Healthcare is big business and getting even bigger. I’m interested, since as a “boomer,” I will likely be up for lots of healthcare costs in the future. Luckily, I’m healthy at the moment and dealing with only minor health issues (knees hurt, cholesterol is problematic and such). Yet, despite reasonable planning, I know that a catastrophic medical problem for either me or my spouse could easily prove financially disastrous.
Medical facilities are the 34th most profitable industry in the country and health insurance companies are the 35th most profitable. I’m not sure where YOUR business is in that profitability measure, and you may be wildly profitable. Yet I’m not sure I can justify the cost of providing healthcare for employees in most small businesses. Healthcare premiums are up 130% since the year 2000. Many of the companies with which I work are severely challenged by the increase in the cost of healthcare and their employees keep looking at a reduction in spendable income since their portion of the healthcare for their families keeps increasing. So what are we going to do to solve this problem?
Well, I’m not sure I trust the federal government to get this right. When you look at the amount of lobbying money that is being spent by the healthcare industry to put politicians in their pocket, I’m not sure we citizens and small business owners will ever get any relief. Two things are becoming clear, we need to change the system and the industry is fighting the proposed changes – and that can’t be good for us.
Insurance and healthcare is largely invisible to us. If you get a statement from your insurance company and/or the hospital, it is very likely you will not be able to understand the documents. They are filled with codes and what I believe is language that can only be described as “purposeful obfuscation.” Possibly the only thing that is more obfuscating than those documents, or at least as difficult for lay persons to understand, is the “America’s Affordable Healthcare Act of 2009.” Have you read it? – - – Me either!
So what choice do we have? It seems to me we have to either go with the devil we know – Insurance Companies that are and will always want to be highly profitable, or the devil we also know – the government which has never really been in touch with small business, and I mean either party, it doesn’t matter, the Republicans are every bit as bad as the Democrats when it comes to business. In fact, the case can be made that based on GDP, business actually does better under Democratic administrations – look at the data before you jump in my in-basket.
I want to just throw up my hands and give up on this – it seems too complicated and too much work to really find out what’s for real. Instead, I will make the effort to find out as much as I reasonably can and still run my business. This much I know – we can’t let healthcare continue on the present path. Healthcare costs are rising so fast that they are threatening our economy. Fully one third of the costs are “waste.” Waste being defined as unnecessary tests, unnecessarily paying for patented drugs, etc. So I’m for change, I guess. It just remains to be determined how that change will manifest in our businesses and our economy.
What’s your thought? Do you really trust the healthcare industry? Do you trust the government more? Do you not trust them both, and if so, which is the lesser evil in your mind?
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I’m overwhelmed by the complexity of the problem but agree that this is an issue that must be addressed. I don’t trust the government but I trust the health care industry even less. I think the biggest danger with the government is ineptitude and apathy. But the biggest danger with industry is greed which is probably worse.
Our best hope is to look at some other countries which have healthcare systems that work better than ours and to learn from their examples. There are also studies which show that some communities and some clinics in this country provide much better healthcare at much lower cost than others. Again, we need to study and apply these lessons. The biggest obstacle to doing so are the vested interests with big bucks to spend lobbying our legislators. And ideologues who oppose some proposals on principle regardless of the merit.
Dave, I couldn’t agree more. It’s a complex issue made almost incomprehensible by Congress. While I am not a fan of the insurance industry, I would rather deal with them than a government bureaucrat if there is a problem with coverage or reimbursement.
It seems disingenuous to talk about cost reduction (for both medical care and insurance premiums) without any discussion of tort reform, or “real” competition between insurance companies by allowing them to compete across state lines.
As a cancer survivor I am extremely sensitive to this issue. Seventeen years ago I had employer provided insurance and did not have any problems with coverage for treatment. I found out later that my doctor fought with the insurance company for months to cover a very expensive drug that had just come off of clinical trials. He was ultimately successful and I never knew it was happening at the time. Can you imagine having that fight with the government?
This year I was finally able to get my own insurance, and went with a high deductible HSA account to keep my premiums low. Now I hear that Congress may be changing and/or eliminating this type of policy. We shall see (I’m trying not to get too excited about this stuff until we can see a final bill).
Bottom line, I think that when the government gets involved to the extent that Congress is propsing, they make matters worse. They clearly do not understand the concept of unintended consequences!
Thanks for the post.
Barri Carian
Dave, you’ve tapped into a hot topic, and one of interest to any small business owner. The cost per person for healthcare (even with a big deductible) is now well over $1000/person/month, or about $12k per year. That’s a huge expense ! Many of my clients have opted to just supply an HSA account, take out a “catastrophic” insurance policy to pay any huge medical bills and then just have their employees pay on a “per visit” call to a clinic, a doctor, or a dentist (subsidized through the employer-matched HSA account). There are many doctors and clinics in SoCal that are offering very attractive “per visit” rates ($40 per visit, $30 for a generic prescription, $25 for lab tests etc). By my calculation, unless the employee catchs something very serious or gets in an accident, this plan would work. You could even go to the doctor EVERY SINGLE MONTH and still save money over a PPO or HMO.
Best,