In this podcast, David Contorno and Emma Fox explore the US healthcare system and how it affects employers and patients. They discuss how insurance companies, brokers, hospitals, and drug companies all benefit from higher costs, and suggest that people should be aware of both sides of the equation and how it affects their pocketbook. To illustrate this, they share their experience of finding medical care in Venice, Italy, where they encountered a security guard at the doctor's office and were charged only €25 for a minor surgery that would have cost $300-$400 in the US. They encourage patients to take responsibility for their own healthcare decisions and research their options as much as they would research a car purchase.
Episode Outline:
(00:16:56) Healthcare Hangover
(00:00:00) Healthcare Hangover Cure
(00:04:28) Finding Medical Care in Venice
(00:08:40) Medical Care in Venice
(00:12:50) Health Care Costs
Quotes:
(00:00:40) Hope is not a strategy. They need to do something.
(00:19:47) People are losing their lives. They're losing their sanity, they're losing their homes, they're losing their security anytime that they have to engage with the US healthcare system.
(00:11:40) And I left feeling, like, so in disbelief, like that's how easy it could be. And I think probably the closest experience I've had to that here in the US. Is probably with direct primary care.
(00:15:56) But it doesn't have to be this way. I want everyone to know the reason it's this way is because every entity that employers and patients rely upon to manage the cost of health care benefits from health care costs going up, most brokers are paid commissions, so as the premium goes up, how much money they make goes up.
(00:07:22) I'm like, I don't even know how long this tick has been in there. I could have picked it up in England. Now we're in Italy, and I just knew that we needed to do something.
Blog Post:
Have you ever been in a situation where you needed medical care, but were unable to access it? David Contorno and Emma Fox, the hosts of the podcast "Healthcare Hangover", know this feeling all too well. In the podcast, they explore the US healthcare system and how it affects employers and patients.
The US healthcare system is a complex web of insurance companies, brokers, hospitals, and drug companies, all of which benefit financially from higher costs. David and Emma suggest that people should be aware of both sides of the equation and how it affects their pocketbook. To illustrate this, they share their own experience of finding medical care in Venice, Italy, where they encountered a security guard at the doctor's office and were charged only €25 for a minor surgery that would have cost $300-$400 in the US.
The hosts of Healthcare Hangover believe that employers need to demand better, not just ask, pray, or beg. The best time to come to brokers is the easiest renewal, when the increase is lower than expected. Insurance carriers make more money when costs go up, not down. Employers think something will change, but don't know who has convinced them of it.
It's important to understand that insurance companies are highly profitable and deliver shareholder profits almost like no other industry can. Insurance companies are making money and not paying out anywhere near what they're collecting. This means that patients can run the risk of something not being approved or covered by the insurance company and getting billed the full amount.
Employers who are self-funded may have stop loss insurance, but they are the ones paying for it. Legislation has been trying to fix the "surprise medical bill" issue of people being out of network and getting a much bigger bill. Most brokers are paid commissions, so as the premium goes up, how much money they make goes up. Carriers are held to the medical loss ratio provision of the Affordable Care Act, which means they can only retain 15% of premium for their overhead and profit.
Unfortunately, employers are struggling to keep up with their financial responsibility of the health plan, leading to degraded benefits, skipped bonuses, and degraded pay raises. Brokers, carriers, hospitals, and drug companies all benefit financially from health care costs going up. It's the doctors, patients, and employers who are literally footing the bill for the US healthcare system.
That's why it's so important for patients to take responsibility and research both the quality and cost of care they are about to receive. Employers are becoming more aware of what is happening behind the scenes in the healthcare system. Direct Primary Care is a movement that is gaining traction in the healthcare system. Patients should not trust healthcare providers blindly, as they have financial incentives to dish out care. Poor decisions made in the healthcare system can have long-term consequences on a patient's quality of life.
David and Emma's experience in Venice is a great example of how researching your healthcare options can save you money. They were discussing David's sensitive skin and allergies, which had caused him to develop hives. Emma noticed a small black speck on her leg near her ankle that looked like a dried circle of blood. Emma tried to brush and take off the speck, but it wouldn't come off. David, who had grown up in tick country, knew that the speck was likely a tick and that it should not be removed with fingers.
They tried to use their US travel insurance to find medical care, but the virtual care service did not recognize them. The insurance representative was unable to provide any help and eventually hung up on them. Everyone they asked suggested going to the hospital, but Emma refused. Emma and David used Google Maps to find a primary care doctor in Piazza San Marco and walked there. There was a security guard at the doctor's office.
The janitor they asked for help spoke a little English and directed them to a generic door with no sign. The doctor had gone out for lunch and came back to open the door for them. The doctor's office was clean and had a reception area, but no receptionist. Emma had a tick and the doctor was surprised as they are not common in Venice. The doctor charged €25 for the initial consultation. The doctor performed minor surgery to remove the tick and used a magnifying scope to make sure it was all out. The procedure took about 10-15 minutes and the doctor charged €25 for the whole visit. In the US, the same procedure would have cost between $300-$400.
At the end of the day, it's important to remember that insurance companies pay for the majority of the cost, but the premiums are paid by the employee. That's why it's so important for patients to take responsibility and research their healthcare options as much as they would research a car purchase. By taking the time to research and understand the system, you can save yourself a lot of money and headaches.
Episode Links
Connect with Emma Fox
Connect with David Contorno
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