LAS VEGAS -- Several times a year, the industry faithful gather to shake hands, exchange business cards and trade expensive dinners. And while every trade show features its share of new product debuts, merger announcements and iPod giveaways, no one talks about the pale pachyderm squatting in the middle of the exhibit hall.
And when someone does, it's usually met with a firestorm of denials and political name-calling. It happened right here in the pages of this magazine a couple of months ago, when Mike Browne pointed out that "Prices are out of control." Never mind that he's in the business of selling mini medical plans. Just talking about health care earned the wrath of at least half a dozen readers.
So when the agenda for this year's Benefits Marketing Mania revealed California Insurance Commissioner John Garamendi would be the keynote speaker, this editor's expectations spiked. And not just because Garamendi's running for lieutenant governor of California.
It didn't take the commissioner/candidate long to get started. Less than five minutes in, he dropped his message: Health care is a national security issue. And, just like that, the elephant took center stage.
"The more we spend -- as a society -- on insuring our sick, the fewer we actually cover," Garamendi told the speechless crowd.
But what about that wave of consumer-driven products?
"If you're healthy and wealthy, [HSAs] are a great product," he offered dryly.
So, what does the future hold? How will the industry deal with escalating health care costs and declining coverage?
"Probably as poorly as we have over the past 60 years," Garamendi said, "patching it together until it breaks down completely."
The recent sale of HCA -- the country's largest hospital chain -- to a group of investment bankers bears this out. Most analysts agree costs will climb for diminished services. Just another case of health care defying the traditional economic model.
And while Garamendi hinted at a "universal model," the commissioner stopped short of dropping the two dirtiest words in insurance: single payer.
But the fundamental question at the heart of the exchange lay untouched in the corner with the leftover chocolate pistachio cake: What is the role of the state regulator? Does he serve as the industry ombudsman -- beating back overreaching federal regulators and whiney consumers? Or does she fight as the champion of the people -- policing greedy corporate giants?
The answer, of course, is perched somewhere in between. The regulator's job is a more precarious balancing act than most.
Whether you agree with the commissioner's comments, this issue is getting harder to ignore. And do any of us really want them to decide this without us?
From the September 2006 issue of Benefits Selling Magazine • Subscribe!
