Real cost of health care

Did you get a $100,000 fine for a data breach?

Actually, what is a breach?

Almost every day the news carries a story about a company that has had a “Breach” of their security and PHI has been disclosed. There are so many of them that most go unreported now and only the really big ones get any attention. But what exactly is a breach anyway?

Technically it is “make a gap in and break through …”, so whales breach the surface, people regularly breach their contracts, and babies who come out bottom first, yikes, are “breach birth.” But those are not what the news is talking about!

Breach in the case of PHI and HPIAA (I will define those in a minute) means somebody did not protect the information they have on themselves and other people that they are legally responsible to care for.

So now you ask me “Then Bill a breach might not be just somebody getting into our computer?”

Move to the front chair, you caught the brass ring on that one! (Antique reference to Merry go Rounds for the younger readers)

Yes, a breach can be as simple as sending somebody your log in credentials in an open email. “Who would be watching my email, I’m no big deal?” The bad guys do not have to watch “your” email, they just run a bot that looks for email patterns that look like passwords.

In our case we tell employers every day we will provide a secure format to transmit information to us. They ignore that and then send us a census with every employee’s personal information, including all of their identifying data. By anybody’s definition that is a breach.

It discloses PHI – “PHI is any health information that can be tied to an individual..(Google)”

It violates HIPAA – “HIPAA is the acronym for the Health Insurance Portability and Accountability Act (Hipaastore.com)”

And that causes this “The penalties for noncompliance are based on the level of negligence and can range from $100 to $50,000 per violation (or per record)(Truevault.com)”

Life has truly become a regulatory minefield, but unlike abandoned war mines, there are maps for HIPAA and other legal mines. And this is where I again stress the importance of professionals in your life. Not every “Professional” is the same so you need to do your own due diligence but the stakes are high and violation costs can put you out of business so the search is worth the effort.

And, of course, you can always contact me and say “what was that thing you wrote about, I’m confused.”

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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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Do you really need to outrun the bear or just be self-insured?

Stop and take a breath because if the term “Self-Insurance” made you stop breathing, you need to relax and keep reading.

The purpose of this post is to introduce you to a concept, not to get real technical.  I will get technical in future messages.

There is an old joke that goes like this. Two guys are camping and one of them sees a bear coming into the camp. He begins to put on his running shoes. His buddy says “Why the shoes…you can’t outrun a bear?” The guy with the shoes says “I don’t need to outrun the bear I only need to outrun you!”

So, you might now be asking, how does that relate to being self-insured?

What if this year, your medical plan did not have a rate increase but all of your competitors saw 10% to 45%? That might be between $30 and $135 per month, per employee assuming an average cost of $300 per employee. Would that give you a competitive edge?

Read more…

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

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