The current attitudes about healthcare policy in the United States, commonly expressed by political pundits and the media, may not tell the real story of what is happening in the healthcare benefits industry. These groups often paint a picture of a broken healthcare system, where employees are being left to pay increasing costs for substandard healthcare throughout the United States. According to many in the media, insurance companies and insurance advisers are the villains who stand to profit from our country of aging Baby Boomers and overweight Gen-Xers.

American healthcare is portrayed as a zero-sum game, with clear winners and losers. Rather than looking at success stories in the industry, naysayers choose to focus on the blunders of the past decade.

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“American healthcare is portrayed as a zero-sum game, with clear winners and losers.”

But the data on which these political pundits and journalists are basing their dismal view of the healthcare industry is outdated. They’re using information that’s several years old and doesn’t give a complete picture of the industry.

However, this new, more relevant data is available. I know, because I frequently use it to advise employers about their healthcare options. Here’s one example that isn’t uncommon in today’s environment: Upon initial benefit plan review, one large company’s plan averaged a 23.5% increase over six years. By the time we reached final plan review, the increase averaged just 3.56%, resulting in a total savings of $3,844,846.82. That’s more than one year’s medical premium.

[Image credit: Bloomberg]
[Image credit: Bloomberg]

When the media reports incorrect data and paints an ugly picture of the current healthcare climate, they participate in a cycle of misinformation. Media leaders and university experts influence decisions being made in Washington more than the actual employers and consumers who could — and should — command access and heavily influence pricing. These so-called experts are reporting and teaching a heavily-slanted view of the healthcare system, when what is actually happening in the market remains a mystery to many people.

In addition to outdated data and misinformation, the way that insurance advisers and insurance companies work together hasn’t be told truthfully.

In reality, insurance carriers and advisers are driving a process that is critical to the successful management of a healthcare plan. We’re working on the front lines to help our employer-clients solve problems and comply with new laws as they’re implemented. We’re constantly looking at current data to inform and advise our clients.

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“Insurance carriers and advisers are driving a process that is critical to the successful management of a healthcare plan.”

The perception of healthcare right now is that, through all of these changes, it’s shrinking or stagnant. However, over the last 25 years, the market has cycled through periods of growth. Currently, the industry is actually expanding and maturing to meet the new, unique market demands.

Through this period of growth, following the implementation of the Affordable Care Act, the big insurance companies have earned record profits. But these companies have also taken on an unprecedented amount of risk. Healthcare is getting increasingly costly for employers, who are then placing some of that burden on employees. This was inevitable when the ACA was enacted. However, at the same time, employers are increasingly aware of the benefits of helping their employees to be healthy; there is much work to be done, but it’s headed in the right direction.

To move forward as a country with the ACA in place, we need to be more mindful of what’s being fed to us. That starts with education.

Employers need to work closely with their insurance advisers to understand the big picture of healthcare reform and the how it relates to their specific company. They should become responsible for understanding the details of their health plan, the risks and the legislative changes that will continue to take place over the next several years.

Employers then need to help their employees understand the costs associated with their healthcare and help them make informed decisions.

The “us versus them” mentality that has pervaded our healthcare conversation must stop before we can move forward. Employers can no longer wait and see what happens, reacting to healthcare changes instead of being proactive. They must instead develop a sharp focus on education to make informed decisions.

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Robert Stumper

Robert Stumper

Robert Stumper is a senior managing consultant with Corporate Synergies.