As Scott Brown considers the future of U.S. health care and insurance, he thinks something is going to have to give because the current situation is not sustainable. He is already seeing clients who are moving in directions that are more radical and drastic than what he has seen in the past.
Some are abandoning insurance companies.
Some are using multiple plans to reimburse providers.
Since Medicare data is public, one approach has been to negotiate with hospitals about a payment plan for non-Medicare clients that is better than Medicare but lower than the current rate for uninsured patients. For example, if Medicare would pay $1,000, the offered price might be $1,500. The hospital then has the option of saying yes or no.
Phil Brown Insurance acts as the intermediary between the vendors and the hospitals in order to create and operate a workable program. The fact that hospitals can choose not to accept the suggested prices for services is a problem, but negotiating provides new ways to deal with a difficult problem. Keeping things easy for the client often involves paying more money; controlling costs requires doing something that might be harder.
Although Scott Brown does not think the U.S. will implement Medicare for all, the future is still a big unknown. The ACA has already caused major changes in health care. The outcome of court challenges could have a major impact going forward, and so will the influence of the other branches of government. The only thing that is certain is that costs are going to continue to rise as hospitals invest in new technologies and new drugs. How those technologies and drugs get paid for will be determined by the political landscape. The options currently are going through a carrier or being self-insured, but if prices continue to rise then there has to come a point at which neither of those options will work anymore.
At this point, pharmacy costs are growing more than medical costs. Researchers have been able to accomplish amazing things, such as finding a drug cure for diseases such as Hepatitis C — a disease that has not had a cure until now. Someone can take a pill for four months and be cured at the end of that time. But the $90,000 price tag is a significant barrier to access. Treatment for rare diseases can cost more than a million dollars. As Scott said, “How can we pay for something everyone wants that is expensive? People will want that care or coverage somehow.”
Phil Brown Insurance is doing its part to create solutions through a team approach. Every client has an account manager. One person may focus on administration and another person may focus on account services, but they are cross-trained so that if a client needs to talk to someone and the usual person is out, someone else can help. Small clients don’t need the same support as large ones, but Phil Brown Insurance can handle both sizes with the same personal approach.