Change Will Come Slowly

50 years ago, Mercedes Benz decided to build the best automatic transmission possible. They did something simple and logical. Company engineers and designers took apart and studied a transmission from each of the major auto makers. They ended up with what they wanted. The best transmission in the world.

The US has many fine and alert brains in Congress. You would think that someone would say, “Let’s take apart and study all of the world’s major health care systems and see how they work. Let’s look at how Canada, Spain, France, The UK, Australia, Germany, Holland, Italy, Cuba, Venezuela and China take care of the health needs of their people and not break the bank. Then we could mix and match and come up with the best health solutions for our people.”

That seems simple doesn’t it? Why don’t they do it? The countries above have successful systems but none of them use the insurance model the way we do. No other country that is successful in providing medical care, that does not break the bank, allows a “middle-man” to do the paperwork and siphon off a big chunk for themselves.

Remember, the US has a $2 trillion dollar healthcare nut. That is $7 grand for every one or our 300,000,000. Up to $2,100 per person goes to the insurance companies. That’s a pretty good piece of change for an industry that does nothing to provide medical care.

The Pharmacy Benefits Managers (PBMs) are quintessentially insurance companies regardless of the double speak. They are good at taking “usual and customary” and paring it down to the core. The Medicare Part D providers are really good at what they do. Neighborhood pharmacies have just had to close up shop. What about you? You see it on the EOBs. Your usual and customary is $80.00 and they pay you $50.00. And you don't complain. That’s a long story of doom and gloom for another time.

The higher costs that we Americans pay and the staggering number of children and adults we leave uncovered all translate to bloated profits for an industry that does nothing at all to deliver health care. The insurance companies have a really sweet deal. We pay up to 30% of our health care dollars to insurance companies who merely take the money in, remove a large chunk for themselves, and then dribble out the rest, often not without a fight. How long are we going to stay stupid?

Change will come slowly. It is our fault that we just went blindly along. Then you have to think of everyone who makes their living in the 30% business.