Group Health Insurance healthcare cost transparency, how can we get it

When people crow about how the Affordable Care Act, #ACA, did such great things by “reforming” healthcare in America, I have to laugh.  This was not #HealthReform, it was Insurance Reform.  Believe me, I am no fan of the insurance companies, at all.  Being an Independent Insurance Broker means we don’t work for any insurance company.  Honestly, I’m not impressed with any of them, but they are a necessary evil.  Insurance reform was fine…..really.  Everyone should have access to affordable healthcare, how can anyone dispute that.  As I see it, the problem with the ACA is that it did not do anything to control the COST of healthcare.  You can reform Health Insurance companies all day long, but if a day in the hospital is $5000 and going up, we’ve done nothing to address the healthcare costs.

Until you control the cost of healthcare, the cost of insurance will continue to rise

Yes, controlling the cost of prescription drugs is a good start, but it does not go far enough.  That is only one issue associated with the problem.  How about straight up fraud.  How about providers billing and coding incorrectly.  How about the lack of transparency in the cost of procedures….and the list goes on.  Until we figure out a way to rein in the pricetag for a hospital stay, office visit, outpatient procedure, we will continue to have this problem.  When popular medical groups can dictate pricing to insurance companies, that’s a problem.  The insurance companies just pass on the cost to their Group Health Insurance members.  Networks are getting smaller and smaller, especially in metropolitan areas of CA, because the insurance carriers cannot pay to be in all of the networks like years ago.

Transparency studies have been done…with shocking results

There have been countless studies done where the same procedure was billed out at very different rates, depending on where it was done.  Typically, in the northern regions of CA, procedure “A” will cost about 15-30% less than if you go to a more central or southern region of CA.  Providers in the same county can bill out a procedure at much different rates, sometimes as much as 60% less.  When you ask them why, no one seems to know, or can give you a plausible answer.  If there was a way to somehow “advertise” the procedure rates, for specific services, you would not only have transparency, but competition, which would most certainly drive down pricing.

Brauer Insurance is an Independent Insurance Agency focusing on Group Benefits for companies with under 100 employees.  Call us  (877) 421-4325

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