Oil is creaping back in to the middle 3 dollar range at most pumps (and rising other commodity prices), foreclosures are mounting like crazy - in Charlotte NC where we have a home 51% of all 2010 sales were foreclosures....unrest in the middle east, and these insane media/journalists on various shows bring on these also insane "pitch" men for whatever it is they want us to believe talking about how things are in pretty good shape? Are these folks using street drugs?? I mean are they serious? If you took out Obamanomics, i.e. just pour an agregious amount of tax payer dollars in to the broken system to prop it up and make it look like it is not that bad....a mistake, and another lie to us, the US drones. Reality, unemployment is probably 20-25% - what if folks have worked somewhere for 10 yrs at a 1099 and get layed off...oops, we don't count them and they don't count? Ridiculous.... with that as my backdrop, we are in the a great Dip and at the Tipping Point for what we do in my company, which is liberate small companies (5-300 employees primarily) from the bondage of health insurance carriers, their brokers, and the awful advice and push they both give their clients.
High-deductible health plans are the answer to the quandry, and giving employers tools to incorporate consumerism is also the answer. Why do you think Cigna, Aetna, United Healthcare have had THEIR own employees forced in to high-deductible health plans for over 10 years...THEY KNOW THESE THINGS WORK FOLKS!! THEY JUST DON'T WANT YOU TO KNOW THEY DO, BECAUSE THEIR PREMIUM TANKS AND SO DOES THEIR VALUE.
I represent the solution, and Health Insurance Geeks push answers....it does not mean everyone will heed the message but at least we are part of the solution, not part of the broken problem that the majority of brokers and health insurance carriers are still trying to protect.
Monday, February 28, 2011
Wednesday, February 9, 2011
My Manifesto - Remove Politicians from Health Insurance
They and them.....are the problems. They meaning all of the politicians jousting to make sure they save their seats, their donors, their pitch, their perks, and THEM, the vested executives of health insurance companies that simply are not following what we are begging for in the US....affordable coverage. Funny thing about this is it is simple to solve really...we just need to lead the TRIBE (and I am a happy Leader of the tribe to which I refer) .... a HUGE TRIBE can get lots done...we need a full court press against large employers, unions, and insurance companies and the politicians intertwined within to FORCE them to deal with disgruntled Americans on this subject. Look what Twitter and Facebook did in Egypt, I mean COME ON PEOPLE!
I SIMPLY DO NOT WANT THE GOVERNMENT TOUCHING ANYTHING HEALTH INSURANCE RELATED...read that again please. Our government is responsible for many of our current bankrupt entitlements and I do not care who points a finger in either direction, Democrat, Republican, Independent, whatever...
In a country (yes us in the US) where we can't even fill top level IT and engineering jobs from within because our talent pool is frankly less than those in other developing countries, we are up against the ropes and ready to go down like Apollo Creed in Rocky III (I think it was that one)...pretty scary stuff for someone like me born on a tiny island off the coast of western Greece to a Greek dad and American mom...they brought my sister and I to the land of opportunity, the great U.S. and raised us here. Now 40 yrs later our society is crippled with debt, inter-political fighting and nothing is getting better, actually worse.
I read about what a Tribe can do (thanks again Seth Godin, you're great) and am throwing a stake in the sand and trying to build my tribe. My company actually sells individual, family and employer-sponsored health insurance, and here I am trying to lead the TRIBE to do things differently. My contemporaries or Peers think I am nuts "our business will get killed"....actually exact opposite. The losers that are trying to oversell, under-educate and profit will lose in the end, and I am not one of them. I just want to help people, employers, their families and employees, and lead my clients to solutions that give them the power to chose, spend wisely and always have predictable financial models in which they can have faith.
