How to Be Part of the Health Care Solution

KM | April 30, 2008

Individual leadership can empower and transform those who lack health insurance

Each year national "Cover the Uninsured Week" runs in late April or early May with dozens of public and private enterprises joining the effort to  educate Americans on the solutions that are readily available to more than half of the 47 million people the U.S. who lack health coverage. Cover the Major national participants include Aetna, Kaiser Foundation, Robert Johnson Wood Foundation and the Magic Johnson Foundation. MedSave.com's role as a social entrepreneur is to help Americans look at the problem in a way that facilitates an immediate solution.

As individuals we tend to view the complexities of our national health care crisis as far beyond our understanding, let alone our scope of influence. Yet societal change is always the result of individual change. MedSave.com believes that individual citizens can be effective components of transformation of health care delivery in the United States. MedSave.com suggests that there are at least six specific actions each of us can take as individuals to become part of the national health care solution. These actions may require a little education and effort, but can ultimately make a big difference to those without health coverage.

1. Offer suggestions during a life transition

Most of the nation's uninsured are ordinary people going through normal life transitions. All of us know some people in this type of transition. A gap in coverage may be triggered by temporary unemployment, divorce, seasonal or part-time work status, stating a business, attending college, recent graduation, relocation, early retirement or recent immigration into the United States. At this hectic point of life, health insurance may be the last thing on their minds. Yet these people often welcome a bit of advice from a concerned friend or associate.

Surprisingly, the majority of people who become uninsured have a total household income of more than $75,000, so affordability is not necessarily the limiting factor. Many people go without health coverage simply because they over-estimated the cost of insurance or were not aware of the best insurance options. They simply do not know where to find good coverage. Adults who are not enrolled in employer-provided health coverage are likely to have gaps in their health insurance. The National Institute of Health Care Management (NIHCM) indicates that 25% of the uninsured middle income Americans - about 12.5 million - would immediately enroll in coverage at their own expense if they only knew that affordable commercial insurance was available through services like MedSave.com. Even when full health coverage is not an option, at least some type of affordable entry-level commercial health insurance is available to almost everyone. The solution might be as simple as sending a link to a Web site like MedSave.com that lists affordable health insurance choices on a state-by-state basis. Simply mentioning that affordable health insurance is available can make the difference between being insured or uninsured..

2. Start a conversation with low income associates

Most of us have daily contact with uninsured people in our daily lives. Many of these are the lower income workers who work in retail stores, farms, cleaning services, landscapers, and many other occupations that traditionally do not provide health benefits. A new study funded by Aetna for Plan for Your Health Foundation shows that 63% of Americans are not familiar with the government-assisted health plans available in their area. Over 10 million people are eligible for free or cow cost coverage through various Medicaid and state child health insurance programs but remain uninsured simply because they are not aware of the programs. While this can be a delicate topic, it s possible to stat a discussion without making any assumptions or financial implications. An easy approach is "I was reading about the free health insurance available in (our county) and wondered if you had heard about it. It seems like a good deal for someone who has to find their own health insurance". Look up the health plans available in your state and make a note of the contact information to pass along when appropriate. Either do a Web search or start with the listing of state insurance departments at MedSave.com. The new brochure from the Magic Johnson Foundation at www.planforyourhealth.com might also be a useful tool.

3. Nag you kids

Our experience indicates that the purchase of health insurance policies purchased by single adults under age 25 is frequently prompted by a parent, usually the mother. Peak enrollment time for young adults even appears to coincide with visits to their parents. Yet 25% of the nation's college students and an even higher portion of new college graduates do not have health insurance. Most do not realize that coverage is available at a cost of less than $100 per month. MedSave.com data shows that a parent is also the premium payer in a substantial portion of these policies. It is clear that parents are the driving force behind coverage for young adults, whether accomplished through educating, nagging or paying the insurance bill themselves.

