I had a quick visit with Armstrong & Getty this morning to discuss the UHC CEO murder, America’s reaction thereto, why so much of the ire on this topic is off base, Obamacare’s medical loss ratio mandate, the Medicare cost shift, and some super simple advice on purchasing insurance products.
Since 2009, I’ve been on air with Jack and Joe well over 100 times. It's always an honor to be on their show.
Exorbitant Hospital Pricing in the U.S. Undermines Morale, Employee Compensation, and Employer Profits — It Must Stop
As the sun dipped below the horizon on a brisk spring evening, a young mother crouched behind home plate, catching for her daughter. Already showing signs of a future softball superstar, Gisele unleashed a wicked rising fastball. It clipped the edge of the glove and smashed into her mother’s face, cracking bone and pushing her nose sharply to the left.
In a display of savage tenacity, Mom wiped the blood away, grimly reset her nose with a crackling snap, and resumed her catching duties for the evening. Despite her efforts, the misshapen lump and the nose’s noticeable leftward slant gave her the hardened appearance of a seasoned mob enforcer.
Doctors told her she’d almost certainly require surgery but wanted to let the swelling subside and see how her breathing progressed before they intervened.
Months later, she couldn’t breathe through her left nostril;
she wanted her beak fixed. Luckily, she found herself on a Mahoney Group plan
backed with Reference-Based Pricing and Cash-Pay options at recognized centers
of excellence.
At 140% of Medicare, we will pay $7,811 for this surgery. If circumstances such as geography, timing, or specialized surgeons demand a higher price, we can negotiate. But that is seldom required. In this case, Gisele’s Mom is getting her nose fixed up for a voluntary cash price of $7,750.
Plus, since Mom agreed to use the cash-steerage option, her employer is paying 100% of the cost of the procedure and waving all deductibles and coinsurance.
And from now on, Mom’s going to wear a catcher’s mask.
This ain't yo grandpappy's RBP! Five different ways employers are installing RBP to save millions on healthcare costs.
All Economic Stakeholders in American Healthcare Are Incentivized by Perpetual Sickness – Except One
News of this began about a year ago, and it is now a reality: Employers have a massive new tool to control healthcare costs.
With over 15 years of teaching benefits and human resources at the university level, coupled with exclusive experience in working alongside C-Suite executives to implement and manage highly efficient benefit plans, I have a crucial piece of advice for any HR professional looking to be seen, appreciated, and impactful in their career.
The insurance industry is massive, powerful, and 100% designed to win every single time. Commissions on some items you buy are more than 50%. YOU DON'T NEED ALL OF THAT!
Rx Costs have increased 500% since 2000; kickbacks now account for one-third of all spending on pharmaceuticals. What is an employer to do?
What are health insurer overrides? What do they mean for employers and employees? How do you know where they are most likely to lurk?
I've uncovered a new nugget of insider intel on this one - insurance brokerages are turning the volume up to 11 on their insatiable longing for these hidden payments.
Today, with the greatest sense of professional pride I’ve ever had, I announce that I’ve come home to where I belong and where I will finish my career. I’ve been in benefits full-time for 22 years (32 years if you add part-time work after high school, during college, and in law school). Since 2002, I forged unimaginably rewarding and life-changing bonds with clients, teammates, and vendor partners.
Unfortunately,
also during that time, the underlying businesses housing my team’s efforts were
sold. Each time, this corporate
shuffling resulted in a larger, more bureaucratic, and an entity less aligned
with our values. Liberty Benefit sold to
BB&T, which then merged with Sun Trust to form Truist and rebrand and
reshape their hundreds of insurance agencies as McGriff.
Culturally,
philosophically, and at the deepest levels of intrinsic motivation, these
entities became further and further removed from my mission and purpose:
To provide businesses with the most cost-effective, innovative,
and high-quality employee benefit plans while simultaneously helping them
manage their risk and compliance and treating every dollar as though it is the
last an employee can afford to pay for care.
I wrote that
in 2004, and it has been my North Star ever since. Regrettably, often the larger an organization
grows, the further it removes itself from such a mission. Stock prices, shareholder demands, quarterly
growth, EBITA, and a pursuit of new sales at all costs are not conducive to
making sure each client continues to receive exactly what it needs – even if
they were last year’s sale.
So, after
watching changes that did not align with my business values take over and then
seeing private equity swoop in, 2023 became a year of endless introspection,
prayer, and discussion with my wife. Something had to change.
With a heart full of pride, energy, and vigor, I announce today that I am the newest member of the Mahoney Group, a privately held and employee-owned organization with no interest in Wall Street’s stock prices or private equity. As I restart my career at 50 years old, I am now brimming with joy.
I used to
think I wanted to retire between 50 and 55.
Now, I chuckle at that assessment. The kids are grown and on their own. My youthful exuberance to hunt, fish, bike,
and backpack is still there, but only as a hobby—not an all-consuming addiction.
No. I know
where I can make the biggest impact, and that is by providing businesses with
the most cost-effective, innovative, and high-quality employee benefit plans
while simultaneously helping them manage their risk and compliance and treating
every dollar as though it is the last one an employee can afford to pay for
care.
In so doing,
my new teammates at the Mahoney Group and I will fight doggedly to ensure you
are not being taken advantage of by a deeply flawed healthcare delivery
system.
On we
march!
Craig
Gottwals
I spent one morning this week chatting with Armstrong and Getty regarding the news that the federal government will finally begin negotiating the price of drugs. 10 of them. Two and a half years from now.
Well, it's a start...
Your health insurance costs and premiums have skyrocketed compared to the rate of inflation since Obamacare passed. Meanwhile, insurance carrier stock prices have grown by 1900% in the same timeframe.
"They're making unimaginable amounts of money... off of you." -Joe Getty
Craig Gottwals, aka "Craig the Healthcare Guru,” talks about that and more in a new episode of A&G's Extra Large Podcast.
Listen to the Armstrong & Getty Extra Large Podcasts featuring Craig.
Originally posted here.