Nice commentary, Katy. I met you while on the Board of a health sharing ministry.
You are so right in that insurance companies are not interested in saving you money. In fact, the higher the prices, the higher the premiums, and as long as employers are willing to pay those premiums, insurance companies are happy to see them go up. (Their commission is that much higher.)
The fact that this translates into lower wages is lost on the average worker. To them, “good insurance” pays for everything they might want. But this has led to employers only paying for the worker and leaving out their families.
Things are not getting better and ObamaCare made things worse by mandating that insurance cover every obvious lower price item that everyone should get instead of being reserved for the big ticket items we hopefully never will need.
It would be like asking homeowners insurance to cover leaky faucets when it should be there just in case the house burns down.
Appreciate this thoughtful response, David! I will gently push back on the idea that big corporations answerable to shareholders being involved as the primary driver of higher costs. We have many corporations that are publicly traded who deliver competitive prices in fierce markets to consumers in other industries. Even in the insurance business (think auto or home insurance). In fact, every industry is able to do this. Health care is different because anticompetitive behavior that is illegal is not enforced against. These companies are treated differently. The investment/pension industry was the same until the crash in 2007 and a bunch of laws were passed (namely the fiduciary rule in I believe 2009). Same law there - ERISA. The health side of the ERISA house is ripe for similar disruption now as the pension side was then. If all these companies had to act as prudent fiduciaries acting “solely in the interest of the pls beneficiaries” as the law requires we would see different behavior. This fiduciary movement has started. There is now legislation being proposed by the jumbo employers’ trade group to this end and it may get some legs. We’ll see! My proposals to deal with these behaviors are laid out in steps 3 and 4 of a plan proposed in the article that is part 2 of the one above. https://www.katytalento.com/p/dear-republicans-theres-still-time
Totally agree that the original sin was the ACA requirement for covering pre-existing conditions. And it was always there in the group market, provided there was continuity of coverage. That’s not insurance at all. But politically, that’s not going away. So enforcing against the anticompetitive behaviors now - especially in the carrier contracts with both providers and employers - would go a long way toward re-establishing some market workarounds.
Nice commentary, Katy. I met you while on the Board of a health sharing ministry.
You are so right in that insurance companies are not interested in saving you money. In fact, the higher the prices, the higher the premiums, and as long as employers are willing to pay those premiums, insurance companies are happy to see them go up. (Their commission is that much higher.)
The fact that this translates into lower wages is lost on the average worker. To them, “good insurance” pays for everything they might want. But this has led to employers only paying for the worker and leaving out their families.
Things are not getting better and ObamaCare made things worse by mandating that insurance cover every obvious lower price item that everyone should get instead of being reserved for the big ticket items we hopefully never will need.
It would be like asking homeowners insurance to cover leaky faucets when it should be there just in case the house burns down.
I look forward to your proposed solution.
Thanks so much Dr. Eck, I remember you of course! You've summed up the problem nicely! Praying that Congress finds some fortitude.
Appreciate this thoughtful response, David! I will gently push back on the idea that big corporations answerable to shareholders being involved as the primary driver of higher costs. We have many corporations that are publicly traded who deliver competitive prices in fierce markets to consumers in other industries. Even in the insurance business (think auto or home insurance). In fact, every industry is able to do this. Health care is different because anticompetitive behavior that is illegal is not enforced against. These companies are treated differently. The investment/pension industry was the same until the crash in 2007 and a bunch of laws were passed (namely the fiduciary rule in I believe 2009). Same law there - ERISA. The health side of the ERISA house is ripe for similar disruption now as the pension side was then. If all these companies had to act as prudent fiduciaries acting “solely in the interest of the pls beneficiaries” as the law requires we would see different behavior. This fiduciary movement has started. There is now legislation being proposed by the jumbo employers’ trade group to this end and it may get some legs. We’ll see! My proposals to deal with these behaviors are laid out in steps 3 and 4 of a plan proposed in the article that is part 2 of the one above. https://www.katytalento.com/p/dear-republicans-theres-still-time
Totally agree that the original sin was the ACA requirement for covering pre-existing conditions. And it was always there in the group market, provided there was continuity of coverage. That’s not insurance at all. But politically, that’s not going away. So enforcing against the anticompetitive behaviors now - especially in the carrier contracts with both providers and employers - would go a long way toward re-establishing some market workarounds.