PLATFORM:BUPA'S RECENT Supreme Court victory on risk equalisation must prompt us to look at the Republic's healthcare system in a broader perspective, writes Feargal Quinn

While the state of healthcare in the US has been much criticised, US supermarket company Safeway has been leading the way in promoting new ways of looking at healthcare.

At present, about 47 million Americans have no healthcare insurance, and tens of millions of others are underinsured.

Those with good jobs and large benefits packages enjoy extensive health cover. Meanwhile, tens of millions of people in the US cannot afford basic treatment, prescriptions, or even a visit to the doctor.

In the debate over how best to fund and organise healthcare, much attention is focused on curative medicine and the important issue of treating people who are ill.

However, Safeway has identified the incredible potential of preventative medicine, and has taken positive steps to keep its employees as healthy as possible in their daily lives.

Health insurance in the US is usually offered through employers, with government assistance for the very poor and elderly. Many employers in the US are now dropping healthcare coverage because of its high cost.

However, Safeway, which operates 1,740 supermarkets in the US and Canada, has reduced its costs by pioneering a programme to promote health in its workforce.

As part of the programme, the company's employees each receive a health savings account, which is funded by Safeway to the value of $1,000 (€681), but which they can spend as they wish. Expenses that exceed $1,000 are covered by the employees themselves.

Safeway has also reduced its healthcare costs by encouraging proper nutrition and exercise. At staff cafeterias, the calorie content of all meals is displayed. The company subsidises healthy options, but charges the full price for less healthy choices.

There is also a company fitness centre as well as subsidies for local gym memberships.

The scheme has been so successful that it is being extended from a pilot programme for management to cover the overwhelming majority of Safeway's 200,000-strong workforce.

While Safeway had annual sales of $42.3 billion in 2007 and spends about $1 billion a year on employee healthcare, its healthcare costs were reduced by 13 per cent in 2006, remained flat in 2007 and are expected to remain flat or fall further in 2008.

The company's wellness plan is now a powerful tool to help contain healthcare inflation and boost profit.

Having led the way in improving its own employees' health, Safeway has formed a nationwide coalition of more than 60 companies calling for an overhaul of the for-profit healthcare system in the US - the most expensive system in the developed world.

Steve Burd, president and chief executive of Safeway, is especially concerned by the lack of transparency in most healthcare plans, which do not allow patients to pick the best plan for them and which do not encourage people to maintain healthy lifestyles.

Burd cites research that estimates that 74 per cent of all healthcare costs are related to four chronic conditions: high blood pressure, high cholesterol, arthritis and respiratory diseases such as emphysema.

He believes that changes in individual behaviour can alleviate most of these conditions, and that health initiatives - like those at Safeway - can play a role in encouraging these changes.

While many advocates maintain that the only way to improve healthcare in the US is by creating a not-for-profit, single-payer system, as used in a number of European countries, Burd believes that his reforms could lower healthcare costs by up to 40 per cent.

Nobody in Ireland could sensibly wish for the vast inequalities, inefficiencies and costs that the US healthcare system produces, but there is certainly room here for policies that promote wellness in addition to simply curing diseases.

In this respect, at least, there are lessons to be learned from the US, and the current debate on health insurance in the Republic should include broader issues such as the role employers can play in their workers' health and the personal choices of employees.

Safeway has taken a bold lead and demonstrated that companies can make changes on their own to reduce healthcare costs by improving employees' health.

This dynamic model of rewarding wellness can be of massive benefit to employers and employees not only in the US but also in this country.

• Feargal Quinn is an Independent member of Seanad Éireann and chairman of EuroCommerce