Sometimes the longer we do something the more we become entrenched in the ideas, processes, solutions and paradigms we’ve created and espoused for years. It occurred to me during a conversation with a client, I too, had fallen into the trap. I still catch myself referring to a client’s health care funding strategies as health insurance. Although, based on the definition above, that is quite the misnomer. If there is one thing that is certain, it is that medical claims begin to incur the very moment any funding plan / policy / contract, goes into place.
With this understanding, it becomes clear that the portion of funding going towards real insurance is actually fairly small. If a particular employer has 1.5M in known exposer, i.e. known diseases, known surgeries, know pharmacy spend etc., that is not insurance. We are now looking for the most cost efficient way to pay known expenses. In the past, we have relied on the insurance carriers to pay those expenses. However creative and nontraditional thought is changing that paradigm. Question – do you as a business owner, in areas other than healthcare engage an outside third party, profit motivated entity, to pay your known obligations? Answer – I doubt it.
Suffice it to say, the traditional approaches are being questioned. Employers and consultants are looking for more efficient ways to pay for healthcare. Many of those ways include returning to the purchase of actual Healthcare not Health Insurance. Finding ways to put the provider and the payer together rather than keeping them separated as the current model does. There has never been a better time to ask the questions why and why not. If you have questions, let me know!
Upsetting the Apple Cart 