according to Dan Serbin, executive vice president of human resources at the company.
Washkewicz says his new willingness to talk is not based on a business advantage. “It’s not going to help us sell more of anything,” he says. “I just think this is the solution to our country’s big heath-care problem. If more and more companies were to do this, we’d have a healthier population and be able to spend money elsewhere instead of pouring all of it into health care.”
But what about the common wisdom that covering more services typically drives up the costs of a health-benefits plan?
Even after eight years, Parker Hannifin, which is quite decentralized and gives its divisions and locations a fair amount of operational autonomy, has not yet been able to aggregate cost impacts for the company as a whole. Health care is generally viewed from a holistic standpoint, notes Serbin, and many operating units have not yet tried to differentiate between the effects of the CAM offerings and those of other, more traditional health and wellness efforts.
The most proactive unit in tracking health-care cost movement has been the company’s plant in Richland, Michigan, where a high-performance wellness team was created to push the initiative. There, cost-tracking mechanisms were set up at the outset. Annual per-employee medical costs have sunk by more than half since 2007, from $6,500 then to $3,200 in fiscal 2012 (which ended June 30), Serbin claims, though it’s still not clear how much is directly attributable to the CAM efforts.
Says Washkewicz, “It’s early days, but we’re going to aggregate this and show the payoff in lower costs. And then we’re going to publicize the hell out of it. I know we’ll never be able to add up every dollar and penny, because how can you quantify the productivity lost from days missed and doctor visits? But we won’t need to account for every penny. There will be tremendous results.”
The company has, though, bowed to public perception in one regard. After years of calling its initiative the Complementary and Alternative Medicine Program, the moniker has been changed to the more vanilla Prevention and Wellness Program. Washkewicz notes that for many people, “CAM” conjures a notion that it’s “quackery.” (That may explain why other companies known to be leaders in CAM awareness generally decline to talk about it with the media.)
A big challenge for Parker Hannifin has been putting together a network of CAM practitioners accessible to the majority of its 27,000 workers at 350 locations in North America. That’s where the program has been solely offered so far, though plans are afoot to bring it Europe (and perhaps elsewhere; the company has approximately the same number of workers in the rest of the world as it does in North America). In some of the more off-the-beaten-path places, practitioners of all the covered CAM services are simply not available.
It’s also important to Washkewicz that the program be on at least a “level playing field” with traditional medicine. That is, the company generally pays for 80% of its employees’ health-care costs, whether for conventional or CAM approaches. “It’s about choice,” he says. “If you are comfortable with the drugs your doctor prescribes, you can keep going to him. But if want to go with less invasive, more holistic, less toxic health care without being stuck on drugs the rest of your life, we’re offering a good place to start.”
Parker Hannifin recently hired a doctor specializing in CAM services, Sherri Tenpenny, to provide counsel on optimizing program results and recommend additional services for inclusion. She patiently went over each of the company’s CAM services with a CFO reporter, describing the medical basis of each one. Most of the time, before going on to the next one, she offered the same comment: “Health plans don’t cover that. But they should.”
Tenpenny started out in emergency medicine and was an emergency-department director for 12 years. “As I started becoming aware of all the integrative CAM tools that are nontoxic and noninvasive but can’t be turned into billion-dollar industries, I spent a couple of years being really angry,” she says. “You know, my dad paid a lot of money to send me to medical school and get trained, and I only got half an education. And I didn’t even get the best half!”