In my company we say constantly "the copay is and was the devil"....smart insurance companies knew we would all get addicted to the copays like "crack" and now when we try to lead folks away from that old "COPAY" they shiver...what's the copay? what's the copay? well the answer should be $1,000/mos/employee in premium is the copay. What flavor would you like please? No copay, no health insurance problems...no ridiculous mandated benefits (pay for what we buy like car insurance) no health insurance problems. No middleman in the prescription supply chain (yes you insurance companies) no health insurance problems. No drug advertising like it was long ago, no health insurance problems. But first, nuke the copay, and start asking our doctors what they will charge us. I mean COME ON, can you imagine getting your car overhauled at Honda and not knowing what it would cost? The lazy here in the US would say, man that sounds great!! Okay, lazy, you can't afford the new "copay adjusted" cost of a Honda CIVIC which is now $80,000 and a great lease payment is 2100/mos...okay, who can afford that? Well the 500% increase of it would be just like what has happened in the U.S. with the copay. It melted the system.
I am done for today.
I SIMPLY DO NOT WANT THE GOVERNMENT TOUCHING ANYTHING HEALTH INSURANCE RELATED...read that again please. Our government is responsible for many of our current bankrupt entitlements and I do not care who points a finger in either direction, Democrat, Republican, Independent, whatever...
In a country (yes us in the US) where we can't even fill top level IT and engineering jobs from within because our talent pool is frankly less than those in other developing countries, we are up against the ropes and ready to go down like Apollo Creed in Rocky III (I think it was that one)...pretty scary stuff for someone like me born on a tiny island off the coast of western Greece to a Greek dad and American mom...they brought my sister and I to the land of opportunity, the great U.S. and raised us here. Now 40 yrs later our society is crippled with debt, inter-political fighting and nothing is getting better, actually worse.
I read about what a Tribe can do (thanks again Seth Godin, you're great) and am throwing a stake in the sand and trying to build my tribe. My company actually sells individual, family and employer-sponsored health insurance, and here I am trying to lead the TRIBE to do things differently. My contemporaries or Peers think I am nuts "our business will get killed"....actually exact opposite. The losers that are trying to oversell, under-educate and profit will lose in the end, and I am not one of them. I just want to help people, employers, their families and employees, and lead my clients to solutions that give them the power to chose, spend wisely and always have predictable financial models in which they can have faith.
In my company we say constantly "the copay is and was the devil"....smart insurance companies knew we would all get addicted to the copays like "crack" and now when we try to lead folks away from that old "COPAY" they shiver...what's the copay? what's the copay? well the answer should be $1,000/mos/employee in premium is the copay. What flavor would you like please? No copay, no health insurance problems...no ridiculous mandated benefits (pay for what we buy like car insurance) no health insurance problems. No middleman in the prescription supply chain (yes you insurance companies) no health insurance problems. No drug advertising like it was long ago, no health insurance problems. But first, nuke the copay, and start asking our doctors what they will charge us. I mean COME ON, can you imagine getting your car overhauled at Honda and not knowing what it would cost? The lazy here in the US would say, man that sounds great!! Okay, lazy, you can't afford the new "copay adjusted" cost of a Honda CIVIC which is now $80,000 and a great lease payment is 2100/mos...okay, who can afford that? Well the 500% increase of it would be just like what has happened in the U.S. with the copay. It melted the system.
I am done for today.
Thursday, February 3, 2011
Individual & Family Health Insurance coupled with Group-Sponsored Plans
So get this....now many employers are passing on the full cost of dependent care (think your spouse and children) on to their employers. So when that happens we as employees see quickly how much insurance really costs.
The smart thing to do is to price out if you can do better on your own. Assuming you are relatively healthy, not diabetic and take limited maintenance medications for mild ailments, you certainly can do better on your own. The one thing to look out for are the nuances in product development. Things like maternity that are mandated benefits for employer-sponsored plans, are not in the individual market. But, for those folks who have already built families and are getting crushed with premium pay-throughs, take a look at our rate site and see if you can do better - www.healthinsurancegeeks.com.
The Geeks
The smart thing to do is to price out if you can do better on your own. Assuming you are relatively healthy, not diabetic and take limited maintenance medications for mild ailments, you certainly can do better on your own. The one thing to look out for are the nuances in product development. Things like maternity that are mandated benefits for employer-sponsored plans, are not in the individual market. But, for those folks who have already built families and are getting crushed with premium pay-throughs, take a look at our rate site and see if you can do better - www.healthinsurancegeeks.com.
