“Please, Almighty Being, would you help a few healthcare executives find the strength to unleash me from the bondage of the small group insurance marketplace? And, could we have this filed as complete by 2021? Thanks. Err… Amen?!?”
Yep. You read my ask correctly. I am a small business owner who would love nothing more than to be just a source of financing for our employees to buy their own health insurance. I don’t think I’m alone. You see, I want our employees to choose for themselves. I don’t have this authoritarian belief that I should hold the power to decide what’s best for our team. We all have different needs. We are at different ages. We each engage with the system—when both healthy and sick—differently.
We live in a time where goods travel around the world at ever-faster speeds. There are consumer retail organizations using their data to customize solutions that I don’t even know exist, yet.
But… we live in a world where a middle-aged woman, when changing jobs, has to worry about if her diabetic specialist is covered. Or, how much will her insulin cost? That’s crazy to me. Where we work should have nothing to do with the quality of healthcare we receive. Instead, if you told me it should be based on where we live, then I would bite. And, I would help you build it.
I want solutions that attach to each employee. We don’t need my business to hold that contract. If insurers really want to step up their product innovation game—before those big, household name retailers figure it out—they should want to establish personal relationships with each of our employees. Just don’t do it through me. I have enough to do to meet payroll and to help this business thrive today and tomorrow.
As an employer, I am all-in on taking responsibility for helping each member of our team with their health responsibilities. At least to a point. I’d prefer my areas of focus to be as a financial resource in the name of health… and, as a productivity motivator.
And, it’s not just me. To quote one of our employees, his stated preference is to get me out the way.
“I don’t need my employer making this decision, just help me have the means to buy the insurance I want.”
There is this industry belief that employees want their employers to make these decisions. That is just simply not true. Take for example ICRHA: a model that launched this year which allows employers to reimburse employees for premium and/or qualified medical expenses through a Health Reimbursement Account. If the market conditions are right, small employers (like m4) are going to jump at this as a means to reduce the “pain in the ass” factor of maintaining health benefits.
I have to hold back my gag reflex every time our group policies come up for renewal. The process is archaic, and this is despite untold gazillions of dollars that have gone into technologies to supposedly make all of this easier. Some of our insurer friends always think one of my fellow small business owners is trying to screw them. The fraud processes are there for a reason, I know. Group risk pools only want those that are “legit” to join them. Usually, this is because they offer a better value over other options.
But… maybe these dollars—and these complex administrative processes—are solving the wrong issues? If we maintain a viable individual market with adverse selection protections, we should be okay. As an employer, I am begging you, Almighty Being, to spur the types of innovations and regulatory protections that allow for me to get my ass out of the middle.
Take care of m4’s employees. They are really important to this business. But… for your sake and mine, please quit allowing them to be used as leverage. I know I need to be able to recruit, and I will. Thankfully, there are still a lot of people out there that want to be part of the dream of building something special. I imagine there are a few people reading this sitting at a corporate desk that just might be the next to branch out and do something awesome.
Still, it’s always going to be difficult for me to compete against the biggest employers. That deck is already stacked against me. You shouldn’t want me worried about that. I grew up being told that American exceptionalism—via our economy—is driven by the creativity that is unleashed via the entrepreneurial, small group business “idealist.” Let the big companies play their game the way they want. I have no beef with them. I just want to go a different direction by not having to play the same game. I think our employees understand that… and, they are fine with it. Corporate benefits with the big kids with the big checkbooks are always around the corner when plan B has to be put in motion.
I want to be on the ground floor of growing the healthcare industry into its next decade. The individual and small group markets are really hard market segments to solve. That’s good. For the idealist, that should mean, “Let’s get to work.”
Given how a large number of Politicians act like children in statehouses and in DC (and… no, not all of them), I really don’t want them taking over the healthcare industry. Do I want them to smartly regulate it? Sure. I do. And, it would be really cool if they made the hard decisions that may make them Twitter memes because the outcomes are for the good of the healthcare consumer. Nobody should be ruled by mobs. That’s not leadership. That’s shepherding your flock. Small business owners are probably too diverse to fit into one of those flocks. Please, think bigger. Think in terms of guiding frameworks, absolutes and penalties.
I want my dollars, combined with those of our employees, to be used to spark the R&D that leaves us all in a better place. There are so many cool things out there that could be unleashed if you, industry friends and P&L decision makers, allow me to get out of the way. Imagine what new things we can create together as a healthcare community with doctors trying out their own primary care models, geneticists that are building really targeted plans for individuals, network-free offerings that actually support services with real pricing, technologists that want to communicate with us personally, and so much more.
I feel our best days as an industry are in front of us. I challenge each of you to see that, too. Embrace change. Find where the growth is coming from before others do. I can only hope that you’ll treat these coming years like an Easter Egg hunt where small businesses and individuals—many of whom feel priced out by the game many of you are currently refereeing—are openly inviting you to use us for R&D. I’ll go first and say welcome… but, it comes with one condition. I want out of the middle. I want my employees to be liberated. I want you to be accountable to them—not me. Deal?