Health insurance isn’t complicated. People are.

There is a perception that health insurance is complicated, when in fact when you break it down it’s actually pretty simple. The people in the insurance industry have made it complicated for everyone – employers, employees, providers, and users.

Does anyone feel in control of their healthcare costs?

  • Employer premiums are rising far faster than inflation
  • Costs seem impossible to control
  • There’s no data to make good decisions
  • Appears overwhelmingly complex
  • After a bad year costs increase and after a good year, costs stay the same or increase

This leads to the “Healthcare Paradox” – IT IS WHAT IT IS.

Despite health care often being the second largest expense after payroll for many employers, it receives little scrutiny, while much smaller expenses are closely managed.

Here is the formula to simplicity:

  • Get rid of the “bundled” insurance company approach and instead “unbundle.”
  • Eliminate the PPO network and instead let people receive care where ever they want and where they can receive the highest quality of care.
  • Self-insure the small claims and only insure the large ones
  • Obtain a quality Health Plan Administrator
  • Ditch the big Pharmacy Benefit Managers and instead get one that doesn’t take your money through spread pricing and rebates.
  • Create a plan design that doesn’t rob your employees of their take home pay.

It’s that simple – employer costs will go down so they can attract and retain employees, employees save money and get higher quality of care, providers don’t have to deal with the big behemoth insurance companies and get their money faster, and everyone is happy.

The problem is that those who could solve the healthcare problem for everyone – won’t! The insurance companies, the hospital industry, traditional brokers/consultants, and Big Pharma all want to keep the status quo because they all make too much money the way it is.

Did you know that medical bills are the number one reason for bankruptcy? If more employers would seek out alternatives to their current programs of health insurance and stop accepting increases in cost, and stop cost shifting to employees, health care and health insurance would be sustainable and affordable for all. 

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Frank Stichter