The Geeks
Friday, January 28, 2011
Individual & Family Health Insurance, and HEART
The end of 2010 and now early in to 2011 I have seen a surge in a queries for individual health plans, as well as family health plans - sometimes the dependents of a worker, i.e. spouse and children. In addition the amount of folks on COBRA and coming to an end has been astonishing. I really do not trust the 9.5+% unemployment rate by the way...I feel it is much closer to 20% when you look at real life and the folks who are working minimum wage jobs to make ends meet as opposed to their normal vocation....I could go on and on, but back to my point.
Many, many employers are passing on the cost of health insurance other than that for the employees, to the EMPLOYEES. It has been a massive change in the last couple of years as the U.S. and global economies have abolutely melted down. I see many more folks coming to our organization in search of alternative than in some instances paying 1k +/mos in insurance premiums that their employers are burdening them with as we have now fallen off the cost cliff at least here in the U.S.
So, what do you do? Well, depending on some states like CA and KY for instance this can be super news as child-only policies are still offered and in addition pre-x is gone for children under 19, so they can't be assessed those...having said that I have still seen insurance companies rate them up quite a it, as well as burying the costs in parents if they are attached to a family plan. Now the bad news, other than those 2 states, we at least can't sell child-only policies.
More "so-so" news is just the underwriting process for attaining family plans instead of taking in the chops from your employer - let me explain:
I work for X company, and used to pay 30% of the full premium for my family - for example 1600/mos in total premium charged to my company by the health insurance company, and $480 getting taken pre-tax from my paycheck bimonthly for example ($240/paycheck)...that was how it used to be....Now my company is saying, we will pay 100% of you (the rate charged to the health insurance company for me is let's say $500, and the $1100 is now being passed on to me to cover my family. So I went from $240/paycheck for all of us, now shooting up to $550/paycheck...like a 220% increase)....
We are seeing this ALL OVER THE PLACE! So then we get the phone calls and it is good news if you are healthy - and what I mean by that is no diabetes, no heart ailments, or major chronic illnesses in the family etc...if you fall in to this category you can taken the controls back fast and purchase private health insurance for a much better premium. Now let's say your loved one (the fomer dependent on the employer plan) has diabetes, and you have an autistic child. YOU MUST STAY PUT!! You will not be able to secure health insurance outside of CA or KY for just your child, and then anywhere else in the U.S. basically (other than NJ and NY for example) your spouse will be declined b/c of the Diabetes, and then the children can't get a private plan b/c there are no child-only policies...get it? The insurance companies screwing us again.
And by the way, let's talk high-deductible health plans, a la consumer-directed health plans. I do feel they are our savior, but health insurance carriers are still gouging us price-wise...Oxford Health Plans in NYC for example...they are an awesome company, but for the plan designs they offer, they have cornered us in to buying what they want to sell us ($800/single employee) POS and PPO plans that have astronomical pricetags, and make them record profits. When we compare those plans to their high-deductible health plan offerings with managable deductibles (let's say $1500/year for a single person) it is easy for a broker, consultant or the insurance company/and consumer for that matter to talk themselves out of buying the savior (high-deductible health plans) b/c we can transfixed on that $1500 deductible as opposed to the rich PPO with 0 deductible in-network anyway. So here is what maddens me, the $1500 plan is still $425 + per single employee monthly. That is not priced well, period. In my company we joke about TARP (troubled-asset recovering program) that the Fed Govt established to basically stabalize our country and bail out some banks. If what should happen to health insurance companies did (i.e. that $425 plan, sank to $250 where I think it belongs) we would then need HEART (HealthInsuranceCompany Eroded-Asset Reconfigured Trust) or something of that nature as they would have their claims reserves set up with a premium 50% lower let's say, and would all tank in a quarter. It is funny to say it so matter-of-factly, but I believe it in my bones. But some would say it SHOULD HAPPEN! Well, one thing is for sure, I do not what the government involved in health insurance, and believe for starters Medicare should be run privately...we have given the government plenty of time to bankrupt that system....so make that private, keep health insurance private, but do please blow up the profit machine, the current metrics, all of the waste with too many employees and too much paper (everything automated to some degree)...coming from a distrbution perspective (which I am) big deal, slam my commission (which is how I pay my mortgage, and not much more these days) and allow me to continue to help individuals and small companies as I love to do, and let's make it a day. We have already had our revenue hammered by more than 55%, which frankly has been fine with me. I am in business to help and in order to make the revenue work, it just means I need to help 55% more people every day than I used to for the same static money. Again, fine with me, as that means in the end I actually help MORE PEOPLE.
