AhAfter a year defined by record inflation and double-digit health care premium growth, years later we look back on 2023 as the year that ignited change in U.S. healthcare and led to a new system of the future. I hope you can. Proud of generations.
I will do everything in my power to make it happen.
When thinking about reinventing healthcare, we see two distinct issues that need to be addressed. And how can you remove cost barriers and put patients first?
advertisement
totally unsustainable
If you do the math, it’s easy to see that a reorganization of healthcare incentives in the US is inevitable.
of Average family premium From $6,348 in 2000, it ballooned to $21,342 by 2020, an average annual increase of 6.25%.of average wage $30,846 in 2000 will increase to $58,130 by 2020, an average annual increase of 3.22%. Put another way, US health insurance premiums are rising at almost twice the rate of wages.
advertisement
If nothing is done and health insurance premiums continue to rise, the average family premium will exceed $100,000 by 2046. If premiums and wages continue to rise at the same rate, average family premiums will exceed average wages in 2055. Just over 30, your family will need your full adult income to pay for health insurance. Imagine the stifling effect on the economy and the lives of Americans.
Reinventing long-term healthcare
I have a simple question for the leaders of all organizations in the healthcare industry. Are you serving the patient’s best interests? Naturally, everyone would say, “Of course!” But that’s not true unless the amount of money people have to pay for health care is part of how an organization thinks about the best interests of its patients.
Health care is out of reach for many Americans and medical debt is Main causes of personal bankruptcyMore initiatives should address this directly. Individuals can receive the best clinical care, but if the cost of that care is too high, there will still be people and families who are suffering.
As a healthcare entrepreneur, I wholeheartedly agree that healthcare organizations need to be profitable. But not at the expense of the patient’s financial ruin. A portion of one healthcare giant’s annual profits (chosen by a large insurance company or a pharmacy benefits manager) could write off most of the US medical debt.
As this finally comes to the fore, Americans and their employers will increasingly seek healthcare partners who are committed to their financial well-being. Companies that make it affordable and seamless will win the future of healthcare.
Reinventing for now
To refocus the healthcare industry on a fair cost of health care, employers and workers can immediately take several steps to bring costs down. As such solutions become more widely known and implemented, the tide of ever-increasing healthcare costs will begin to change.
Expand use of the Medical Benefits Navigator. To the surprise of many, the cost of treatment not an indication of qualityThe same surgery by the same surgeon can be expensive many times in a hospital rather than an ambulatory surgery center.People don’t realize they can pay $16,000 in one place and $4,000 in another with the same providerHow will they know this? Employers can provide Medical Benefits Navigator In addition to health benefits, employees can make cost-effective care decisions.
Make hospital financial assistance more readily available. We need non-profit hospitals They often offer free or discounted care based on income levels sufficient to reach the middle class. But these programs tend to lurk in the shadows. Those eligible for financial assistance are often unaware that these programs exist, do not apply, and are vulnerable to medical debt. Surprisingly, for hospitals, provide charity care than chasing bad debts. Those eligible for this assistance should not miss this opportunity.
Promote self-insurance business. In the past, self-insurance and self-financing only made sense for companies with over 1,000 employees. We are now at a tipping point where even a small business with 25 employees can pay their bills out-of-pocket, protect against risk with stop-loss insurance and cost containment programs, and realize savings for their organization and team. I switched his 87-person company, Goodroute, to his self-insured route on January 1, significantly reducing business and employee costs while improving benefits.
Accept sensible drug pricing. The high cost of drugs contributes to unaffordable health care. As new treatments enter the market with multi-million price tags, now is the time to rethink drug pricing and payment methods. companies should be reduced. There is an opportunity for a new generation of healthcare innovators to design a better way.
Let 2023 be the year of new ideas in healthcare. Although the industry is highly profitable, it cannot continue on its path. Things have to change. Those who see it now will have the honor and reward of creating a new system.
Michael Waterbury is CEO of Goodroot, a community of companies reinventing healthcare one system at a time. Goodroot companies are active in some of the spaces described in this essay.
First Opinion Newsletter: If you love reading opinion and perspective essays, get our weekly First Opinion Roundup delivered to your inbox every Sunday. SIGN UP HERE.
