CURRENT FLAWS IN HEALTHCARE ANSWERED BY HEALTHSHARING
By Dale Bellis, Executive Vice President and Spokesman
Before Liberty HealthShare, I administered healthcare for more than two decades, including self-funded employer plans. Over the years, I observed fundamental flaws in the way we pay for healthcare.
THE FIRST BIG FLAW
Reliance on a third party pay system to manage and pay for healthcare costs is our biggest flaw. That payment model has grown up here in the U.S. since World War II. Healthcare payment systems have become more and more complex. Numerous other parties have been wedged between the doctor and patient: brokers, insurance bureaucracies, pharmacy benefit managers, managed care consultants, billing reviewers, and multiple other consultants, all intent on helping the third party company conserve their resources and manage their costs.
Who is left out of this equation? The healthcare consumer. You and I, the patient.
The problems compound when that third party pays our medical costs from their own funds. It’s their money at stake. Not ours. When my medical costs are paid from someone else’s pocket, at least two problems occur.
TWO BIG PROBLEMS OCCUR WHEN SOMEONE ELSE PAYS THE BILL
First, I lose significant freedom over my healthcare choices. When the money to pay my medical costs comes from someone else’s pocket, I give up a great deal of independence over the care of my health. Medi-crats make decisions about my health as to what's permitted.
Second, I don't know the true costs. If someone else is paying the bill, and I neither see a bill nor know the costs, I have no incentives to control those costs. It's somebody else's money after all. In this scenario, all I care about is what I pay out of my pocket. So long as I pay my part, it’s now up to someone else to pay the rest. I have no incentive to be a cost control partner. This system breeds a mentality of entitlement. “Take care of me”, is my primary thought.
That's why healthcare costs are skyrocketing. Medical costs increase to the level permissible only to the third party payers because the individual consumer is not a stakeholder in the costs. I predict we will continue to see skyrocketing costs if the third party pay system persists as the dominant payment paradigm.
THE SECOND BIG FLAW
You and I pay a fee for the doctor or hospital to care for my sickness. It's how doctors and hospitals are compensated. It's called fee for service.
Sound good? Right? Wrong!
The focus is not on my health, but on my sickness. The tendency of this entire economic system is to focus on illness and disease, not prevention, wellness, and the improvement of health. We've got a sick care system, not a health care system! The system incentives doctors, particularly, to focus attention on a disease or illness.
Doctors are frequently constrained by time or administrative demand from assisting their patients to improve their health. The prevention of disease, or a focus on maintaining health, is not a part of that encounter. It's all about treating illness. Sadly, that's an upside-down paradigm if we're really interested in the care of our health. We need relationships with our health care providers that fosters increased health. A payment model that incentivizes the care of sickness, not health, must fundamentally change.
My critique is not about the doctors themselves, who overwhelmingly want to make a difference in patient’s lives. My critique is about a woefully inadequate economic healthcare model.
THE CONTRAST IS HUGE!
The difference between health care sharing and third party pay is stark and real.
It’s our money at stake. When we seek care, we are free from bureaucratic intrusion. Our money isn’t used for expenses that would violate our conscience, and because it is our money and the money of our fellow members at stake, we seek care at the most advisable price, trimming costs and price shopping. We’ve got skin in the game! You and I break the cultural mold of over-consumption of healthcare because our money and the money of fellow members pay for our health cost decisions. That’s the answer to cost controls in healthcare!
We are health focused. We share the essential value that our bodies are temples. We have a moral and spiritual obligation to care for this physical body created by God. The follow-on impulse of that is to be health conscious, health aware, and to engage in lifestyle choices that promote health and wellness. With this in mind, I urge you to find a primary care doctor that becomes a partner and cheerleader in your pursuit of good health.
That’s why healthcare sharing is such a viable answer to these flaws in our healthcare world today. You’re in the right place! Congratulations!