Consumer Mindset: U.S. Healthcare's Kryptonite (and Salvation)
Consumerism, Open Enrollment / By Lance De Peralta / June 9, 2022
medASTUTE wants to help you become a smart healthcare consumer.
Why?
- Because you deserve great care at an affordable price.
- Because you deserve to be treated with dignity by our healthcare system.
- Because you deserve to be stress-free by not having to worry about your medical bills.
It all starts with mindset.
Whether you're an employer or employee, you need to stop thinking like a PATIENT and start behaving like a CONSUMER. After all, American healthcare is a business. Plain and simple. In fact, healthcare represents about 20% of our nation's economy - to the tune of $4 TRILLION! Guess who's helping to fund it? YOU!
First of all, your taxes finance government programs like Medicare and Medicaid.
Secondly, your premium and out-of-pocket dollars are the lifeblood of the U.S. healthcare system. Recently, I came across an article which revealed that the CEOs of 7 of the largest publicly-traded health insurance companies earned a staggering $283 million last year - more than at any time in the last 10 years. Some (if not all) of these companies should be familiar to you. In fact, you may have even purchased a product/service from them:
- Anthem
- Centene
- Cigna
- CVS
- Humana
- Molina Healthcare
- UnitedHealth Group
CVS - the drug chain?!? More like CVS the conglomerate. Ever heard of Aetna? It was once of the biggest health insurance companies in America. Today, it's a CVS subsidiary - "CVS Health" subsidiary to be precise - and has been since November 2018. If you're an Aetna member, then your pharmacy benefit (if your policy includes it) is most likely managed by CVS's other subsidiary - Caremark.
I'm sure you've heard of BlueCross/BlueShield. Matter of fact, if your insurance card has an image of a cross and/or shield - in the color blue - then you're a BlueCross/BlueShield member! Did you know that Blue Cross/Blue Shield is a franchise? You know what else is a franchise? McDonald's, Burger King, The UPS Store, Marriott - I could go on. Can you guess who the largest BC/BS franchisee is?
Anthem.
Back to the article.
As the chief executives of public companies, much of the $283 million they earned was from stock. With the exception of CVS (although it has rebounded in recent years), the insurers' stocks have performed well historically.
Introducing…
The $400+ per-share club
The $200+ per-share club
The under $100 per-share club
I'm all for rewarding performance.
However, I question the explanation provided by CVS: "…our leaders benefit when shareholders and a broader set of employees benefit.” This must be one of the most tone-deaf statements ever strung together.
(When asked to comment, none of the other insurers responded. Wise move.)
When shareholders benefit?!?
Oh right. Those institutional investors who control most of the insurers' outstanding shares - and their fates.
And a broader set of employees benefit?
Huh?!? Whose employees - theirs? CVS can't honestly be referring to the 163 million Americans covered by their employers' health plans who continue to watch their premiums and out-of-pocket costs rise year-after-year while their medical bills pile up, right? Those same people who happen to pay the insurers' salaries?
Have YOU been getting your money's worth?
I'm guessing you haven't. In fact, I would bet you're contributing a good portion of your income to our healthcare system:
While soaring stock prices were a contributing factor to the financial windfall, I would argue that these CEOs, along with their companies, are in these extraordinary positions of success because of people like you. Their very existence - and livelihood - depend on you. Remember, they're in the business of healthcare - selling insurance and other healthcare-related services. And for better or worse (mostly worse), you're paying the price (both literally and figuratively).
BUT YOU CAN DO SOMETHING ABOUT IT.
As I said in the beginning, it all starts with a consumer mindset. On the surface, this may seem overwhelming, but there are some things you can do now that will help you start to think and act like a healthcare consumer.
OPEN ENROLLMENT PREPARATION
Employers:
Employees:
- Mark your calendar!
- Understand cost-sharing
- Terminology
- Math
- Define your customer profile
- Needs and requirements
- Finances
- Terminology
- Math
- Needs and requirements
- Finances
COACHING
- Purchase Marshall Allen's amazing book "Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win." He provides a practical blueprint on healthcare consumerism for employers and employees alike. Many people have already benefited from the tactics and strategies Marshall lays out in the book. Click here for my review. Bottom line: for less than most copays you'll ever pay, it's worth the investment.
- Contact medASTUTE! With our help and decades of industry experience:
- Get timely and practical education about U.S. healthcare from industry "insiders."
- Learn key terms and concepts to manage out-of-pocket costs and improve health.
- Discover price and quality information to make better care decisions.
- Search for the best providers (quality) at a fair cost (price) for "shoppable" services (choice).
- Get timely and practical education about U.S. healthcare from industry "insiders."
- Learn key terms and concepts to manage out-of-pocket costs and improve health.
- Discover price and quality information to make better care decisions.
- Search for the best providers (quality) at a fair cost (price) for "shoppable" services (choice).
Mindset - develop and refine it and you'll be well on your way to becoming a better, more informed healthcare consumer. You owe this to yourself and your loved ones.
