Wednesday, April 20, 2011

High-Deductible Health Insurance Plans

Our tribe here at Health Insurance Geeks has been growing exponentially, and it has been rewarding, as we have been pounding our drum to a different beat for years now.

I read often of dips and events that create new industries or explosive growth for outliers, and it appears we have been the benefactor of just that....we waited patiently and kept our mission, and now it is paying off big time.

Some of our clients who are stuck in the old way of thinking or are not ready for the proactive work necessary to move to a consumer-directed health insurance model with a high-deductible health plan, but I can say this...ALL of our clients have had it front and center by us, and they are simply the best solution to our quagmire here in the U.S. with respect to affordability of health insurance for the skyrocketing prices of healthcare services.

The lobbyists in Washington would never open the backroom doors they do all of their negotiations in, but lets be honest, the whole problem is profit and greed. As an entrepreneur who used his life savings to build something he believed in, and made it a success on a model where our earnings are substantially less (less premium means less income for us) I can say it can be done. We as consulting brokers have also been scalped many times over the last 17 yrs as far as how and what we earn. It is funny that pharma advertising has not become illegal like it once was? Health Insurance carriers have not been forced to operate as nonprofit, nor have all of the hospitals? Have Mercy, if that happened, the CEOs would not be able to afford their helicopter leases and the 30,000 sq foot mansions in the Hamptons.

Hey I am a capitalist like the next guy, but first and foremost someone who loves his clients, and loves what he does...as long as I can put my 4 kids through college and take care of my family and continue to love what I do, I can't ever see profit and greed taking control of my motives. Unfortunately, I have been involved in venture capital transactions and spent lots of time around senior executives in banks and insurance companies, and my LORD, I never heard the word customer...it was always EBITDA, or something relevant to how we continue to make more and more money, and the customer seemed left out....

That is why Health Insurance Geeks (www.healthinsurancegeeks.com) has done so well, always, always, keep the folks who made us, our customers, FIRST.

Monday, April 11, 2011

Consumer-directed Plans

Well it is interesting to me as an expert in the field of company-sponsored benefits, specifically group health insurance, that most carriers are selling against the solution to the quandary in the U.S. - consumer-directed health plans.

As somoeone who understands underwriting as well as anyone, I guess this is simple, health insurance carriers do not possibly want to offer something for 25-50% less premium (consumer-directed plans with HRA or HSA and high-deductibles) as they will STILL get stuck with high claims....remember folks, 5-105 of a company's employees drive 80-90% of claims volume. That means a few employees and/or their dependents can blow up an employer's health plan even if they have say 100 employees.

So simply the insurance carriers, whether charging 400/single employee for a copay plan, or 175/employee with a high-deductible plan, they will still be on the book for a portion of a huge claims (remember these clever guys reinsurance claims over a specific level, say 25k, 50k, or 75k and build that additional stop loss premium in to a group composite rate...)....so maybe Obama and his henchmen need to negotiate better with the Republican Congress and figure out a way to back stop, stoploss for carriers in exchange for them lowering their rate base and passing the real problem in the U.S. (chronically ill patients either not managing illnesses well - think Obesity, Asthma, Heart and Diabetes all in one cluster, or someone who just has huge claims and is catastrophically ill - cancer et al).

The real problem is not healthcare in the U.S., but how to better manage the 5-10% of the population who is consuming enormous amounts of costly healthcare in an inefficient system....if the government truly wants to help, folks who are chronically ill should be mandated to quality based medicine, and the providers in those systems should be compensated MORE, yes MORE, to manage better.

That folks in a nutshell is the solution, but we have these idiots in Washington arguing about things that are not the solution....universal care, single payor, government or no government...none of it matters, evidence-based medicine does....less hospitals, though BETTER hospitals and the same for physicians....more physician assistants, nurse practitioners, and places like Walmart walk in clinics and CVS minute clinics for the routine cold - GTEAT solutions.

We the people demand a solution, not the eggheads in the government.