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I grew up with parents who worked in healthcare (my dad, specifically, has a ton of connections within the health and life insurance industry), I've sold health insurance, I now have a full-time job in a hospital system, and I'm working on launching a health insurance-related product (to augment Obamacare benefits for small businesses) and I can tell you, they didn't touch on many of the most important issues in the industry today. I'm not going to criticize Obamacare, but there are a bunch of things they could've done that would've been easier to implement and easier to understand that would've fixed the system! For example, get rid of the PPOs and give the "discount" they provide to everyone. PPOs provide no real value and have basically stuck themselves in the middle of the transaction and inflated costs, which inflates insurance premiums. Getting rid of them would immediately reduce costs quite a bit and make healthcare (and, indirectly, health insurance) much more affordable. I guess the politicians wouldn't outright get rid of a whole sector of an industry, though, which makes it harder... When I sold health insurance, one of the things we would often suggest is, if possible, to get a cheap policy with a high deductible and simply put the difference into an emergency fund until you can cover the deductible. This gives you access to the PPO, so you can pay the reduced rates (which are actually quite affordable if you make a decent income!) if something happens, while making the whole thing much more affordable. |
The PPOs have very large revenues and therefore wield great power in determining the outcome of any move to reduce their influence.
This is regulatory capture by economic interests that don't provide value in the health care service chain. It's making health care more expensive for everyone.