In today's environment, people are hungry for integrity and appropriateness.  We use buzzwords like "transparency" for the demand for accountability.  This is reflected by a loss of trust brought about by inappropriate, sometimes erroneous, or even fraudulent billing practices paired with crippling pricing for health care.  And when we don't trust the bill, we demand a breakdown – accountability for why a bill is inappropriately high.

PricewaterhouseCooper's annual medical cost trend study predicts a rise of 4-10% in 2021.  Renal dialysis accounts for one of the most taxing health care costs on our nation's economy.  And with the crippling costs of dialysis, some anticipate an extension of the 33-month coordination of benefits period due to the heavy burden on our Medicare system.

One business-owner here in Meridian, Idaho shared with me that health care for his employees was his biggest expense, and with an expected 20% increase in premiums expected next year, he is at a loss for how to provide the benefits he needs for the employees he cares about.  Many of the employers I have talked with who have previously not considered self-funding are now open to learning about this option because the pain of staying in a fully-funded plan that they can't afford is overwhelming.