EDITOR:
I appreciate and respect other industry professional's opinions; however, upon further review, I found myself obligated to respond to Mike Browne's "It's Out of Control." [May 2006]
The primary problem with Mike Browne's argument is that he offers no real solution to the problem other than a gap plan or mini med, which is the product he markets. If you examine the increased premium medical insurance companies offer, you will understand the direct correlation to the large increase in claim amounts per participant in the last 15 to 20 years.
The claim increase is due to several factors, in my opinion, and the opinion of most wellness experts: sedentary
lifestyle, non-favorable diets and habits. I do not discount that the "aging population," new technology and medical inflation have also contributed; however, the former three controllable variables are far more critical.
Therefore, the answer is to control it through enhancing the participant's level of health with a wellness program. I have personally seen this program be successful and have customers who have the same or lower costs for 2006 than 2001. This approach is not easy however, you can accomplish what most everybody desires: controlled health care costs.
Michael Fredericks
Group healthcare consultant
Gardner Insurance Services
Akron, Ohio
EDITOR:
I have a problem with your [May] edition, notably Mike Browne's seemingly uninformed diatribe on the health insurance industry. Browne's summary of work experience lists no history in the health insurance industry. If I may ask, why was he given a podium to speak on an issue such as health insurance?
His description of the problems employees have with group QHDHPs just illustrates his lack of knowledge in the field. Any broker who sells this kind of product knows the employee doesn't "negotiate with their doctors" for lower rates. Where did that come from? The doctors have already done their negotiating with the PPO networks.
Any broker who sells this product knows the premium savings to the employer, compared to traditional PPO options, is usually sufficient enough that the employer can redirect some funds to supplement the employee's HSA accounts. That directly lowers the employee's overall annual exposure.
Anyone who sells this product in Colorado knows most QHDHPs here cover all preventive services at 100 percent -- no copays or deductible.
I'm not naive enough to think the QHDHPs and HSAs are the silver bullet to cure our industries woes. QHDHPs shortcomings still need to be shored up but I believe there is a responsibility for you, as an industry-specific communications vehicle, to paint an accurate picture of what these products do for us. Even if you are just the messenger, is there not some need for you to ensure the message is accurate?
I won't touch Browne's comments on China's health insurance market or what a national health plan here might look like.What was the point he was trying to make? Those statements, I'm sure, didn't endear him to the broker community.
My suggestion would be for Browne to speak to what he knows. I'm sure he is excellent at selling mini-med plans and the like.
Lars Parkin, RHU
Agent/broker
Bliley Insurance Group
Boulder, Colo.
EDITOR:
I have been providing insurance products to my small business clients in New Jersey for more than 30 years.
It seems no matter what trade magazine I read, the story is the same: Health insurance rates are out of control
with no happy ending in sight.
As I read Mike Browne's [May] interview, it became apparent he has all but given up and is resigned to a
national health plan as a possible solution. Since I derive about half of my income from the sale of health
insurance...and my wife and children are used to living indoors and eating regularly...to me, that is not a viable
option. Besides, I don't believe it will solve the long-term problem.
In my opinion, all of the carriers providing group medical insurance in this country are missing the boat on the real problem. They don't have an effective way of educating their members about preventive ways of staying well. I'm not talking about partial reimbursement of a gym membership or discounts on supplements.
In ancient China, people of means had healers who were paid a monthly stipend to keep them well. When
someone in the family got sick, the fee stopped until that person was well again. That's what I call health
insurance. What we have is sick insurance that reacts to a condition after the fact instead of preventing it in the first place.
These companies need to launch a major educational campaign on what happens to your body when you're 20, 50 or more than 100 pounds overweight. How it leads to heart problems, or diabetes, or joint replacements, or a host of other maladies caused by this epidemic we call obesity. Show the obvious benefits of regular, moderate exercise and how it not only changes their lives, but the lives of their children, so they can finally break the cycle and prove obesity is not inherited. It doesn't take a rocket scientist to understand if you consume more calories than you burn, you're gonna get fat.
At 60 years young, I have the metabolism of a dead person. In an attempt to stay in some kind of shape other than that of a pear, I get up at 5-5:30am and spend 30 minutes on a rebounder for cardio, then another 15 minutes on resistance exercises almost every day. I promise you, most mornings I would rather remain snuggling with my wife of more than 35 years instead of jumping around and getting sweaty. My wife hates getting on the treadmill for 40 minutes most mornings...but she does it. It's all about choices.
Obesity is obviously just one cause of benefit utilization. I could go on about smoking, drinking to excess, eating the wrong foods, not managing stress effectively and so on. Clearly we could make a huge impact on medical costs by making the right diet and lifestyle choices.
John Garamendi, Insurance Commissioner of California, wrote last year in his publication "Priced Out Health Care in California," that "Nationwide, obesity costs the health care system an estimated $118 billion per year."
That's billion...with a b. Did you know, if you had a million dollars in a stack of $1,000 bills, it would be about seven inches tall. A billion dollars would be taller than the Washington Monument.
I do know this: something has to be done and I honestly don't think the answer is National Health Insurance. Until
the average American is willing to take a proactive approach to being accountable for their own health, a National plan or HSA accounts, or Associated Health Plans will be like putting a Band-Aid on a gunshot wound.
That's it. I'm done. Thank you.
Phil Gatti
Vice President
Protector Insurance
Brick, NJ
