According to Greek legend, a poor peasant named Gordius became the king of the Asian country of Phrygia because of a rather vague prophecy. An oracle had prophesied that the nation's future ruler would come riding into town on a wagon, so when Gordius and his wife arrived in the public square driving an ox cart, the populace named him king.

To show his gratitude, Gordius dedicated his cart to Zeus and tied it up in the god's temple with a highly intricate knot-the legendary Gordian knot.

Never one to miss opportunities to predict the future, another oracle then foretold that the person who solved the Gordian knot would one day rule all of Asia. The knot resisted all attempted solutions until the year 333 B.C., when Alexander the Great arrived on the scene.

While that might not have been the solution Gordius and the oracle had in mind, Alexander did hold up his end of the bargain, becoming the ruler of not only Asia, but the largest empire of the ancient world.

The most famous quote about Alexander the Great is comes from Plutarch, a priest at the Temple of the Oracle at Delphi: "And Alexander wept when he looked across the world, for there was nothing left for him to conquer."

With nothing left to challenge him, Alexander slipped into a deep depression, became an alcoholic and died at the age of 33.

Too bad he didn't try to tackle healthcare. The complexities of today's system might drive him to drink, too, but one thing is for sure: 2,500 years later, he'd still be challenged up to his eyeballs.

All FOR ONE We in healthcare can use all the help we can get, and although we won't be getting any from the long-dead world conqueror, assistance is coming from a powerful new set of allies: employers.

At first, it seems intuitive (from a corporate perspective) that having a worker at his desk is better than not having a worker at his desk, even if that worker is a little under the weather. Some productivity is better than none, right?

As it turns out, no. According to research from the Institute for Health and Productivity Studies at Cornell University, 60% of the total cost of employee illnesses come from what is known as "presenteeism"-when employees continue to work despite illnesses that reduce their productivity. In other words, rather than staying home to rest one day and then being healthy for the rest of the week, the employee trudges through the entire week at a fraction of normal productivity. Not only is productivity reduced, but the chances of the illness developing into something more serious increase dramatically-as do healthcare costs.

"Employers have to start looking through the right end of the telescope ... not at what it costs to keep their employees healthy, but what it really costs not to keep them healthy," says Sean Sullivan, founder and CEO of the Institute for Health and Productivity Management, editorial advisor for MANAGED HEALTHCARE EXECUTIVE, and co-subject of this month's Executive Profile (see page 22).

Gregg Lehman, CEO of Gordian Health Solutions (named after the famous Greek king) and Sullivan 's counterpart in this month's cover story, adds that the return on investment for health and lifestyle management programs for employers is so large that" it's practically irresistible."

Let's hope so! Employers are a critical part of the healthcare continuum, and as health plans' biggest customers, they have the critical mass to drive change. Adding their considerable weight to the struggle just might be enough to tip the scales in everyone's favor.