Saturday, October 06, 2007

Enhancing the Common Good

I work for a non-profit health benefits company in Canada.

The only non-profit health benefits company in Canada.

Many have written to me to ask me “what does that mean?”

So I thought I might take this opportunity to explain. At least I will attempt to the very best of my understanding. I will keep it simple, because I understand that there is very little that is interesting about providing health benefits.

The company I work for is Green Shield Canada. We provide pre-paid health benefits to groups and individuals all across Canada.

Pre-paid benefits means that you have an “account” of coverage for all aspects of your health care that you or the company you work for are willing to provide for you.

Some companies pay up front for what they expect you will need for glasses or for physical therapy. Some pre-pay for manufacturer name brand pharmaceuticals. Others may deem that they do not need to provide coverage for glasses or generic brand pharmaceuticals are sufficient.

As a company, we adjudicate those claims made by those we cover.

To adjudicate means:

to settle or determine (an issue or dispute) judicially.

- source: Dictionary.com Unabridged (v 1.1). Random House, Inc. 06 Oct. 2007.

To do this, our staff determines the validity of each claim based on the rules agreed to by the company you work for – the company or group that has pre-paid for your benefits.

We have built some very sophisticated computer systems to help accomplish this. In most cases, our computer systems adjudicate your claim when you are still standing in the pharmacy, or at the dentist or doctors office, settling your account with them.

As a non-profit company, we do not make profits. We have surplus. Surplus – like profit – is the monies above our costs to perform the service. Some of those surplus we re-invest in our company – to enhance our computer systems or to enhance our ability to perform our works.

The remainder of our surplus is re-distributed back into the communities that we serve. This is what we call our “Social Surplus”. And this is quite a substantial amount of monies.

Every year we receive formal requests from all kinds of organizations, charities and non-profit groups that exist to help those in need. A very special committee reviews each request, and if appropriate – funds are provided.

One of our biggest social-surplus partners is the United Way. Another is Easter Seals.

There is no one at Green Shield Canada getting rich off our business. But that is not to say that we do not make a proper living.

You see, this endeavor requires skilled persons. And very few in this world have the luxury of being so financially independent that they can donate their entire work lives to our efforts. Our salaries are constantly reviewed that they are competitive in the communities we reside in. Otherwise all our best people would leave to work elsewhere.

This does not make them insincere in their contributions to Green Shield Canada. It is merely a reality that people have to provide for themselves and their families to the best of their abilities before anyone can expect them to have a charitable nature.

Green Shield Canada was founded by a group of Windsor pharmacists in 1957 – led by William Wilkerson. It was created to help resolve the problem for those families that had to decide between providing food and shelter rather than medicine for their families.

In his typical style – all surplus generated would go back into the community. Mr. Wilkerson truly was a man of a special ambition. His memory is the very foundation that our current mission is based on.

Over the next ten years, Mr. Wilkerson was also very instrumental in the development of the child-proof medicine bottle cap. It was originally called the “palm-n-push”. While it has caused most of us frustration from time to time, the original intent was to eliminate the needless deaths of children who were swallowing their parents medications thinking the little pills were candy.

When Green Shield Canada won the contract to build and maintain the computer systems that adjudicate and administrate drug claims paid for by the Ontario Provincial Government for senior citizens and socially assisted persons; we added yet another monumental break-through. We implemented a means to check drug-to-drug interactions – so that when a senior received a prescription at the pharmacy – while that claim is being adjudicated by our computer system – we would be able to check that prescriptions against all other prescriptions they had recently received to make sure they did not combine to result in a poisonous or fatal manner.

Since all seniors and Socially Assisted persons in Ontario have their prescriptions entered through our system, this check against all other prescribed medicines they have taken is indeed more complete than anywhere else in the world.

There is no telling how many lives have been saved by this simple logic algorithm.

When I first returned to Windsor seven years ago, to marry my wife Darlene, to start our family, and to begin my career anew with Green Shield, the thing that amazed me most was the reaction people in Windsor had when they learned who I worked for.

And who do you work for, Mr. Brill?” – would say the bank manager.

Green Shield Canada”, I would reply.

Ooh, very good”, would be the reply.

The response always had a sentiment of being impressed. And that is the impression that Green Shield Canada holds in Windsor. Often it’s followed by the question “are there any openings there…?

For all those that I work with at Green Shield Canada, there is not one person I can think of that is insincere in fulfilling our roles. There is no one that I know of that is only there to earn a paycheck.

There is – as any place else – the occasion to complain about your job, your boss – or even the company. But those complaints are generally frustrations that we all face on a daily basis as we wrestle our way through life. The same as one complains about a rainy cold December and the aspect of another green Christmas in Windsor.

To let you know, I have no professional motivation in writing this entry. This space is my own, and it has been a great joy to me to write my various tales and accounts of my life. To my knowledge, there is no one at Green Shield Canada that actually reads my blog.

In truth, the place I work has over the last seven years had a significant and important influence on me; both professionally and personally. It has made me a more socially conscious person – a more charitable person. It has made me a better person I believe.

And you can’t really understand a lot of what I write unless you understand the significant components that influence my life.

And Green Shield Canada has most certainly influenced the person I have become.

if you would like to know more about Green Shield Canada, visit our website at

http://www.greenshield.ca

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