By Brodie Stone - Co-Founder at Poppins Health
December 12, 2021, 09:00am EST
Over the past 50-plus years, new technology, life-changing drugs and many other advancements have dramatically improved the healthcare industry. Yet in this time, very little has changed for health insurance plans. In fact, they have gone in the opposite direction by becoming more complicated and more expensive.
There has been a lot of talk, and more recently, new regulation, directed at transparency and making it all easier. Yet no amount of talk, and certainly no amount of regulation, will make existing health insurance plans easier and better for the average American or for small businesses. The only way the experience in healthcare will improve is to fundamentally change how we navigate and pay for healthcare. And that is exactly what health insurance plans are supposed to do.
Then versus now
Forty years ago, health plans were exceptionally simple. People with health insurance had very low deductibles and premiums were a small percentage of total income. Modern technology was in its infancy and little data was available.
Over the years, a few key developments made health insurance plans increasingly complex:
The reality of today’s healthcare options
The healthcare industry has developed into a complicated mix of providers and insurance companies, and networks have transformed into a complex list of prices. Meanwhile, health insurers have manipulated the design of the plan in an attempt to lower premiums and help people cover out of pocket expenses and instead created an impossible math equation and a sea of acronyms. Taken together, today's most prevalent health plans are too complex for members to understand. Transparency, which has become an official buzzword of the healthcare industry, is meaningless.
For many of us, convenience reigns supreme when choosing where to get care. However, in certain pockets of the country, especially among large companies, change is happening. Networks and health insurance plans are being redesigned using technology to make information more accessible. These plans can seamlessly tell you how much you need to spend out of your checking account to get care. They spend more for preventive and behavioral health while lowering total cost, and relentlessly help their members avoid the (few) providers that are not delivering positive outcomes to patients.
At the end of the day, this is what a health insurance plan should do. The average American will spend over $7,500 and the average family of four will spend over $22,000 this year on health insurance before taking into account out of pocket expenses. We don’t ask for much in exchange. We must start asking for more.
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