Sounds all great right? Well I am one of the honest guys in this business, but I am surrounded by dirtbacks and agregious big companies who want their executives to keep fat paychecks. So blow em up, keep the smaller/boutique businesses humming (the engine of the U.S.) as they should be and always should be. The big corporate interests and the government are the problem.
I could write 20,000 more words without a break, but these are my thoughts for the day, and I think a good brain dump.
Many, many employers are passing on the cost of health insurance other than that for the employees, to the EMPLOYEES. It has been a massive change in the last couple of years as the U.S. and global economies have abolutely melted down. I see many more folks coming to our organization in search of alternative than in some instances paying 1k +/mos in insurance premiums that their employers are burdening them with as we have now fallen off the cost cliff at least here in the U.S.
So, what do you do? Well, depending on some states like CA and KY for instance this can be super news as child-only policies are still offered and in addition pre-x is gone for children under 19, so they can't be assessed those...having said that I have still seen insurance companies rate them up quite a it, as well as burying the costs in parents if they are attached to a family plan. Now the bad news, other than those 2 states, we at least can't sell child-only policies.
More "so-so" news is just the underwriting process for attaining family plans instead of taking in the chops from your employer - let me explain:
I work for X company, and used to pay 30% of the full premium for my family - for example 1600/mos in total premium charged to my company by the health insurance company, and $480 getting taken pre-tax from my paycheck bimonthly for example ($240/paycheck)...that was how it used to be....Now my company is saying, we will pay 100% of you (the rate charged to the health insurance company for me is let's say $500, and the $1100 is now being passed on to me to cover my family. So I went from $240/paycheck for all of us, now shooting up to $550/paycheck...like a 220% increase)....
We are seeing this ALL OVER THE PLACE! So then we get the phone calls and it is good news if you are healthy - and what I mean by that is no diabetes, no heart ailments, or major chronic illnesses in the family etc...if you fall in to this category you can taken the controls back fast and purchase private health insurance for a much better premium. Now let's say your loved one (the fomer dependent on the employer plan) has diabetes, and you have an autistic child. YOU MUST STAY PUT!! You will not be able to secure health insurance outside of CA or KY for just your child, and then anywhere else in the U.S. basically (other than NJ and NY for example) your spouse will be declined b/c of the Diabetes, and then the children can't get a private plan b/c there are no child-only policies...get it? The insurance companies screwing us again.
And by the way, let's talk high-deductible health plans, a la consumer-directed health plans. I do feel they are our savior, but health insurance carriers are still gouging us price-wise...Oxford Health Plans in NYC for example...they are an awesome company, but for the plan designs they offer, they have cornered us in to buying what they want to sell us ($800/single employee) POS and PPO plans that have astronomical pricetags, and make them record profits. When we compare those plans to their high-deductible health plan offerings with managable deductibles (let's say $1500/year for a single person) it is easy for a broker, consultant or the insurance company/and consumer for that matter to talk themselves out of buying the savior (high-deductible health plans) b/c we can transfixed on that $1500 deductible as opposed to the rich PPO with 0 deductible in-network anyway. So here is what maddens me, the $1500 plan is still $425 + per single employee monthly. That is not priced well, period. In my company we joke about TARP (troubled-asset recovering program) that the Fed Govt established to basically stabalize our country and bail out some banks. If what should happen to health insurance companies did (i.e. that $425 plan, sank to $250 where I think it belongs) we would then need HEART (HealthInsuranceCompany Eroded-Asset Reconfigured Trust) or something of that nature as they would have their claims reserves set up with a premium 50% lower let's say, and would all tank in a quarter. It is funny to say it so matter-of-factly, but I believe it in my bones. But some would say it SHOULD HAPPEN! Well, one thing is for sure, I do not what the government involved in health insurance, and believe for starters Medicare should be run privately...we have given the government plenty of time to bankrupt that system....so make that private, keep health insurance private, but do please blow up the profit machine, the current metrics, all of the waste with too many employees and too much paper (everything automated to some degree)...coming from a distrbution perspective (which I am) big deal, slam my commission (which is how I pay my mortgage, and not much more these days) and allow me to continue to help individuals and small companies as I love to do, and let's make it a day. We have already had our revenue hammered by more than 55%, which frankly has been fine with me. I am in business to help and in order to make the revenue work, it just means I need to help 55% more people every day than I used to for the same static money. Again, fine with me, as that means in the end I actually help MORE PEOPLE.
