The Time Has Come to Rethink Health Insurance

| HealthSharing

The Time Has Come to Rethink Health Insurance

 

The U.S. healthcare risk environment can be summed up as a devolutionary process that has made health insurance both illogical and unaffordable. Medical practices have spent years marking up a range of services. While the true cost of an EKG is pennies on the dollar, for example, many charge up to 10 times that amount to generate more revenue, while layers of added complexity continue to cripple billing.

What we need to do is address the underlying problem, which is the way the system is structured, and not cover it up with Band-Aids. Considering that health insurance is ranked the second most important factor of employment after wages across all age groups, employers are missing an opportunity to attract and retain talent with better benefits in a challenging labor market.

 

In bringing a health plan to groups of 20 or 1,000 employees, benefit brokers and advisers understand that as many as one-third to two-thirds of those covered lives aren’t even going to be able to participate. The reason could be that it’s something they can’t afford or don’t view it as a benefit. As we always say, a benefit not taken is a benefit not provided.

So we need to pick a price point where employees and their dependents will be able to sign up for that benefit. Let’s start at $5 a month for a full-time employee, which is just three cents an hour for a benefit that’s meaningful, and let individuals and families then decide how much they want to build on top of that to finance their routine or urgent care.

 

Until – and unless – we can, A) actually manage the price point, and B), return control of this product to the consumer, we will always have a disengaged audience. For producers, the altruistic side of this mission is providing a great benefit at an affordable price. On a base level, restructuring health insurance to significantly increase plan enrollment will help stem revenue losses. Would you rather be paid $20 on 50% of the workforce or $10 on 100% of the workforce? We can all agree that the latter scenario is a much higher calling to pursue on behalf of employer clients.

Jawad Arshad, M.D., is CEO of WoW Health Solutions, LLC and Eric Silverman is founder and owner of Voluntary Disruption.

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