2011 and the Obamacare Collapse

I think most agree Obamacare is dead in the water, as frankly it should be...it focused on political jousting, and health insurance carriers when it did not focus on the problem that health insurance carriers are faced with - how to FUND claims from agregious hospitals, and physicians and how to control billing/costs of services. In addition, we as consumers, employees, business owners (I am all 3) need to be pro-active with our healthcare, and start asking physicians more questions when we get prescribed medicines for example that cost 600 dollars for a 30 day supply (remember pharmaceutical companies DO NOT want you to get well per say, then you do not need their overadvertised medicine). The copay system which is entirely the problem (who cares what the cost is if we pay $30, $40, $50 whatever)....so back to consumerism, which where I grew up in this business, was the drumbeat almost 20 years ago. We saw it coming, and now it is reality. And your advisors (yes, I am picking on your insurance brokers) are giving you poor advice b/c most of them are also part of the problem. Remember your broker gets paid a percentage of premium and usually DOES NOT WANT you to leave the problem (the copay system) so they can continue to get fat and happy. Insurance carriers do not beat the drum, because they are faced with the same fate. So they are both the problem.

We built our company knowing reform in some way was coming (though we have been saying this for almost 20 yrs now) and that we were going to need to survive in a world where commissions get hammered because the premium stucture should and hopefully will collapse. And quite frankly as Seth Godin (author) states in a great audiobook The Dip, we are in the middle of a dip in healthcare/health insurance. Those of us part of the solution are dying for this to happen faster - collapse of the inflated premium structure to fund the problem - the copay system....btw, doctors also bill as much as possible (so do hospitals) as they are incented by quantity not quality in the current system.

Obama has actually used the word quality some and has referenced the Cleveland Clinic, and Mayo for example - two world class institutions with the best care. Unbelievable that the best are actually efficient right? Well listen to Godin, he will explain how that is....well LOTS of folks attached to the current supply chain that need to get nuked, and this has nothing to do with single payor healthcare or government run healthcare. They (GOVT) have proven to us over many years that they (the government) know how to do one thing - create bankrupt organizations - a la Post Office, Medicare, Social Security to name 3. Call any government agency and see how great the service is - "hold sir, I have my union mandatory smoke break now."

Don't let these government clowns touch my healthcare nor it for my family of 6, PLEASE!! Do however, "light up" hospitals and physicians ...we have too many who really are not that great (outcomes, readmissions, infection rates) overcharging (seems right inline with previous note about quality not being great) and we do not beat the drum enough of the ones who charge a fair dollar for incredible outcomes (there have been published examples of this in NYC all over the place)...the hospitals who are part of the problem need to be shut down, we can triage and push lots of Primary Care to "telemedicine" - come on, we have Skype now, so push my doctor to get online, see me eye to eye, and triage my bronchitis with GENERIC meds and save this failing system. We are ready for this folks....I have invested my life's savings in an organization pushing this system so obviously I have self-interests, but I am part of the solution not the problem. Everyone I listen to on TV also has self-interests but I do not understand how we can't all be a part of the solution - bring costs WAY down, bring outcomes WAY up, and make the advisors (brokers, consultants, insurance carriers) learn to live on half the revenue. The good will always rise to the top, and the bad will hopefully fail and/or go in to another business.

I think that's it for now...I need to do more brain dumps, more often. Q4 always makes our business bananas, so I go underwater a bit. My final comment is this....we passed on lots of business last year that just could not understand how high-deductible health plans work and the tools coupled with them that make them work. I actually wanted to tell some of those "decision makers" (usually the ones calling themselves that, are NOT) that they simply are part of the problem and not open-minded enough to understand the solution. I understand my arrogance in that statement, but it is true.