I am trying to figure out why we spend so many countless employer hours educating and becoming educated on health pans and employee benefits packages. I am talking about a serious amount of time that is spent away from production and instead is filled with broker and employer meetings regarding the renewal, mid- year claims review, the multiple employee education meetings, retaining a trained staff at the employer's office to handle plan and human resources administration and the list goes on and on.
What is the answer? The only answer that is fair and balanced is the introduction of insurance model based on individual needs that are determined outside of business hours. We purchase our auto and home insurance through local insurance agents but yet we are tied to employers to manage are healthcare. One business or municipality in a specific city may have a fantastic benefits package paying 100% of the employee rate and 50% of the dependent rate. And if I am lucky enough to be an employee there I can participate and have great access to healthcare at a rate that is significantly lower than the national average. My counterpart across the way may work at another company in town and they provide benefits but only pay 50% of the employee rate and the plan is catastrophic coverage at best. What happens if my employer changes the plan next year and all of a sudden I have to pay more in terms of premiums and cost sharing? There is no control, nor consistency in this approach. Nor any relationship to the health plan, other than an employer agreement. In this scenario, we are not connected to the cost of the premiums or to the decision making process.
Let's take back control and know more before we purchase. We need to consider an independent model, where citizens can purchase health insurance through local independent or captive agents Agents are able to offer a multitude of various carriers and plans. Under the current employer model we are bound by one plan, the one the employer has chosen for us. (And what if the employer made a foolish personal or business decision and the business goes belly up, then I've just lost the plan that my dependents and I were counting on and COBRA won't apply because there is no longer a plan in force) This is what I mean when I say we need to take back control and end the reliance on the employer based model.
No Connection to the Cost of Healthcare Services. Only at the dentist and at the doctor's office is when I pay for the services once I have "left the building". There is absolutely no connection between the cost of the services and utilization. Consumers need greater access to medical claims cost prior to the office visit instead of the standard "gotcha" billing approach that we are currently susceptible to. For example, when I buy other goods as a US consumer I know at purchasing time what the item will cost. {i.e. one gallon of milk ($3.79)} When I go to the doctor's office they send me and/or my insurance carrier a bill after the services are rendered. Why did I go to this specific doctor, well because this is one of the providers in the health plan that my employer offers. I would much rather prefer more access to consumer data like what will that lab work cost me, how much is the MRI at facility A vs. facility B? We need a re-education process on how to purchase health plans and after we purchase them we need to further educate ourselves and ask relevant questions regarding how much we will have to pay for services once they are rendered.
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