By MATT McCORD
American manufacturing is making a comeback. Pushed by tariffs, provide chain instability, and shifting financial priorities, corporations are reshoring manufacturing—reinvesting in U.S. labor and operations.
However there’s one main impediment nonetheless standing in the way in which: the crushing value of American healthcare.
For many years, U.S. employers have overpaid for healthcare with out bettering outcomes. Ballooning insurance coverage premiums bloated administrative prices, and an opaque, middleman-driven system have left companies with the very best healthcare prices on the earth—twice as a lot as prime world rivals.
If manufacturing is returning, shouldn’t we be demanding a extra environment friendly and productive healthcare mannequin to assist it? The identical industries that when offshored to flee labor prices should now confront the truth that the previous manner of shopping for healthcare is damaged.
The Consolidated Appropriations Act (CAA) & The Rising Fiduciary Threat
The sport has modified. The Consolidated Appropriations Act (CAA) of 2021 imposes strict new fiduciary necessities on employers that sponsor well being plans. Corporations can not blindly belief massive insurance coverage carriers or PBMs to behave of their finest curiosity.
If companies fail to correctly handle their healthcare spend, they’re now chargeable for extreme prices, lack of transparency, and conflicts of curiosity.
🔴 This isn’t simply theoretical—JP Morgan Chase is now dealing with a class-action lawsuit over the way it managed its worker well being plan, with board members named as defendants.
Employers have all the time scrutinized workplace provide prices, journey budgets, and vendor contracts—but they’ve handed over healthcare procurement to third-party insurers with zero accountability.
Now, that lack of oversight is a authorized threat.
Why Employers Want a Chief Well being & Advantages Officer (CHBO)
Each main enterprise operate has an govt chief guaranteeing technique, effectivity, and accountability:
- CFOs handle monetary well being with precision.
- COOs streamline operations for optimum productiveness.
- CIOs leverage know-how to drive innovation.
So why can we proceed to let third-party insurers and middlemen dictate healthcare buying and not using a devoted govt overseeing the technique?
Mark Cuban just lately referred to as for a brand new C-suite function: the Healthcare CEO (HCEO). A extra acceptable and fewer complicated time period stands out as the Chief Well being & Advantages Officer (CHBO). This chief would act as a fiduciary to the corporate, guaranteeing that its well being advantages technique delivers higher outcomes at decrease prices—similar to a CFO does with monetary oversight.
This isn’t a job for HR.
Most CHROs are already managing compensation, expertise technique, DEI, workforce growth, compliance, and extra. Anticipating HR to additionally grasp advanced healthcare contracting, negotiate with PBMs, and implement fiduciary accountability is unrealistic and unfair.
A Chief Well being & Advantages Officer would guarantee:
✔ Strolling away from wasteful business incumbents (massive insurance coverage carriers, opaque PBMs, overpriced hospital networks).
✔ Constructing customized well being profit plans with direct contracts and value-based care.
✔ Utilizing a pass-through PBM to make sure drug pricing transparency and decrease prices.
✔ Eliminating middlemen that add value with out bettering care.
✔ Negotiating like a CFO—treating healthcare as a enterprise expense, not a sunk value.
The Mistaken Strategy: Value Shifting is Not a Answer
For years, companies have responded to rising healthcare prices by pushing the monetary burden onto workers—larger deductibles, elevated out-of-pocket bills, and restrictive networks.
However a workforce buried in medical debt, avoiding care, or battling persistent situations with out therapy shouldn’t be a productive workforce. As an alternative of asking,
❌ “How far more can we make workers pay?”
we must be asking,
✅ “How a lot can we save by buying healthcare smarter?”
A Fiduciary Strategy to Healthcare Buying
Simply as a CFO would by no means let an organization overpay for uncooked supplies, a CHBO would by no means let an organization overpay for healthcare.
This implies adopting trendy, fiduciary-driven healthcare procurement methods comparable to:
✔ Clear pricing and direct contracting with high-quality suppliers.
✔ Move-through PBMs that remove unfold pricing and rebate traps.
✔ Superior major care and on-site clinics that cut back hospitalizations and ER visits.
✔ Customizable well being plans that match the corporate’s workforce wants—not a one-size-fits-all insurance coverage provider plan.
The perfect corporations don’t tolerate inefficiency in another main expense, so why ought to healthcare be any completely different?
Name to Motion: It’s Time for Daring Motion
The authorized dangers of ignoring healthcare procurement have by no means been larger.
Corporations that embrace CHBO management and fiduciary-driven healthcare buying will acquire an enormous aggressive benefit. They’ll spend much less on waste, present higher advantages, and appeal to prime expertise.
The businesses that follow the established order? They’ll proceed overpaying, dealing with lawsuits, and scuffling with rising prices.
Manufacturing is returning to America. However with out fixing the damaged healthcare system, we threat driving it away once more.
It’s time for daring management. It’s time for the CHBO.
Matt McCord, MD is an anesthesiologist and founding father of Opioid Free Solutions and Benesan.org, serving to employers deal with overprescribing whereas modernizing well being advantages buying
