Nashville Business Journal | Joel Stinnett

Health care costs, obesity and chronic disease are on the rise in Tennessee, but what employers should do to combat those issues is up for debate.

Five candidates for governor of Tennessee participated in the Gubernatorial Candidates’ Forum on Health and Wellness on Tuesday, hosted by the Governor’s Foundation for Health and Wellness and the Nashville Health Care Council at Trevecca Nazarene University.

The event featured questions from state business leaders, including HCA Healthcare Inc. Chairman and CEO Milton Johnson, Vanderbilt Health System CEO Wright Pinson, United Way of the Mid-South President CEO Kenneth Robinson and Scripps Networks Interactive Senior VP Crystal Washington.

Republican Randy Boyd, co-founder of Knoxville-based Radio Systems Corporation and former state ECD chief, said one of the keys to driving down health care costs for employers is allowing employees to make smarter decisions about their care. He said eight years ago his company began giving employees $4,500 a year to put into their health savings account, while simultaneously raising their deductible from $500 to $5,000.

“The idea is to make them better consumers of health care,” Boyd said. “This may sound like a small point, but imagine a marketplace where nobody ever asks the price and no seller knows what they’re charging — it’s a broken system.”

Republican Bill Lee, chairman of the Lee Company, said rewarding healthy practices is the key to improving employee health and lowering costs, and that his company lowers premiums for wellness-program participants.

“The question about employers and what they can do goes back to what I see as the real challenge all the way across our system — which is a lack of real incentives for outcomes that we want and behaviors that we want either at the payer, provider or patient level,” Lee said. “Our people are rewarded by lowering the costs of their premiums if they employ this program of ours and that is absolutely driving behavior in our company.”

Democrat and former Nashville Mayor Karl Dean said employers can also encourage healthy behavior while at work by providing access to healthy foods and time to exercise. The state government can help, he said, by expanding green spaces and supporting state parks, as well as working to create more jobs — saying financial wellness often determines health wellness.

“One of the things I think is critical for our state is to face the issue of poverty and the need to create more jobs and more opportunity,” Dean said. “We need to get people in a position to where they can get good jobs, hold them, support their family and as a result be healthier.”

Other takeaways from the forum:

  • All candidates said they support a bill repealing the tobacco pre-emption clause that says state law supersedes local laws relevant to where smoking is allowed. The bill would allow local governments to pass their own policies regulating smoking.
  • State Speaker of the House Beth Harwell, a Republican, said she is co-sponsoring a bill that would ask the federal government for a waiver requiring able-bodied Medicaid beneficiaries to work. She said there should be a safety-net for low-income residents but that it should not turn into a lifetime entitlement.
  • Democrats Dean and State House Minority Leader Craig Fitzhugh repeatedly said they are in favor of expanding Medicaid in Tennessee, while the three Republicans lobbied for the use of federal block grants.
  • Republican U.S. Rep. Diane Black did not participate in the debate.