Saturday, November 21, 2009

Where is Reform?

At healthinsurancegeeks.com, we spend lots of our time educating small companies about health insurance, how it works, why it is "broken" right now, and taking apart the myth that we hear on all of the news channels that follow our mislead government. Speaking from an apolitical stance, both sides have it completely wrong and are not talking about the problem. Here is the problem, we have no CONSUMERISM in healthcare. Anyone working over the last 20 years that got used to the 2, 5, 10, 15 copays will understand this.... if i have a visit that costs 20,000 or 1,000 and I pay 2, or 10 bucks for it, what do I care? If EVERYONE had a small deductible to meet before anything was reimbursed, and copayments evaporated in to thin air, and we had the choice of huge networks of physicians, but the monthly premium dropped dramatically, wouldn't that work? That is the deal from how we see it, if we went "back to the future" before copays came on to the scene, and had deductibles and coinsurance for EVERYTHING, we would fix this broken system overnight. This way, we all pay our fair share. Maximum out of pockets expenses would be capped so none of us go bankrupt, and perhaps the government could backstop some of the reinsurance for insurance companies? The problem with the politicical debate is none of them are talking about this solution, because it is so simple it will make them all look quite foolish.

They are at a stalemate, the insurance companies know this will work (that is where we the founders of healthinsurancegeeks.com started our careers, at one of the largest, fastest growing insurance companies in the world in the early 1990s) but do not want to give up their greedy profit schemes....and the politicians "probably" know this will work, but remember they are politicians not insurance experts! Lobbyists step in and now all of a sudden, they need to throw their weight. Sorry to go on a diatribe, but as an expert in this field, someone who has accessed care, and a married father of 4, I understand this as a regular American. We switched our own EPO plan to a high deductible health plan, effective January 1, 2010, as the premium absolutely sank, to 1/3 of what I was paying, we have taken on a big deductible, but get to use network doctors who via their contract with our new carrier, must accept the payments/contracted rates when we visit. That means our copays go "bye-bye" but when we take our kids to the pediatrician, rather than paying 100-125 for a sick visit, we pay 50-60 per the negotiated pricing. Not bad considering my premium sank, I am able to open an HSA if I so choose, and my doctor visits are really only going up from 30-60 per say, as our old plan had a $30 copay.

This is not magic, it is just plain old consumerism at it's best.