Sounds all great right? Well I am one of the honest guys in this business, but I am surrounded by dirtbacks and agregious big companies who want their executives to keep fat paychecks. So blow em up, keep the smaller/boutique businesses humming (the engine of the U.S.) as they should be and always should be. The big corporate interests and the government are the problem.
I could write 20,000 more words without a break, but these are my thoughts for the day, and I think a good brain dump.
Thursday, January 20, 2011
Republicans Push for Repeal of Obamacare
Well folks, here we go, round one....and you knew it was coming. At least we have free preventative visits annually for adults over 19 (males/females annual physicals) and females get their free OBGYN visits. In addition children's wellness including immunizations, also all FREE.
No lifetime limits on benefits, and no medical underwriting for children under 19. That part is already sealed and is good news. Now for the big problem, which is how to afford a system for healthcare with no medical underwriting especially for individuals and small businesses, how to get everyone in the country in to the system so we do not have adverse selection, and how to keep the system run privately rather than adding another big burden to our government who has proven they know how to crippled our finances and have long before Obama came along....just see Social Security and Medicare for a reference point. GOVERNMENT, stay out of our healthcare, and go away. You spend like drunken sailors.
So, we need to be able to buy insurance cross boarder from state-to-state from my perspective, and if North Carolina or Pennsylvania want to underwrite my family and me, have at it....we need MORE competition, and more carriers, and more price points, and more options, and need to be able to tell the doctor who wants to charge us 375 bucks for a 20 minute visit, "How does 175 sound. Dr. Smith next door charges that, went to Harvard, has a practice with great metrics that I have reviewed, and has no malpractice suits against him. How about you?"
We need to get here, and we will with more competition, with strong consumer-directed health plan models (been talking about them for almost 20 yrs now)...we are in the Healthcare DIP (see Seth Godin on that one)...and have been for years. We are going to outlast the DIP in my business model, that I know. The benefactors are going to be those of us that have built organizations around assuming we will have a much more efficient model one day everywhere, but are currently already doing it.
These are the most exciting times of my career. My peers for the most part, all consume themselves with worry, or bury their heads in the sand. That will get us nowhere.......
No lifetime limits on benefits, and no medical underwriting for children under 19. That part is already sealed and is good news. Now for the big problem, which is how to afford a system for healthcare with no medical underwriting especially for individuals and small businesses, how to get everyone in the country in to the system so we do not have adverse selection, and how to keep the system run privately rather than adding another big burden to our government who has proven they know how to crippled our finances and have long before Obama came along....just see Social Security and Medicare for a reference point. GOVERNMENT, stay out of our healthcare, and go away. You spend like drunken sailors.
So, we need to be able to buy insurance cross boarder from state-to-state from my perspective, and if North Carolina or Pennsylvania want to underwrite my family and me, have at it....we need MORE competition, and more carriers, and more price points, and more options, and need to be able to tell the doctor who wants to charge us 375 bucks for a 20 minute visit, "How does 175 sound. Dr. Smith next door charges that, went to Harvard, has a practice with great metrics that I have reviewed, and has no malpractice suits against him. How about you?"
