While Congress and the President arm-wrestled through the Health Summit, the private sector doesn’t sit still waiting in a frozen state for the result of inside-Beltway-health-baseball.

Employees/consumers and employers have aligning in mutual self-interest when it comes to health care benefits, costs, and disease management, according to a survey sponsored jointly by Deloitte and the International Society of Certified Employee Benefit Specialists, 2010 Top Five Total Rewards Priorities Survey.

This latest recession has focused the minds of companies and their workers and driven the collective priority of managing health costs while maintaining job and retirement security. In this 16th annual survey iteration, Deloitte and ISCEBS assert that this is the strongest alignment of employer/worker interests in the 16th years of conducting the study.

77% of respondents worry about their ability to afford retirement and 60% are concerned about staying employed. While 4 in 10 employees plan to delay retirement, knowing they’ll need to save more and pay down debt, the #1 focus is on maximizing health status.

The report states that, “survival mode” is “in full force.”

The top 5 priorities for 2010 are:

  1. The cost of providing health care benefits
  2. The ability of reward programs to attract, motivate and retain talented workers
  3. Aligning Total Rewards strategy with the business and brand
  4. The willingness of employees to pay for an increasing portion of benefits and manage their own rewards budget
  5. The ability of reward programs to accommodate the needs of different worker segments.

Among employees, there’s also a growing realization that physical health is a huge component of financial health. Thus, 65% of employees say they’ll participate in wellness and disease management programs to maximize their health — the #1 personal challenge polled by Deloitte. Below this health-maximization priority are to save more money, pay off debt, increase contributions to pensions, and delay retirement. Thus fiscal health and physical health intertwine.

Health Populi’s Hot Points: If the recession has been good for anything, it’s at least raised Americans’ understanding that the loss of job is tantamount to the loss of access to health insurance in the employer-sponsored health system that’s unique to the U.S.

With a forecasting hat on, one thing’s for certain: employers will be redesigning health benefits in and beyond 2010 and will be — I’ll repeat, will be — allocating more costs to employees. Thus, the mention of consumers managing their “rewards budget.”

So while we line-itemize our monthly spending for eggs, butter, college education, gas, and mortgages, don’t forget to add an important line item you’ve probably not called out before: your rewards budget.