It's sometimes easy to look at national issues and then overlook the impact they have on us as individuals. Easy, too, is the opposite. We can be mired in our own situation and lose sight of the possibility that the problem is larger than our little world.

Health care seems to be one of those issues that falls in both extremes.

For decades, Caterpillar-UAW negotiations always focused on wages, work rules, time off, etc. Here we are in 2004, and health care is the issue. Cat wants union employees to join their salaried counterparts and share in the company's rising health care costs.

There's an irony in all of this. While union employees at Caterpillar are complaining about sharing in their health care costs, small businesses in the area see employees leave for jobs at Cat. The key reason usually given: "I want their health care coverage." It's been interesting-and sad-to witness the changing role of employer health coverage for small businesses as the cost of providing coverage has gone out of sight. We've gone from "I'll take the job. What's your health insurance like?" to the exact opposite.

The problem seems clear, or does it? Just as physicians need to know the patient's problem before prescribing treatment, we also need to understand why health care costs are quickly moving out of sight and beyond reach for many. At the end of the day, someone has to pay for the costs of advancing health care horizons. While we might settle for second or third best when buying a new family car, we all demand the very best when it comes to health care.

Throw in the effects of the aging baby boomers and skyrocketing cost of medical malpractice insurance for physicians still willing to practice in Illinois, and we begin to see the curse and blessing of a health care system second to none in the world.

Glen Barton, former CEO of Caterpillar and former chairman of the Health and Retirement Task Force for the Business Roundtable, an association of CEOs, recently wrote: "Traditionally, Caterpillar, along with other major corporations, have insulated employees from the true benefit of their healthcare package by paying the vast majority of costs without educating employees about the total value of this benefit and the opportunities they have to affect the cost of care. While the long-term impact on healthcare costs and consumer-driven health plans is being debated, most healthcare experts agree that accountability and responsibility on the part of employees is a major component in the long-term solution to rising costs."

Education is key. For the consumer, programs such as Caterpillar's Healthy Balance® encourage individuals to manage their own health, and incentives such as reduced premiums for the non-smoker and use of generic drugs are effective. To control health care delivery costs, preferred hospitals, physician networks, pharmacy benefit management, and increased Medicare legislation must be pursued for consistent quality of care.

A first step toward positive change in the cost of the nation's health care picture is growing awareness and understanding of its major impact on business. For those who provide it, the cost of health care significantly impacts the ability of business to compete on all levels-locally, nationally, and internationally.

It's a national issue with a very strong impact on us locally. Health care benefits should be a mutual responsibility between the consumer, benefit providers, and health care professionals. "Teamwork within the healthcare industry and in the legislative arena is critical to improving the quality and efficiency of healthcare delivery for all Americans. This teamwork will help make it possible for U.S.-based companies to continue to offer healthcare benefits for employees and retirees while maintaining global competitiveness," said Barton.

Our little world isn't so little anymore. We have to accept responsibility. IBI