Contributed by T. John Nelson, Diamond Willow Financial
We can probably agree that there are many issues that plague the healthcare and healthcare insurance industry, yet the problem remains that there is a disconnect. A disconnect between what doctors have to bill in order to stay in business, what the insurance company will actually pay and what the consumer wants or needs.
During my 2018 Congressional Campaign, I spoke to many individuals, including business owners, medical professionals, lawmakers and insurance industry professionals regarding healthcare and healthcare insurance.
The most common responses I received back from consumers were:
• “My medical insurance premiums keep going up (I can’t afford healthcare insurance).”
• “The Affordable Care Act is not so affordable, I can’t afford to get sick or go to the doctor.”
• “My insurance company is cutting back on my benefits.”
• “We need a single-payer system.”
• “Billing insurance companies is a nightmare.”
• “Healthcare is too expensive here in Alaska. I can go out of state for a fraction of the cost.”
• “It should be the duty of the government to take care of its citizens.”
What if we were simply asking the wrong questions?
What is it people really want? Healthcare Insurance or Health-Care that is affordable and to simply have their healthcare bill paid for? Doesn’t the consumer simply want peace of mind knowing that when they go to the doctor that their medical bill is affordable? And peace of mind knowing that the insurance company will pay what they say, and it won’t bankrupt the consumer in the process?
I would argue that unless you are a state or federal employee, work for a large corporation or already have a subsidized healthcare insurance plan (i.e. Native, Denali Kid Care or are already on a Medicare/Medicaid plan), then you really do not have Healthcare insurance, but only Catastrophic Care Insurance.
I spoke to one couple (63 years of age). Their premium is $2,000 per month with a $5,000 deductible. This means they pay $29,000 per year before the insurance company pays one dime! Or the other person whose provider would bill the insurance company over $3,369, yet another provider would charge $1,347 for the same service, if the consumer paid upfront and didn’t have to bill the insurance company. Are you shopping around for your medical services?
Where do we go from here?
What I offer is this: my expertise, experience, observations and perhaps a reasonable recommendation. At the very least, food for thought to help others find the right solution for all Alaskans. What are my qualifications to provide a recommendation? Well, I work in the financial services industry as a financial advisor. I am presently licensed with the State of Alaska Division of Insurance to provide healthcare insurance solutions for individuals and businesses. Let me rephrase this. I am licensed with the State of Alaska and NOT the federal government.
According to the US Constitution, our compact (a contract) between the states):
The Tenth Amendment to the United States Constitution, which is part of the Bill of Rights, was ratified on December 15, 1791. It expresses the principle of federalism and states' rights, which strictly supports the entire plan of the original Constitution for the United States of America, by stating that the federal government possesses only those powers delegated to it by the United States Constitution. All remaining powers are reserved for the states or the people.
(Source: www.en.wikipedia.org/wiki/Tenth_Amendment_to_the_United_States_Constitution)
What does this tell you? This IS a state rights issue, or I would be licensed with the federal government’s Division of Insurance. I cannot provide insurance in another state, without getting appointed with that state’s Division of Insurance first. Yet, we wonder why the not-so-Affordable Care Act failed? It is another example of the federal overreach on sovereign states rights! States must take the lead in solving their own healthcare issues. Will this eventually lead to the federal government running the program? Possibly, if every state agreed, but for now. It still remains an issue that each state must individually address.
Think about it this way: Who am I to tell you how to run your household? Who is Alaska to tell Texans how to run their affairs? Or who is California to tell Alaskans how to run our state? Yet, is it my responsibility to pay for my neighbors’ care, because they can’t afford to, or simply don’t want to? If I choose to not pay for my own care, are you okay with paying my bills because of my personal choice? We keep waiting for the federal government to fix healthcare, yet if we truly understood the US Constitution and what our forefathers established, then we would go to work on fixing healthcare, instead of waiting for the federal government to fix it for us.
The purpose for insurance is all about “risk management”. The smaller the pool, the larger the cost. The larger the pool, the lower the cost. One area we can address is increase the size of our pool.
Alaska can do this by including ALL Alaskans in a common pool and putting out to bid with a healthcare insurance provider(s) for a multi-year contract. We don’t even need to exclude other insurance companies, we can invite them to participate as well. Alaska could do this TODAY!
Alternatively, how many BILLIONS of dollars do Alaskans send out of state each year to insurance companies who are in business to make a profit? Why don’t Alaskans just pay the healthcare bill directly? What if Alaska decided to be a self-pay state? Outsource the actuarial record-keeping and be the insurance provider for All Alaskans? Just food for thought when you vote to send law-makers to Juneau to represent us.
I welcome your feedback and comments in order to work together to solve healthcare issues for All Alaskans.
Respectfully,
Thomas "John" Nelson, APMA®
Financial Advisor / Diamond Willow Financial