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Employers Are Ready To Innovate Their Health Plans. Insurers Don’t Care.


Private health insurers know that someday the inevitable will happen—a significant number of people will refuse or be unable to pay the high health insurance premiums the industry has shamelessly extracted for decades. Insurers also know that all of their “cost-saving” efforts over the years were simply stalling tactics, temporary appeasements to employers (payers) to make them feel like they had some control over their multi-million dollar health plans. Insurers were so confident in their relationships with employers that they even took the name “payers” for themselves. However, lately, large employers have questioned their partnerships with insurers and are taking steps to improve the health care experience for their employees and decrease their health plan budgets. But get this; they’re keeping their private health insurance plans.

Large Employers Are Tinkering With Their Health Plans And Calling It Innovation

If you read about health care even occasionally, you know about the new company, Haven. A venture created by the heads of Amazon, Berkshire Hathaway, and JPMorgan Chase. Large companies that got together to create a health insurance company with the goal of lowering health insurance and health care costs for their employees. The health insurance status quo said, have at it. Private health insurers know better than most what’s required to make health care more affordable—medical care price controls and health care trade-offs. Insurers have perfected the art of managing health care trade-offs—most benefit plan documents contain pages of excluded health care benefits. And since employers aren’t talking about price controls, with the exception of
reference based pricing, which is technically a form of price controls but with numbers that are easy to manipulate, insurers aren’t that pressed about this new wave of employer health care “innovation.”


Still, we don’t know what “innovations” to expect from
Haven, but based on what I’ve read so far, it involves technology. And Haven’s not the first group of large, wealthy employers exploring how technology can help control health care costs. According to a very informative article in Benefits News, before Haven, there was The Employer Health Innovation Roundtable (EHIR), “a grassroots group made up of nearly 60 of the country’s biggest employers that represent nearly 8 million employees.” This group includes mega companies such as Apple, Target, and Google. Basically, representatives from EHIR watch presentations from health care tech start-ups and decide if they want to pilot the “benefit” at one of their companies and report back its findings to the large group via case study or some other format. Continue Reading...

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We Should Not Reward Large Employers For Making Health Insurance More Expensive And Less Accessible For All


We expect private health insurers to be anti Medicare For All (M4A). Criticizing M4A proposals is just time and money to them, and they have plenty of both. They have no desire to reduce the cost and complexity of health insurance or health care. Besides, you can’t solve a problem that you do not think exists. Attacking something without coming up with a better solution is easy and unfair, but even these tactics would not work for private health insurers without the support of their major corporate clients. So why do major corporations back the health care status quo, and why do we reward corporations that don’t support affordable health care for all?

It’s A Bro Thing, A Control Thing, And A Money Thing

It was just over one year ago that
Amazon, Berkshire Hathaway, and JPMorgan Chase announced their joint health care venture. The three business giants said they were combining forces to “provide low-cost, high quality service from a (health care) company ‘free from profit-making incentives and constraints.” But soon after the announcement one of the Big 3, JPMorgan Chase CEO, Jamie Dimon, promised not to compete with private health insurers and would instead restrict the new venture’s efforts to helping the employees of the three companies. We know why Jamie tried to walk back his threat to upend private health insurance—some of his company’s clients are in the health care industry—but why do other major companies support the industry, and do not publicly support Medicare For All?

I can think of a few reasons.

Despite
surveys showing that health care costs are a major concern of all private companies, large companies seem to prefer private health insurance to a government-run or universal system. No major corporation has cut all ties with the health insurance status quo. Instead, corporations work with major health insurers to support each other's profits and shareholder returns at the expense of the country. Also, many leaders of “American industry” believe that they know more about health insurance and health care than health care policy analysts, government officials, and economists. They think the private sector is just generally better at running any business even if it has public policy implications. Continue Reading...

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