Unmasking the Realities of Healthcare: A Call for Integrity and Fairness

The illusion of security offered by traditional health insurance plans is becoming increasingly apparent in Human Resources offices nationwide.

Traditional health insurance plans often come with hidden costs, conflicts of interest, and a lack of transparency, leading to higher expenses and diminished benefits.

Our new documentary, "It's Not Personal, It's Just Healthcare," uncovers hidden truths and systemic challenges affecting employers and employees.

The Illusion of Security

Employers often face unjustified rate increases despite good plan performance and manageable medical needs. For example, a large benefits broker informed an employer of a 15% rate hike despite three years of favorable plan performance.

Have you had a similar experience?

This raises a critical question: why are costs rising when usage often isn't?

Integrity in Action

"My job is demonstrating integrity," my friend Al Lewis ???? recently commented. Shouldn't that be true for all of us?

This ethos drives our documentary.

The healthcare and health insurance industries are rife with conflicts of interest, often prioritizing profit over people.

This misalignment of incentives profoundly impacts major stakeholders—employers and employees alike—forcing them to bear the burden without having the tools to understand what that burden is.

The Unseen Costs

Transparent advisors often uncover startling facts about pharmacy and medical costs.

?One particularly striking case involves a patient in dire need of Keytruda, a life-saving drug. The hospital billed $75,000 for a treatment that costs only $6,000 wholesale. When the employer objected, the facility's response was chilling: “Then the patient will die.”

?(This was quickly resolved in favor of the employer and patient, by the way.)

This exorbitant markup is a stark example of the widespread price gouging and irrational pricing in healthcare. Patients are frequently confronted with a heart-wrenching choice between life-saving treatment and financial ruin, underscoring the desperate need for reform, even for those with supposedly 'excellent' health insurance.

Misaligned Incentives

Healthcare costs often rank as a business's second or third-largest expense, yet they are often overlooked as an area where costs can be controlled.

Many executive teams accept these increases as the norm, resulting in a lack of pay increases, 401k loans to pay medical bills, and often delayed or avoided care.

By understanding what drives costs and where costs should be controlled, employers can regain control and use their previously wasted dollars for, well, whatever they want.

Wendell Potter , a former insurance company executive, provides insight into the industry's practices, revealing how insurance companies mislead both employers and employees while prioritizing shareholder profits. The current system, characterized by unchecked price increases and lack of oversight, is unsustainable and detrimental to all parties involved.

Keith Smith , co-founder of the Surgery Center of Oklahoma, demonstrates the feasibility of providing high-quality care at a fraction of the cost. His facility charges significantly less than traditional hospitals, proving that transparent pricing and ethical practices can coexist with profitability. Not only does he have a line of patients at his front door, but he also has a line of surgeons wanting to operate at his facility because he pays his surgeons very well and very quickly, unlike traditional insurance.

Real-World Examples

Every client has at least one large project that could change the course of their business if they had the funds—a new piece of equipment, a new role their current budget doesn’t cover, or software that would improve business processes.

Some benefits-related achievements we can share include:

• Cutting employee contributions by 25%, holding that for five years, and counting.
• Reducing employee/child and family contributions by 20% and holding for three years.
• Lowering deductibles from $5k to $3k to $2k while keeping copays intact.
• Cutting deductibles from $4k to $2k.
• Adding Long-Term Disability.
• Offering 100% coverage for all medical services and prescriptions while reducing total premium costs by 2%.

The Call for Change

Chris Deacon, former administrator for the State of New Jersey's health plan, underscores the importance of aligning financial incentives.

True progress can be made when employers and vendors work towards better health outcomes at lower costs.

However, the current system rewards increased revenue and market share, often at the expense of health and affordability.

HR's Role in Driving Change

Human Resources professionals are uniquely positioned to advocate for these necessary changes.

Their role extends beyond administrative functions to champion the health and well-being of the workforce and the fiscal health and well-being of the organization.

By demanding transparency and accountability from healthcare vendors, employers can ensure better outcomes for each stakeholder.

Achieving the best outcomes requires a shift in approach. Employers can secure better healthcare outcomes and financial stability by demanding integrity, transparency, and accountability. Watch our documentary to join the movement for a fairer, more transparent healthcare system.

To learn about the full extent of these issues and explore actionable solutions, we invite you to watch "It's Not Personal, It's Just Healthcare."