With the economy in shambles and millions of Americans losing their jobs - along with their health insurance - it seems this would be an appropriate time to panic. But there's a silver lining to every cloud, and it's possible that a jump in the number of uninsured could be a good thing. In fact, I believe it's exactly what this country needs. Let me explain...
For years, I've been saying that high-deductible health plans, which substitute a pre-tax savings account for the copayments that most people have grown to rely on, creates a problem for the health care consumer. And when consumers have a problem, the private market steps in and delivers a solution.
Of course, the speed with which the market responds is directly related to the opportunities they present, and while the rate of HSA adoption is encouraging this still isn't enough to attract most investors. But the number of people without health insurance - 47 million by most estimates - now that's enough get their attention.
Interestingly, the uninsured population encounters many of the same challenges as those with high-deductible health coverage - specifically, they must figure out how to pay for emergency care, doctor visits, lab tests and prescription drugs without the benefit of fixed-dollar copayments. And these are exactly the areas where we're beginning to see some solutions from the private market:
Urgent care centers: While the emergency room is an appropriate venue for very serious illnesses and injuries, many people insist on showing up at the ER because it's more convenient than waiting to see a doctor. As insurance companies have begun to wise up and remove the low-dollar copays for these high-dollar medical services, urgent care centers have emerged to meet people's need for care "right now." Most of these facilities are open evenings and weekends, usually don't require an appointment and many even offer online check-in. The best thing about them, though, is that they're much less expensive than an emergency room.
Retail clinics: As medicine continues to advance, many of the conditions people go to the doctor for now can be treated quickly and efficiently by a nurse practitioner or physician's assistant. Capitalizing on this, several pharmacies now incorporate clinics into their retail locations. They keep longer hours than most doctors, allow walk-ins and publish their prices.
Lab tests on demand: Lab tests are a quick, effective and affordable way to catch a number of medical conditions early. And, to make the process even less painful, there are now a number of diagnostic testing Web sites where consumers can learn about and purchase tests online, without a doctor's order. They then take the receipt to one of the thousands of national collection facilities the company contracts with, and, a few days later, log into the site to view their results. The process is convenient and confidential - the consumer determines what info - if any - he'd like to share with his physician.
Discounted generics: In 2006 Wal-Mart shocked the nation with the announcement that it would begin offering a 30-day supply of many generic and over-the-counter medications for $4. Now, consumers have saved more than a billion dollars, the list of covered medications has grown and many other national retailers followed suit.
First-dollar copayments are largely responsible for the mess we find ourselves in right now - they not only insulate consumers from the true cost of health care but also stifle innovation. But things are changing, and as more people find themselves without the copayments they know and love, they're looking for alternatives - and, they're finding them.
Of course, this is just the beginning. Over time, additional solutions will emerge and insurance will become less relevant for lower-cost medical procedures. And when this happens, more affordable, high-deductible, major medical insurance will become a viable option for the millions of Americans. If the government can simply resist the temptation to intervene and instead let the market do what it does best, eventually these problems will fix themselves.
Eric Johnson can be reached at 817-366-7536 or eric.johnson@agentallies.com.
From the June 2009 issue of Benefits Selling Magazine • Subscribe!
