By Andy Sullivan

WASHINGTON (Reuters) - Countless workers in the United States are trapped in jobs they would like to leave because they cannot get health insurance elsewhere, calcifying innovation and mobility in the world’s largest economy.

Daunted by health-care costs, a would-be technology entrepreneur in Texas decides not to start her own business. A communications expert in Washington decides not to strike out on his own. And a freelance magazine editor in Brooklyn decides to take a less satisfying corporate job.

“I would rather be freelancing, no question,” said Jessica Tolliver, a former editor who now works in public relations. “I got my work done in less time, because once I finished what I had to do, the time was my own.”

Economists call this phenomenon “job lock,” and studies suggest that it keeps between 20 percent and 50 percent of workers from leaving their current jobs.

Because health insurance is tied to employment in the United States, workers who leave their jobs can see health bills skyrocket if they strike out on their own or take a position with a company that offers fewer benefits. Workers who would like to retire early stay on, unable to qualify for the government’s Medicare program until they turn 65.

And those who have existing health problems may not be able to get coverage at all.

Job lock is difficult to measure because many employees don’t like to advertise their unhappiness. But economists and small-business advocates say it takes an enormous toll on productivity.

SLOWING INNOVATION

“We can definitely say that it’s slowing down the rate of innovation,” said Tim Kane, an economist with the Kauffman Foundation which promoted entrepreneurship.

For Mike, a Washington-based communications professional who did not want to use his last name, health costs may force him to pass up the chance to be his own boss at a time when he could easily pick up several major clients.

With two children at home, Mike said he was reluctant to abandon the generous benefits he gets at the trade group where he currently works. Self-employment would probably mean spending more for fewer benefits.

“I don’t want a bad event to knock me and my family out of the box,” he said. “It’s a real hurdle.”

As head of the National Federation of Independent Businesses, Todd Stottlemeyer frequently encountered would-be entrepreneurs who let their ideas go stale and their products languish on the workbench because they did not want to shoulder their own health care costs.

When he asked audiences if health insurance has affected their employment decisions, often half the hands in the room would go up.

“There are lots of factors that go into why somebody starts a business or doesn’t start a business: Do I have a good idea, do I have capital, do I have risk tolerance?,” said Stottlemeyer, now an executive at a hospital chain. “Being able to get health insurance … should not be one of those determinant factors.”  Continued…

By Matthew Holt

Anyone who’s been following along on THCB will realize that there’s a huge divide about whether the HITECH act should pay for and dictate a specified, certified type of EMR product use OR pay for data and outcomes and not specify how providers get there. The “cats” support certification and EMR mandating (more or less). The “dogs” think that existing EMRs are often counterproductive and that a mix of other data sources, processes, and patient outreach technologies will get us where we need to in terms of improving outcomes much quicker. And now there’s an extra $20 billion in the mix, just to add some fun.

Rather than write more about that at HIMSS this week I got detailed interviews on film with leading “cats”, Glen Tullman, CEO of Allscripts, and Mark Leavitt, Chair of CCHIT. And then a response from the always highly caffinated dog-lover Jonathan Bush, CEO of AthenaHealth. And no, they don’t agree with each other…..although there is some common ground.

If you’re at all interested in how Health IT & EMRs will play out, these three are must-sees. (I’d view them in the order I took them).

To watch the video click here: The Health Care Blog

How important is a letter grade? Just ask a hopeful student; a grade can make or break a chance of getting into one college or another, one program or another or being dropped from the running all together.

Our society prides itself on getting an “A.” The paragon of perfection. Getting a B isn’t bad; it just means you’re not in the top tier of performance. Receiving a “C” on the other hand signifies “average,” or a lack of trying.
But what about a “D”? In our overachieving, exceptionally demanding society, what does a “D” symbolize?  What about a “D-”?
Can we say “Failure?”

Well make no mistake about it, that’s what the American College of Emergency Physicians is calling the nations emergency care.  According to the AP press, the nation’s overall emergency care system received a D-, and not one single state received an “A” ranking. (Doctors Give US Emergency Care a Failing Grade)
The lack of resources and influx of patients is pushing the problem to its limits. The AP described America’s emergency room system as a “ticking time bomb,” citing a dearth of physicians and nurses “fraught with significant challenges and under more stress than ever before.”

A TV story by WKOWTV.com pointed out that over “300,000 Americans go to ERs for care daily and that ninety percent of the states earned poor rankings receiving mediocre rating or earning near failing marks.”
Can this be true? Can the best efforts and resources of the place and people we turn to in an emergency result in a “D-“? The system we trust the most is going to undoubtedly fail us?

What does this mean for the future of our healthcare, especially on the wake of a financial crisis? Where do we place our expectations? What can we expect from an ER room ranking a “D-”anyways? What is being done to change this?

“This is a national disgrace,” said the organization’s president Nicholas Jouriles, an emergency room physician in Ohio. “The nation’s emergency physicians have diagnosed the condition and prescribed the treatment. It’s time to get serious and take the medicine.”
Medicine that might just end up failing.