More on Healthcare Consumerism

Two great things happened today...one was with my co-founder and business partner and the other with one of my clients. First my business partner was explaining how one of his clients that he migrated to a consumer-directed high-deductible health plan strategy had just had an epiphany as they discovered together the cost of a brand name drug (an injectable) versus the generic substitute....it was for a 90 day supply and the brand was 2,000....YES, $2,000 bucks!!!! The generic substitute was $50 for a 90 day supply.

Now had we not moved this client to a non-copay based plan he would have never discovered this little nugget that is a great example of why a single rate for an employer health plan now is soaring closer to $1,000 than ever for what we call a "rich" plan design...funny thing is what we now call a "rich" plan design, back in 1997 we would have scoffed at vehemently...back then what we call rich now was probably 175 bucks a month for a single...now 14 yrs later it is closer to $1,000. Unreal and the reason is the example above...the DEVIL copay system that hides the costs of things.....

Second example was great...talking to a client of mine for 10 years and we have had a HOMERUN moving them from the DEVIL to a new world, through a consumer-directed model. She and I were going through this years' renewal and ideas on how to starve their insurance carrier this year and POOF!! We came up with a great analogy...health insurance needs to become more like auto insurance....deductibles...can you imagine if you had a $10 copay for a wreck in to a pole that could cost $10k...you would almost look for a pole to hit to make the others in the car laugh a little...who would even care, $10 bucks, why not! Now that is not how auto insurance works....$2500 deductible is pretty common to keep the premium down and as a result you would not catch me dead screwing around in a car and playing with POLES! Same deal in health insurance.....if we pay a larger cost of Rx especially, and doctor's visits and charges/lab xray too, we are going to SHOP WAY MORE and watch our dollars....a result as well will be a radical reduction in healthcare consumption etc...

Now finally one thing to highlight is the really sick in this country, the 15% or so....maybe those are the folks Obamanomics should focus on as they are the real problem no one talks about....they drive 80% of the claims and many times have the same 4 ailments that drive most claims anyway. In no way am I suggesting that they should get subpar care, but large consumers of the system and dollars need to pay their fare share, and that is where the government should both back-stop claims from insurance carriers/employers, while also pointing the VERY sick in to very efficient systems...like Mayo, Cleveland Clinic, etc....see this link

http://www.100tophospitals.com/

The true best hospitals in the U.S. should be rewarded for being such, and the poor ones should be shut down. We have too many....funny that NYC does not even have a top 25 system, which is simply appauling as its costs are 2-3 times other places in the U.S....this is the stuff these clowns in Washington need to work on.