One Man's Grief, is Another's Gain

I lost my Dad two years ago this month. November 12, 2022.

I've learned a lot about grief. I think it's one of the most unusual emotions.

You won't find it on the "How Are You Feeling Today" cartoon chart in a classroom.

Losing my Dad has made me a better employee benefits consultant and health insurance specialist...but more importantly, it's provided a deeply personal, emotional perspective on managing the balance of patient care and cost management.

I know most people hate these topics...but you subscribed to my newsletter...so here it goes!

A few valuable insights from the loss of my Dad.

BACKGROUND

My Dad was diagnosed with Multiple Myeloma in July of 2022. It was supposed to be pretty treatable, and initial prognosis suggested 10 to 15 years of life. He was health, active and 75 years old.

That's not what happened.

Within a few months, the cancer was more aggressive than expected and things started going sideways. By November of 2022, Dad was dealing with kidney failure and complications with his heart. All tracing back to his cancer and treatment.

His 10 to 15 years turned into 5 months. Gone.

It's taken months and years to sort through the experience, and try to find the light in the darkness.

LESSON #1

All doctors and hospitals are not equally equipped to treat you or your loved one.

My dad really liked his doctor. I met him. I understand why. However, his doctor was not trained in my Dad's specific form of cancer...multiple myeloma. We didn't know that at the time. Had the cancer responded "normally" to treatment, we would have never known the difference. When things got sideways his doc, the quarterback of his healthcare, was out of his lane.

If you or a loved one are dealing with a cancer diagnosis, be eyes wide open to the idea you may want an independent second or third opinion before choosing a provider and treatment plan.

RESOURCE #1 - In Ohio, Indiana and Kentucky we are fortunate to have free access to Cincinnati Cancer Advisors . This team of resources is designed to help patients and families navigate healthcare with a professional, independent view on best doctors and hospitals. They are incredible, and spent hours trying to help us get care back on track. I wish we had started with them at Dad's initial diagnosis.

RESOURCE #2 - For employers, you can make a similar resource available to your employees and their families through a program called Cancer Expert Now . We have now integrated this program into dozens of employer sponsored health plans. Employees can access many of the top oncologists in the country for free, independent reviews of the cancer condition and treatment plans. They will work with you, your family and your provider to fast-track patients to the right care.

LESSON #2

Cancer is the largest driver of large claims cost in the United States. Your health plan can be turned upside down if you don't have enough protection.

As a benefits broker/consultant, my job is to help employers offer a health plan that provides the best access to quality care at the most affordable cost to employees and the company.

I am a stalwart on the idea that a health plan's cost and performance is completely dependent on the impact of large claims. 2% of people spend 50% of the money on a health plan. In November of 2022, my Dad would have been a huge cost driver to his company's health plan.

You'll see in this stop loss study by Sun Life (https://sunlife.showpad.com/share/EccaYBykBh4AQ1ZCbmvAO) that the cost of large claims is increasing at a dramatic rate. The occurrence of $1M+ claims is growing at an alarming rate. As an employer with 2 to 1,000 employees; there often isn't enough premium/protection to cover this kind of liability. Last year, our office saw 18 claims over $1M and the largest at $3.4M .

The health insurance market is not kind to a health plan with large, ongoing claims at renewal time.

RESOURCE #1 - In parallel to this experience HUB Heartland HUB International launched a stop loss captive program called the Waymark Collective . The idea of Waymark is that mid-sized employers can buy stop loss contracts as a collective. These employers buy stop loss in larger volume AND share the cost of large, unexpected claims across the pool. Instead of being a $2M health plan with 200 employees; you're now an $80M health plan with 8,000 members. This tool provides insulation for the employer who is dealing with a complex healthcare situation.

RESOURCE #2 - Many times, individuals have access to a variety of health insurance options based on work status, family status and/or conditions. The employer plan is often the "easy" button because education and enrollment is made very simple. In my Dad's case, he was on Medicare. However, just a year earlier he was still actively working...and on a company health plan.

At 74 years old, he had options...elect his employer plan OR elect Medicare. The average worker, does what is easiest. At HUB, we believe patients with complex needs should have access to great resources and counsel on what types of programs and financial tools are available to relieve the strain of health care when the patient has the most need and is most vulnerable.

CLOSING

I hope my personal experience can change the outcome for someone on the other end of this newsletter.

Cancer sucks.

We are fortunate to have access to amazing tools and resources to steer care to the best doctors and hospitals as early as possible.

From there, as employers, we have the ability to "lean in" and help our most valuable people when they need it most.

Just as important, you can protect the rest of the population by protecting the health plan from catastrophic losses that increase the price for everyone.

Thanks all!

Dominic

513.907.9328