Karen Mason, Sr. Vice President, Group, Equitable Life

bh IN BRIEF

A senior insurance company executive, Karen Mason, describes the Conference Board project she’s been supporting for the last two years. The Social Determinants of Health identifies the factors outside the health system that create or deter good health. She speaks to the need for a national catastrophic drug program developed by insurers and ultimately coordinated with government drug plans. The interview closes with her view of what smaller employers need from their insurers.

Q: Tell me about the Conference Board project you've been involved with on the determinants of health. Why does this project matter to employers?

I've worked with the Roundtable on the Socio-Economic Determinants of Health for the last two years. The Public Health Agency of Canada defines twelve determinants, critical factors in making us healthy, or not. The ones most relevant to business are employment and working conditions, income, education, social support networks, personal health practices, physical environment, and health services.

I've learned we need to think of health in broader terms. It's not just the benefit program or occupational health that matters. More fundamentally, organizations can create better health by considering their leadership qualities and culture, how, and how much, work is done, their reward and recognition strategies, and more. The Conference Board has a pivotal role to play in making these determinants matter to business.

Q: What interim goals have been set for the campaign, and how will the WSIB sustain interest and momentum over the next five years?

We are reaching out in many areas. In addition to supporting the CEO Charter and its 250 members, another very important initiative is our Community Health and Safety Charter. Our goal is to make mayors and town councilors local champions, and take the message not only into companies, but also to their communities. So far, we have a number of cities and towns on board, the most recent being Guelph. Ontario municipalities pay us $100 million annually to care for their injured workers. That's way too big to go unnoticed. To close the loop, those municipalities also need to talk to their Chambers of Commerce.

Q: Have the discussions provided any insight on how the health of Canadians can be improved …or why it hasn't?

There is no silver bullet. Each determinant is important and complex by itself, and together, they are truly daunting…but not impossible. The first step is to broaden the conversation on health to increase awareness. Next we must get the key parties engaged and business has to work with government and academics. One of the Roundtable's main purposes is advocacy to get the key players together so change can happen.

These issues need to be translated into business language, issues, and needs, and the Conference Board will issue a discussion paper this Fall to do just that.

Q: Let's turn to benefits, and specifically drugs. Should insurers wait for governments to act, or should they develop their own national solution to protect their clients from high-cost drugs?

I strongly believe the insurance industry should take a coordinated and consistent approach to protecting people from catastrophic drug costs. Those discussions have begun, but I am not sure we can or should do it alone. Governments still bear the biggest burden for prescription drugs, and so we need to work together. Funding mechanisms and participation rules need to be resolved, but it's time to get on with it. People must be covered.

Q: What are the most important issues facing Canadian life and health insurers over the next few years?

The challenge for our industry is our ability to adapt, and improve, and to thoughtfully and effectively respond to our clients' needs. That means better use of information to show where health and productivity can be improved, and more flexible plan designs. Internally, we must ensure efficient, low-cost operations, coupled with constant improvement in the level of personal and self-service. The future of the benefits market is all this and more; but perhaps the greatest challenge is to 'keep it simple'.

Q: Equitable Life's group clients are mostly small and mid-sized employers. What keeps them up at night, and how could insurers do a better job serving them?

Businesses have a few common challenges: growth, finding and keeping the people they need, and staying competitive. Looking at benefits, they are at the same time both a cost and an investment…the latter in employee loyalty, health and productivity, and financial security.

Employers need to place the benefits 'spend' in the context of their broader organizational goals, and figure out how to get the most value from that spending. The key to every insurer's success is to meet the evolving expectations of clients and their advisors, as well as plan members.