Written by Gabriela Benitez, Senior Benefits Consultant at Diversified Insurance Group

“Coming together is a beginning. Keeping together is progress. Working together is success.”– Henry Ford

 Growing up in the small town of St. Anthony Idaho, I watched as my father struggled to pay medical bills. I was a young girl at the time and in need of critical healthcare services. My father told me, “Mija, healthcare insurance is for the rich.” I didn’t get it. How was it fair for my father to make the choice between taking me to the doctor or putting food on the table?

Healthcare is confusing

As a result, I started asking this question more formally, which eventually led me into the world of healthcare at 19. While I went looking for answers, all I got was more confusion. And I wasn’t alone.

According to the Keyser Foundation, 74% of people are confused about how healthcare works. I began to view healthcare as a giant onion with way too many layers. I wondered why it couldn’t be easier.

Since employer group plans began in 1940, we have been struggling to adequately address key healthcare fundamentals like affordability, quality, medical and prescription cost transparency. Then, when the Affordable Care Act was signed into law, the nation had high hopes for improvement. Now, ten years later, the Affordable HealthCare Act has failed to provide in-depth structures to address the fundamentals of our healthcare system. For example, conservatively employer-sponsored healthcare costs have been increasing an average of 4.3% every year since the affordable care act. This is a combined over 40% in the past decade. 

I saw this firsthand as I collaborated with the Utah healthcare reform task force, national organizations, and the office of Economic development in the Exchange act’s implementation. We have been dealing with the same issues for decades.

Rising healthcare costs

 One way or another we are all impacted by rising healthcare costs, lack of transparency, and access to healthcare quality. Healthcare is one of the most personal and expensive things we’ll ever consume. Close to 70% of people who file for bankruptcy do it for health claim reasons. An estimated 530,000 families turn to bankruptcy each year because of medical issues and bills, the research found.

As a strategic business advisor in employee benefits with over 20 years in this industry, I know that our healthcare system needs to be disrupted. I have seen firsthand the many ways it can impact a family. Having worked with Fortune 500 companies and multi-national carriers, I have concluded that a big stage is not always the best place to make the largest impact.

The need for healthcare transparency

This begs the question: What can you and I do to be part of this much-needed change? How do we address healthcare affordability? How about access to healthcare quality and cost transparency? What can we do to better understand the use of our healthcare, and eliminate waste? How can people be better consumers when clearly those in our healthcare system are not doing a good job explaining it? We need to be more prudent in our medical spending just like when we spend our own money.

Participate to bring change

Despite how politically charged this topic can be, I truly love what I do. This is why I started considering what was truly within my reach to do. I stopped being frustrated by it and began participating more in the right committees, boards, state organizations, and national community outreach efforts. I know that even the smallest change that I can contribute can go long way. At least this is what I keep telling myself. And it is working. 

We all have an important role to play in our healthcare system, and healthcare continues to provide us with major opportunities to progress. We need to be curious, challenge the “traditional”, be willing to hear new ideas, and find better ways to collectively simplify and improve our healthcare system. Applying basic business principles offers solutions to make healthcare more cost-effective and care more personal. The use of clinical data and predictive analysis is key to measure employer sponsored plans and successfully implement the right resources that ultimately deliver long-term results.

In conclusion, healthcare expenditures need to be based on educated decisions, cost transparency, healthcare quality, insurance performance, and not influenced purely by social or other legal obligations. We need a mindset shift and take responsibility. It is up to each one of us to get involved! You can get more information about Diversified Insurance Group and contact me here.