American life has been upended by the coronavirus. From the way we work and educate to the way we shop and socialize.
American resilience is on full display, and as our states move to reopen, we have an opportunity to innovate in a sector that is more important than ever: healthcare.
But to fully realize this opportunity, we must have the courage to break with structures that have gone unchallenged for generations, including our healthcare system and the health insurance model that governs how care is paid for and delivered. Both are subpar, but few people ever question if the problem could be insurance itself.
The good news is that alternative models like direct-to-provider arrangements with employers, healthcare sharing ministries and cash pay programs have been quietly growing across the country. This growth has exposed that Americans are fed-up with the insurance industry’s control over healthcare costs and care. Policy makers can and should look to these alternative models and resolve to learn from them.
The crux of nearly all of the problems with our healthcare system — price-gouging, surprise billing, deadly medical errors, high-cost overtreatment and inexcusable undertreatment, fractured health records that don’t transfer between doctors or hospitals, stifled innovation — comes down to the misaligned financial incentives in our payment process.
Health insurance companies and their secret pricing contracts with corporate hospital systems have written all the rules and stacked the deck against patients.
Patients are merely the currency traded back and forth in byzantine negotiations between these sellers of healthcare. This national embarrassment has been exposed like never before over the last few months as COVID-19 has ravaged our healthcare infrastructure.
But add alternatives to health insurance companies into the mix (yes, it’s possible), and the experience of many changes: patients’ health becomes the goal; doctors are liberated from the billing bureaucracy that causes so much burnout; and those who pay most of the bills — employers and the government — have more tools to measure, manage and reward priority outcomes, which are healthier and happier people, at lower cost.
This vision may sound utopian, but millions of Americans are living this reality today.
For example, healthcare sharing ministries — a type of cost-sharing organization that serves Judeo-Christian communities — have been successfully realigning these incentives and operating on a different paradigm for decades.
Healthcare sharing ministries along direct primary care (DPC) and medical bidding sites, are a part of the revolution to demand upfront prices, fair cash payments and negotiations for medical bills. Recent polling shows that nearly 90 percent of Americans believe all healthcare prices should be disclosed.
Americans shouldn’t have to be blindsided by unexpected medical bills.
The reality is, when insurance industry middlemen are bypassed, Americans can enter into honest and accountable relationships with their doctors and hospitals, with prices known in advance — prices that are almost always lower than the insurance-negotiated “discounts.”
It’s time to break up the health insurance monopoly and give Americans better options.
Legislation mandating price transparency and prohibiting surprise billing in healthcare is an essential starting point. Our elected leaders can also end tax discrimination against alternatives to insurance by opening up health savings accounts to healthcare sharing ministries, DPC and other innovative solutions.
Just as the cord-cutting revolution allowed consumers to escape their tone-deaf cable companies, innovative alternatives to health insurance can empower patients to demand more personalized healthcare at a lower cost.
We are at a crossroads: health policy experts in Washington can choose to tinker within the confines of the status quo, or we can seize the opportunity to fuel the competition that puts patients in the driver’s seat.