Most bankruptcies are caused by medical debt. As benefit advisers, we can change financial outcomes

Bankruptcy? What the heck is bankruptcy?

That’s what was going through my mind when my parents sat me down at 17 years old and told me they had just filed for bankruptcy because my dad’s medical bills were too much to handle. 

“But, you both have jobs. You both have health insurance. How could this happen?”

As a teenager, I was so confused. My parents both had jobs and health insurance. How could this happen? My mind was reeling: What am I going to tell my friends? What about baseball camp? summer? What about a limo for prom?

Looking back on it, all of that was trivial. I can’t even imagine how ashamed, embarrassed and broken-hearted my parents were that day to have to tell me, fully admitting financial defeat.

In an  article I wrote for EBN in April, I explained that a single drug called Revlimid was the cause of my parents’ financial woes. My father had multiple myeloma, cancer of the bone marrow, and this was the drug doctors gave him to keep it at bay. My parents were financially ruined trying to keep him alive. 

Read more:How data can bring clarity to health plan management

Their experience is not unique. We all know that choosing between medication and food is a reality for far too many Americans. Knowing what I know now, most of these painful scenarios can be avoided.

There are manufacturer/patient assistance programs (commonly referred to as MAPs or PAPs) available to prevent some of these harsh financial outcomes. Today, Revlimid has one for which a significant number of Americans would qualify. 

For example, one drug’s MAP has the following criteria:

1. You must be a U.S. citizen.
   
2. You cannot be on another government-sponsored health program (i.e., Medicare or Medicaid).
   
3. A family of four can make almost $150,000 annually.

Advisers, I ask you: How many of the health plan members of your clients would qualify for that program? 
Tools like these are available to employees if their employer has a self-insured health plan that is using transparency as its core. These types of programs are amazing for employees and the employer sponsoring the health plan, but they take money away from the “status quo” players like major insurance companies and their pharmacy benefit manager partners. 

Read more: Taking on J-codes: How to navigate this drug category to save money and improve patient care

Which brings us to the point of this piece: Be proud. Do more. Impact lives. 

If you answer the question, “What do you do for a living?” with “I sell insurance…” you are selling your potential and impact short. 

These programs, and others like it, can be a significant key to your new job title: Impactor of Lives.

All it takes is advisers to stand up against a broken system and guide employers to a method that not only will improve their bottom line, but also allow them to make a massive positive shift in the quality and cost of healthcare. We as advisers can help employers decrease costs, improve quality of care, reduce copays and deductibles, and make prescription drugs more accessible and affordable. 

The road is right in front of you — but only if you change your mindset and explore options outside the traditional insurance plans you have accepted as your go-to solutions.

Ask yourself these questions:

1. Do I have the ability to reduce health plan costs for my clients? What have the past three years of cost looked like for my clients?
   
2. Do I build health insurance plans that help employees and their families navigate the healthcare system to get to the best quality?
   
3. Would I stay with my personal financial adviser if he/she lost me the same amount of money year after year as the results I am bringing to my clients?  

If you answered “no” to these questions, why do you do what you do? 
If we continue doing things the same way, we are admitting defeat. We are admitting that we can’t do better. We are putting employees and their families in both health and financial risk, and we are limiting the impact employers can make on the world. Let’s take the pain and suffering my family and thousands of others face every year (67% of bankruptcies annually due to healthcare debt) out of the equation. 

Read more: For clients, benefit advisers can double as superheroes

Employers taking back control of their healthcare benefits spend is paramount and only you can do that for them and their employees. It may be a harder sell to propose a new solution, but in doing so, everyone wins. You get to love your job again because you know you are advising (selling) for a plan that is not going to cause an employee to spend thousands on premiums for a plan that makes them spend $5,000 to $10,000 in deductibles before they get any coverage on a large illness or procedure, which opens the door to financial ruin. 

You are saving your clients hundreds of thousands, even millions, every year preventing premium increases. You are also empowering them all to be more informed and have greater choices in their healthcare. Employees are happier, healthier and less at risk, employers have a significant competitive advantage in acquiring and keeping talent, and you are the hero — an impactor of lives.