We need to get here, and we will with more competition, with strong consumer-directed health plan models (been talking about them for almost 20 yrs now)...we are in the Healthcare DIP (see Seth Godin on that one)...and have been for years. We are going to outlast the DIP in my business model, that I know. The benefactors are going to be those of us that have built organizations around assuming we will have a much more efficient model one day everywhere, but are currently already doing it.
These are the most exciting times of my career. My peers for the most part, all consume themselves with worry, or bury their heads in the sand. That will get us nowhere.......
Monday, January 10, 2011
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.
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.
Monday, October 25, 2010
Will Major Medical with a Wrap-around Plan make a Comeback?
I think about this all the time...the way it was prior to managed care and it's invasion into the U.S. system (which has both good and bad elements by the way)and what was easy about it.....deductible, then coinsurance (you 10, 20, 30, 40% after deductible) and coverage for big stuff like hospital, surgery (in and outpatient) major rehabilitative therapy etc.... running to the doctor for a cold, was billed directly to the consumer...that is where the "wraps" came in to place, to cover other stuff like doc visits.
So a layman would say, wouldn't it help if the doctor-visit part of health insurance system were pushed directly to the consumer, wouldn't we save money? Short answer is yes, but we need to incentivize folks to go for annual check-ups, preventative visits, OB/GYN for women etc...so they do not end up in the ER with a $50,000 claim. Education and communication especially between employer's and employees is essential for workers to start becoming more health conscious and proactive about their ongoing illnesses etc...
I happen to think it would not all be bad if we pushed all of the major illness (hospital et al) to health insurance carriers to cover, as they know how to do it effectively, and create an opportunity for more competition in the market for "wrap around" plans to come back...buy exactly what we want, and to cover what we want (like car insurance per say) and have the price be commensurate with what we purchase.
High-deductible health plans are taking a better foothold now with the economic crash of the last 2 years, and they will surely continue to gain marketshare. Will we see the professional services (doc visits other than preventative) style benefits be pushed back to the consumer? If insurance carriers did that, and decreased their bureaucratic staff numbers by 30-40%, we would have no speaking of health insurance problems in the U.S. Thinned out insurance carriers, and unbiased advisors (brokers and consultants) have been working well in financial services and specifically in stock brokerage, life insurance brokerage, etc...so why not in health insurance?
Call a bureaucratic health insurance carrier and try to get a right answer first shot, no way. It is not to say they are all this way, but certainly, there is room to dramatically reduce overhead of internal staff (salaries, bonuses, commissions, employee benefits, worker's compensation, 401k matches, defined benefit plans, long-term disabilities) and push the work to outside brokerages (1099 the commissions they earn and you're done).....food for thought.
So a layman would say, wouldn't it help if the doctor-visit part of health insurance system were pushed directly to the consumer, wouldn't we save money? Short answer is yes, but we need to incentivize folks to go for annual check-ups, preventative visits, OB/GYN for women etc...so they do not end up in the ER with a $50,000 claim. Education and communication especially between employer's and employees is essential for workers to start becoming more health conscious and proactive about their ongoing illnesses etc...
I happen to think it would not all be bad if we pushed all of the major illness (hospital et al) to health insurance carriers to cover, as they know how to do it effectively, and create an opportunity for more competition in the market for "wrap around" plans to come back...buy exactly what we want, and to cover what we want (like car insurance per say) and have the price be commensurate with what we purchase.
High-deductible health plans are taking a better foothold now with the economic crash of the last 2 years, and they will surely continue to gain marketshare. Will we see the professional services (doc visits other than preventative) style benefits be pushed back to the consumer? If insurance carriers did that, and decreased their bureaucratic staff numbers by 30-40%, we would have no speaking of health insurance problems in the U.S. Thinned out insurance carriers, and unbiased advisors (brokers and consultants) have been working well in financial services and specifically in stock brokerage, life insurance brokerage, etc...so why not in health insurance?
Call a bureaucratic health insurance carrier and try to get a right answer first shot, no way. It is not to say they are all this way, but certainly, there is room to dramatically reduce overhead of internal staff (salaries, bonuses, commissions, employee benefits, worker's compensation, 401k matches, defined benefit plans, long-term disabilities) and push the work to outside brokerages (1099 the commissions they earn and you're done).....food for thought.
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