Friday, January 13, 2017

Fixing our Healthcare Crisis

My good friend, John Koziol, recently wrote a post about Obamacare and that it sucks. I am also a believer that Obamacare sucks and I agree with his assessment that all it did was raise the “count” of how many people are covered by insurance. It forced people to purchase insurance that basically covers catastrophic events. These are people who couldn’t afford insurance in the first place, and now they are doling out money for a plan that still doesn’t address their basic health care needs. Most are no better off, and many are much worse.

For many of us that already had insurance, Obamacare significantly raised our insurance rates. In my situation, my health insurance premiums went from paying $1,000 a month $1,700 a month. Folks, that’s MY portion, after my employer paid their portion!! When your health insurance premiums are more than your mortgage, something is wrong!! Because of that increase, I had to make the tough decision to find a new job that provided health insurance at a more reasonable rate.  

Obamacare simply forced people to purchase insurance. It did not address the REAL issue, which in my opinion, is the exorbitant cost of medical care. In fact, forcing people to purchase insurance only exacerbates the problem. Over time, the system has become broken and people aren’t recognizing why that happened. This is my take on it …

Employers began providing health insurance to employees, which everyone loved. Unions, such as auto workers and teachers, demanded the cream of the crop insurance plans which costs the employees very little or nothing because the employer paid for it. As more and more people were covered by insurance, they disregarded the cost of medical care because it didn’t come out of their pocket. People literally had no idea how much their employer was paying for their health insurance. In addition, people literally had no idea how much the insurance company was paying for their doctor visit, or MRI, child birth, or surgery. They didn’t care about any of this because it didn’t come out of their pocket. They simply had a $10 copay and that’s all that mattered to them.

All this fed into the medical industry being able to raise their prices, again and again and again, without the majority of people realizing it. The insurance companies were paying the bill, not the average person. So of course, with expenses rising, insurance companies increased their rates. You can’t blame the insurance companies because that’s a no-brainer; If your expenses increase, you have to increase your income .. Duh! And because employers were paying the increased insurance premiums, the people still didn’t pay attention.

Finally, businesses had enough and started making the employees chip in more for their health insurance. And deductibles increased. And copays increased. And that’s when people started to complain. But they’re just complaining at the employers and insurance companies, not the medical industry. And the people certainly aren’t recognizing how their “doesn’t matter to me what it costs” attitude created this mess.

I believe one of the keys to fixing the system is transparency and equality. Providers should have a price sheet that lists the cost of each of their services. And the cost is the same for everyone no matter who their insurance company is or whether the patient is paying cash out of pocket. No more charging different rates depending on who is paying the bill. The provider’s price sheet should be available to anyone who asks. Right now you can’t get that. Try asking your provider how much they will charge for a particular service. Most of the time you won’t get an answer. And even if you do get an answer, often the actual charge ends up more.

My current insurance company recently implemented a feature that addresses some of these issues. They have an app that I can load on my phone. If I need a major service, such as an MRI, I can search the app for approved providers near me. But it doesn’t just stop at that. Some of the providers are indicated as “preferred” providers because their costs are less than others. If I chose one of these “preferred” providers for the MRI, the insurance company rewards me with a rebate check of $50, $100, or whatever is appropriate for that service. I believe that’s a step in the right direction by educating the people and allowing them to make wiser decisions. Stop and think about that for a minute. If the insurance company is paying me $100 for choosing provider A over provider B, it probably means they are saving way more than $100 for that service. That should open your eyes to the disparity of the cost charged by different providers.

I believe another key to fixing the system is contribution. People need to have skin in the game. What I mean is that people should have to pay a portion of the insurance premium, and a portion of the services (copays, co-insurance, or a combination). Free does not work. If it’s free, people will abuse it. When it’s free, people are irresponsible and go to the E.R. for a runny nose. When it’s free, people don’t care what the costs are, which contributed to our current situation.

I believe a combination of the above factors (transparency, equality, and contribution) work together to fix the system. When people have skin in the game, they begin to care about the costs. And when people can shop around and compare costs for a particular service, providers will be forced to become more competitive. As the cost of services are brought back down to reasonable rates, the cost of insurance premiums will go down accordingly. It's a win-win.

As many of you know, I have battled the healthcare and insurance industries for years. I hate them. I despise them. Simply put, the system is broken. It's time we fix it. I pray that the incoming administration -- Democrat, Republican, Black, White, Male, and Female -- will all work together and fix it.