My prescription for healthcare in 2019

Like many others in my line of work, I have found a higher calling in what I do as an employee benefits specialist. This is a result of actually delivering results for employers in lowering healthcare costs for their companies and their employees. It is very rewarding to create and witness change so employees can retain more of their paychecks rather than spend them on overinflated healthcare costs.

For many years I bought the argument that healthcare facilities costs were high because of the free medical care they provided to indigents and the uninsured. Boy was I mislead.

Now I know it is often because healthcare facilities are greedy and inefficient and somehow feel a “right” to behave in a way that is the antithesis of competitive business in America.

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A blood pressure monitor stands in the diagnostic imaging area at the Hong Kong Integrated Oncology Centre in Hong Kong, China, on Tuesday, Nov. 3, 2015. Equipped with biopsy facilities, body scanners, and quiet 'VIP' chemotherapy rooms, the Hong Kong Integrated Oncology Centre is the first of a string of such facilities that TE Asia Healthcare Partners, a portfolio company funded by TPG Capital, is planning in Asia. Photographer: Xaume Olleros/Bloomberg

Much of U.S. healthcare has failed American companies and workers in order to pad their own pockets (and profits) despite the fact they receive huge tax breaks as a result of their “nonprofit” status.

The role of being an advocate for employers and employees to help them hold onto more of their hard earned dollars (rather than spend them on healthcare) has motivated me. I am driven to achieve more knowing my work can have such a positive impact on the lives of many.

So my list of “wants” is as follows:

1. I want to witness a large nonprofit hospital facilities group take the lead in providing a written transparency agreement prior to service for patient that outlines the comprehensive plan of treatment and costs to be billed. That agreement also should include a provision that if the surgery results or services rendered don’t meet the needs of the patient, they will not be charged additional amounts to remedy the situation.
2. If such an agreement cannot be achieved voluntarily let’s take a big step as a society to disallow “facility fees” from hospitals which can pad the bills 20% or more and make it illegal to charge the patient more than the actual cost of items such as aspirin, tissues and toothbrushes provided to them in their rooms.
3. Let’s propose a national bill that makes retention of a hospital’s “nonprofit” status contingent upon them billing no more than 170% of Medicare with no facility fees allowed.
4. Let’s create incentives for more Direct Primary Care practices by allowing employees to use their Health Savings Account funds to pay for monthly DPC subscriptions.
5. Create incentives for employees to consider Shared Medical Funding plans by making them tax deductible under a Section 125 plan.
6. Let’s make “functional medicine” that emphasizes diet and nutrition and supplementation to stay well as the cornerstone of medicine we receive. This would reduce the need for hospital beds and high amounts of cancer treatment and treatment of heart disease and diabetes. It also would require our benefit plans cover much more diagnostic testing and nutritional supplements customized to maximize health and disease avoidance.

The problems behind the high cost of healthcare for the American worker will not be solved without education of employers and disruption of the status quo. This seems to me to be one of the worthier causes for the new year.

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