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.