One major reason for companies closing is poorly coordinated health care that results in increased costs for the company with devastating financial results. In 2008, total national health expenditures were expected to rise 6.9% – two times the rate of inflation. Total spending was $2.4 trillion in 2007, or $7900 per person. We can reduce costs to our health care system and improve our nation’s health through pre-placement examinations, reporting problems, coordination with emergency room contacts, specialists (referrals and consultations), physical therapy, sickness and accident, FMLA (Family Medical Leave Act), EAP (Employee Assessment Programs), and TRUST. A good place to start would be incentives, disincentives, memberships, free screenings, support groups, fitness centers, and home education. One thing is certain – health and productivity costs from absenteeism and presenteeism are costs the employer cannot ignore and cannot afford.