Health care exchanges

Are you smarter than congress about health care cost?

This might seem obvious but to properly address an issue you must first understand the problem you are trying to fix. Well clearly our legislators, the media pundits, and most of the clamoring public seem to be ignoring the need for understanding the problem in discussions of Health Care cost and how to pay for it.

So let’s just dive right into the healthcare “cost” issue.

Why is it important – This goes way beyond partisan bickering and protecting political turf. Which also is why it cannot be corrected with hurried and poorly prepared legislation.
This is about you with your injured child – “Do you have insurance? How will you pay for this?”
This is about you losing everything because you – had a heart attack – lost your job – lost your insurance and now face $200,000 in medical bills you cannot pay.
This is about a national cost item that cannot be paid for in any governmental scheme that does not include care restriction and increased taxation. Yes – if you consider unlimited health care a basic right for everybody, that is true!

Language – words matter and if you don’t understand the language, you not only cannot fix the problem you may inadvertently make it worse. We all must differentiate between “Health Care cost” and “Health Insurance.” They are related but not the same:
A. Healthcare cost – this is the actual cost of medical treatment and related services. This exists if you have insurance or not. This is what nobody can afford to pay, and WHY you need insurance.
B. Healthcare insurance – this is a funding mechanism designed to “pool” risk and spread the cost. This is how we collect a relatively small amount of money from healthy people to pay the bills for somebody who needs care. This is how we as a society pay for all those healthcare costs.
C. Access to “Healthcare” – This is the ability for a person to get a healthcare professional to treat them. Everybody has basic access to general healthcare and emergency services. What you might not have is enough money or “Insurance” to pay for your treatment.

So the next time your hear somebody say “Healthcare is just too expensive we have to beat up the insurance companies”, quietly know that they are uninformed.

Economics. There is at least one un-refutable truth in economics. Money coming in must be bigger than money going out. Even governments cannot live forever if debt exceeds revenue. Eventually even government runs out of your money and your ability to create more GDP.

The problem – So the problem is the “Cost” of healthcare. How do we address that?
First it is critical we all stop blaming and finger pointing, we need to talk and agree on a few things.

Try this approach – you do not get to complain unless you have thought about it and bring forward an idea to solve the problem. You don’t have to be right the first time, but you do have to be part of the solution and not just some anonymous internet loudmouth complaining.

Start here:
Problem    National Health Care cost ___________________________________________________________________________

Solution    My idea to provide care and pay for it ___________________________________________________________________

To paraphrase a credit card company – what’s in your mind? How would you approach this problem?

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ACA (Affordable Care Act) changing again – Are you prepared?

Trying to keep up with the changes to the ACA legislation and then interpret direction really requires a large staff of dedicated masochists. I have neither a large staff nor do I enjoy abuse which makes it all the more difficult for me.

I decided to look into the bill that the president signed on Monday. I thought I might just list the index titles and then discuss what actual changes there were.

Well Duh – It turns out there are actually very few “changes”. What really occurs is a delay in implementation. The phrase that jumps out at you is “..amended by striking ‘‘April 1, 2014’’ and inserting ‘‘April 1, 2015’’ each place it appears.” That phrase, or some version of it, appears repeatedly in the bill.

I am not commenting here on whether or not these are good changes, and in truth most people would not take issue with most of it. However, as with most legislation it is dangerous to look at the title and assume it has anything to do with what’s going on in the bill. In this case the bill is titled: “To amend the Social Security Act to extend Medicare payments to physicians and other provisions of the Medicare and Medicaid programs, and for other purposes.”

Read more…

For more information, call Bill Weaver, Focus Benefits Group, 602-381-9900.

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Is this real love or are you just happy to see me?

One of our initial questions for a new client is “Will you be looking for real insurance or the appearance of insurance?”

Silly question you might say because who actually wants the “appearance” of insurance? Actually more times than you might expect a client may respond “I really just need to show I got coverage.”

  • Wellness programs – some employers just want to say they did it?
  • Job requirement – contractors sometimes just need to check a box on a bid form saying they have a coverage.
  • Car insurance – using personal auto coverage for a commercial vehicle.

There are more examples but I think you get the idea.

The typical reason for taking the “appearance” approach is to save premium dollars for a coverage or benefit the client sees no real need for, and that they do not ever expect to use for a claim. “There was this box on a form asking if I have that coverage so I just said yes to get the work!” I would tell you that is just asking to waste insurance money and set yourself up for disaster.

It is important to understand that insurance is a contract to accept risk not a product like your car tires or new cell phone. Under the contract the insurance company agrees to do specific things if a “covered” event (risk) occurs. Risks that have not been included are not covered and it really only matters when the claim is for more that you could ever hope to pay for.

When you purchase the “appearance of insurance” you typically get a contract that is much cheaper but also has been severely limited to achieve that lower cost. That does not mean these policies may not have value it only means you need realize the restrictions and then not be surprised when an event is not covered.

For more information, contact Bill Weaver, Focus Benefits Group, 602-381-9900

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