4. Support behavioral change in the workplace

A staggering 80% of our national health care costs are directly linked to behavior issues like smoking, drinking alcohol, over-eating, lack of exercise, lack of stress management, poor nutrition and lack of sleep. We have known about this link this since the 1950s but little has been done to mold public behavior other than to charge higher health insurance rates for smokers and those with pre-existing medical problems. The old approach is clearly not effective. Health plans are now beginning to link benefits with behavior issues after winning legislative and legal approvals. One approach is the expansion of 'consumer-driven health plans" where an insurer covers only catastrophic expenses and leaves control of ordinary health care spending decisions to the individual. The underlying economic principle that individuals who make purchase decisions about  health care will be more efficient when spending their own money than when using employer funds. Almost a third of our of our health insurance costs are attributable to relatively small expenditures that cost more to pay through an insurance than if they had been paid directly. The adaption of consumer driven health plans often occurs in conjunction with the trend from "defined benefit" health plans of the past to "defined contribution" health plans that will dominate the future of employee benefits. This trend can be compared with the transition from pension plans of past generations to the 401(k) retirement plans that we use today.

An increasingly popular incentive program provides additional health insurance benefits (like a lower policy deductible) to those who meet their stated health goals like weight reduction or smoking cessation. Other health plans reward employees who go to a gym frequently of participate in stress management programs. Regardless of the specific approach, the important point is that, for the first time, employers are beginning to tackle the underlying behavioral issues that lead to higher health care costs and decreased productivity of their employees. Of course, change is always met with some resistance. If you are in a position of influence within your organization, support the changes in your group health plan that reward behavioral change that will ultimately lower our overall health costs. Leadership from individuals within a company who can communicate this larger long term vision of health care will ultimately cause the success or failure of the next generation of health plans.

5. Reject the old politics

The primary reason that America has not made greater progress toward cost-efficient delivery of health care is that we continue to be led by political agendas rather than sound economics. The most damaging political stance is our failure to distinguish between health insurance and health care. State and federal governments have devoted huge resources to regulation of health insurance yet have almost ignored the issue of health care affordability. While all of our presidential candidates have made proposals to change health insurance, there is no credible indication that any of the proposals will significantly curb inflation our nation's health care costs. Few of the many legislative proposals being considered by state governments across the country address health care costs. Reform proposals tend to rely on the logic that says "do this with health insurance and magically health care costs will fall in line". Unfortunately, economics and past experience indicates otherwise. Continuing on the same path while expecting better results is not a path to transformation.

A growing risk is for individuals to postpone action on health insurance decisions while waiting for a new political solution. While the national debate on health care reform is welcome for the long term, it does not help any of us who need medical care now in on the next few years. There is a tendency to take the attitude "I'll wait to see what type of universal health insurance comes after the next presidential election." We must take affirmative action to protect ourselves using the options that are available here and now. It is important to realize that progress toward universal health coverage in the United States is coming in small steps due to natural market forces and will not occur not as one giant politically-driven transofmation.

6. Accept ownership of the issue

Some people believe that the next president will heroically solve the nation's health care crisis. A growing number of Americans choose to believe that they have a right to health care paid for by the government or someone other than themselves. Others simply postpone dealing with health insurance issues until a serious medical problem arises. None of these beliefs will lead to an effective solution. More importantly, these beliefs are disempowering to a person without health insurance.

Health care is expensive. We must conclude that it will continue to be expensive. The probability that our society will transform to a utopia of affordable top-notched care for everyone is slim. We will continue to face difficult decisions that include ethical issues of a life and death magnitude. Economic trade-offs of health care for other valuable opportunities, goods and services will always exist in a democratic capitalist society. Our ability to provide medical treatment will continue to outpace our ability to pay for it. The affordability gap will widen with the development of new technologies and increasing life expectancies. Health care funding is a problems that will remain with us for the long term. Individuals who accept responsibility for addressing the realities as they exist are truly part of the solution. True leadership requires us to acknowledge the difficult truth that financing our health care will be a lifelong concern for us as individuals and as a nation.

These are just six ways that each individual can become an active part of our health care solution. Individuals adopting these approaches could immediately help about 24 million uninsured people! We are sure there are many other ways. If you have other specific ideas, we would love to hear from you!

Get your free quotes

Are you currently insured?

We work with trusted
companies like: