U.S. HealthCare System Is Broken

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How long have we been hearing the US HealthCare System is broken?

HealthCare and the focus on reforming health care has been on front pages of newspapers, trade journals, presidential debates dating back to the early 1990’s centered around the well-known mantra…Healthcare Is Broken.  If we think back, Candidate Bill Clinton, while stumping for the White House in ’91 or ‘92, made reforming the US Healthcare System his #1 domestic issue.  We all know he was elected to the White House, spent 2 terms there, but nothing ever really came of the reformation of healthcare, from a legislative standpoint, under his presidency.  The awareness of the broken nature of healthcare has been at the forefront of, not only our consciousness, but the debate way back some 25 plus years ago.

So, what was it 25 years ago that was broken about healthcare and how has that changed, if any way, all the way to the present?

The issues, as big as the healthcare system is, today it consumes about four trillion dollars every year from a capacity standpoint, claims, utilization, infrastructure build, etc.  All in, it’s about 20 percent of our GDP – 4 trillion dollars!  As big and crazy as that system is, it is largely broken.

I think it can be broken down into 3 simple categories:

ACCESS INTO THE SYSTEM.  Once into the system…

QUALITY OF THE CARE YOU RECEIVE.

Once you’re into the system, and you’re getting care, the third category is

COST…HOW MUCH DOES IT COST?

So, to sum it up, I believe the broken aspects of the HealthCare System are ACCESS, QUALITY, & COST.  Access, Quality & Cost were issues that were paramount in the early 90’s and they are still paramount issues, today, even though 25 or so years have passed!

Talk a bit further about the ACCESS, QUALITY, & COST aspects you just mentioned as being paramount.

First of all, the system is very convoluted.  Let’s start with ACCESS, first.  19.5 days, average, to get an appointment with your Primary Care Physician.  Once you are there, 121 minutes while you’re sitting in the office waiting your turn for that visit, and once in your visit, 8 minutes is the average time spent in front of the physician.  That’s a total waste of time!

Now, let’s focus on the COST aspect! According to Truven Health Analytics, April 2013, the average cost of an Emergency Room visit is $1,316.  Another hidden cost until you accrue it is a visit to an Urgent Care facility with an average out of pocket expense of $150.00 according to debt.org!  No one can argue that costs are out of sight and going higher at a pace that is, not only unacceptable, but unsustainable!  Remember, when you walk thru the Emergency Room door, in essence, you are a “customer”.  So, why would their mindset not be, ”Let’s spend some money!”

Basically, unless you are a physician, married to a physician, know a physician, independently wealthy, or have a ton of time on your hands, We, as Americans, have issues!

The Affordable Care Act, commonly known as ObamaCare, came on the scene a couple of years ago.  Wasn’t this supposed to address these issues?

Yes.  The Affordable Care Act was billed by many, especially many in the government and those pushing for the bill to be passed, as THE solution.  You know…To be that silver bullet, if you will.  Many had the foresight, and now, we ALL know, in hindsight, there is nothing about the Affordable Care Act that is further from the truth.

The premise behind folding in 10’s of millions of people that, previously, had no health insurance, half of whom had an employer provided health insurance offered to them that they voluntarily turned down because they didn’t feel they “needed” insurance.  I’ve heard it called the “superman syndrome”!  You know, perhaps they are young and healthy and don’t think they NEED healthcare!  But, the Affordable Care Act said EVERYONE must have healthcare, now, and if you don’t participate you will supposedly be levied a tax or a fine.  So, all kinds of people were coming into the system, even against their will, but nevertheless, it IS NOT the silver bullet!  It is certainly still not working!

For example, let’s take a typical family of four on the Affordable Care Act Silver Plan.  The yearly premium is around $17,000.  The average deductible on the Silver Plan, I believe, is around $6000.  So, the family of four is paying around $23,000 per year for healthcare and it’s rising!

So, lets now look at what the CDC states are the average usage expectations.  The CDC states the typical family of four will have a yearly average of 14 encounters with a physician.  Those visits may originate from physician offices, emergency room visits, and/or urgent care clinics.   So, add up all of the expenses associated with these visits throughout the year.  Typically, the grand total conveniently falls just shy of the yearly $6,000 deductible.  Doesn’t it?  So, for many people, their plan hasn’t even kicked in to pay!  So, in our example, isn’t the family of 4 self-insuring themselves?  How ridiculous is this?  If that isn’t broken, I don’t know what is!

So, what is a solution?

Well, a solution, certainly not THE solution, but certainly A solution to address issues surrounding broken healthcare and can address issues surrounding ACCESS, QUALITY & COST is the whole phenomenon of virtual healthcare!  When I say the term virtual healthcare, I am speaking of something so much greater than just picking up the phone and speaking with a medical professional!

You’ve used the term virtual healthcare.  Can you describe what you mean?

Virtual healthcare is all about conducting a medical visit in a virtual setting.  The term “virtual” means “not physically existing, as such, but made by software to appear to do so.”  In laymen’s terms:  you are not physically in the doctor office, but you appear to be because of software.”

How is virtual healthcare accessed?

Most people have access to a smartphone.  Smartphone technology has been a major agent of change in virtual healthcare, combined with regulatory, legislative and licensure law changes enabling those with access to a smartphone, to quite frankly, press a button and access a medical professional.

How does virtual healthcare address the COST issue?

Great question.  My favorite, actually.  A 12-month study, of a cross-section of employees from Home Depot and Rent-A-Center, was conducted by Harvard University.  Home Depot contributed 1,300 employees and Rent-A-Center contributed 500 employees.  The number of employees is basically a moot point because the virtual healthcare resolution factor was the same for both companies:  92%.  On top of the time savings, let’s look at the money saved by each company.  Home Depot experienced a $5.9 million cost avoidance, while Rent-A-Center experienced a 1.2 million cost avoidance.  Not to mention the savings experienced by the employees by avoiding expenses that, otherwise, would have to be paid by the employee as they chip away at paying their deductible, or better known, as their portion of the health care expense.  The savings and cost avoidance is staggering!

Let’s talk about the ACCESS & QUALITY issue.  How does virtual healthcare address these categories?

Staying with the Harvard study between Home Depot and Rent-A-Center, only 8% of the 9,300 encounters between the two company’s virtual healthcare consults resulted in the need for care in the physical presence of a medical professional.  This 8% of the consults TRULY represents a bonafide emergency and they should be in that setting!  That means the care for TRUE EMERGENCIES will be that much better!  For example, reduced wait times, increased response times, quality time with physician, increased morale of healthcare employees, etc.  I believe we can expect all kinds of positives resulting when people are presenting their healthcare need in the appropriate setting.

This sounds all great!  I totally get it!  Aren’t these “tele-medicine” companies a dime a dozen?  You can’t help but drive down the freeway and see them aligning the highways, on opposite street corners in major cities across America, see billboards talking about hospital systems with an 800 number you can call, big multi-specialty clinics have an 800 number available 24/7, etc., Aetna, Cigna, United HealthCare, The Blues…They all have an 800 number.  So, it sounds like virtual healthcare is here to stay.  Right?

Yes.  However, I would like to introduce a caution around the motivations of the various different virtual healthcare providers.  You are correct.  The major insurance company payers, you know, they payer of the insurance claims.  They all have 800 virtual healthcare numbers that they want their members to call.  Basically, in my opinion, each of those 800 numbers are nothing more than an “INTAKE” line.  And, make no mistake, THEY ALL HAVE THEM.  And, not only is it insurance companies touting these 1-800 number lines, it is big hospital chains, as well!

So, how do these “INTAKE” lines or 1-800 lines benefit big insurance companies and big hospital chains, as you say?

First, we must understand how these insurance companies get paid!  They get paid when people encounter health care…when they incur a claim!  Even if they are on an administrative services agreement, like a big employer that hires one of the large insurance companies to pay its claims, the insurance company gets a per claim fee, typically.  So, they are going to want to funnel people, appropriately and efficiently, into the system!  I would offer the hospital chains operate the same.  Ultimately, they want you TO COME IN to use their services.  Follow the money…that’s how they get paid!

I encourage everyone to consider the motivations of the various players in the virtual healthcare space.  If they are associated with a payor, one of the large insurance companies, be very cautious, because that is NOTHING BUT AN INTAKE!  Nothing is really changing with the addition of their virtual healthcare service!  Nothing!

True change in healthcare needs to come about!  Not just put lipstick on the pig called healthcare!  Costs are doubling about every 5-6 years, and is NOT SUSTAINABLE!  This healthcare growth rate has not been sustainable for a long time and the people that are being disenfranchised are YOU AND I!  NOT the large insurance companies and not the large hospital systems in the space!  YOU AND I are paying the price!

So, now that we better understand the magnitude of the PROBLEM, what do you suggest as a SOLUTION!

There is no doubt a virtual healthcare solution is RIPE for the times we are now living and the need is there!  Earlier this year, we received a phone call introducing us to a company named Global Rescue Direct.  The parent company, Global Rescue has been providing some of the world’s most innovative health and travel risk-management services to consumers, enterprises and governments.   Entities like US State Department, US Ski Team, and NASA, just to mention very few!  Global Rescue has over 1 million members!  In other words, Global Rescue has been operating, highly effectively, in the virtual healthcare space for over 12 years, in every country EXCEPT the United States!

Here’s how bizarre this is… Global Rescue, a U.S. company, could offer virtual healthcare to a U.S. citizen in Egypt, but NOT a U.S. citizen IN the United States!  Doesn’t that sound crazy?  It’s true!  It wasn’t until regulatory, legislative and licensure laws were overcome that Global Rescue could offer virtual healthcare WITHIN the United States.  So, Global Rescue Direct has entered the virtual healthcare space with a TOTALLY different motive as of August 23, 2016!  So, Global Rescue Direct offers a very robust solution that needs to be considered by anyone weighing their options in the virtual healthcare arena!  For that reason, Lynn and I became Global Business Owners with Global Rescue Direct in an effort to get the word to the people, as quickly as possible!

You said earlier, we must look at the motives of these virtual healthcare providers.  What are the motives of Global Rescue Direct?

As Global Business Owners with Global Rescue Direct, that question is the whole reason we locked arms with Global Rescue Direct.  Lynn and I understand business.  We understand the power of helping people.  In our Global Rescue Direct business model, we make a difference BEFORE we make a dime!  The motive of Global Rescue Direct is to resolve a common healthcare matter outright, as best we can, VIRTUALLY.  And, if we NEVER have to file a claim, that’s GREAT!  Everyone wins!  So, we believe you are beginning to see how the ends justifies the means…Big insurance is focused on maximizing profitability…while Global Rescue Direct is focused on providing a high-quality, effective solution at a cost every person, in every zip code can afford!

Why would Global Rescue Direct choose the direct-selling business model versus traditional marketing business model?

Great question!  Another of my favorites!  Global Rescue Direct felt it was best NOT to team up with government entities, whether it is at the state or federal level and NOT to team up with the large payers!  Why?  Because, frankly, THEY ARE ALL THE PROBLEM!  So, the best way to go about making true change, is to arm an army of entrepreneurs that can go out and talk with family, friends, and neighbors about doing virtual healthcare… THE RIGHT WAY!  And, by doing it this way, quite frankly, we are going to start a REVOLUTION!  We all know the power of kicking our neighbor’s cat!  Don’t we?  This elephant named healthcare is sitting on the chest of every single one of us and we can’t breathe!  When enough people get sick of a problem, free-enterprise is a beautiful thing…they will do something about it!  And we must ask ourselves, haven’t we given enough money and enough time to big insurance and big government to fix the problem.

Let’s take it one step further… When is the last time your insurance company paid you a commission check because you shared a profound service with them with the right motives at the core of the sale?  Like I said earlier, we make a difference before we make a dollar.  Period.

As a Global Rescue Direct Global Business Owner, what is your vision for solving the healthcare elephant suffocating Americans today?

Twenty-five years ago, in 1991, during the 1992 presidential run, remember one of Bill Clinton’s campaign issues was rising costs of healthcare were unacceptable and broken and he was going to fix it and reform it!  Twenty- five years have passed and WHAT HAS HAPPENED?  Let’s fast forward from 2001 to now…. Healthcare costs have tripled!

Healthcare was broken 25 years ago and IT’S STILL BROKEN!

So, WHO IS LOSING!  The healthcare companies ARE NOT LOSING and they continue to be incredibly profitable!  Just look around.  Look at the ones that are publicly traded and see their earnings!  It’s staggering.  Look back at 2008 and 2009 during the economic downturn, some call it the Great Recession, no matter what city you were in, the big industrial construction cranes were still working around the infrastructure of healthcare!  Hotels were not being built, skyscrapers were not being built, but I will tell you… hospital wings were still being built.  Fast forward to today, emergency room only buildings and urgent care clinics are popping up everywhere!  Healthcare is a BIG, BIG, BIG business!  That’s how it gets to a four-trillion dollar industry in present day dollars.  That is 20% of the GDP!

So, we must ask ourselves, “WHO IS LOSING, here?”  Is it the hospital systems, the insurance payors, the government since implementation of the Affordable Care Act?  I think NOT!  The healthcare elephant is sitting on OUR CHESTS!  YOU & I along with the small, medium and large-size businesses!  The healthcare elephant is suffocating the economic engine running our country!

So, we made a decision to partner with Global Rescue Direct and are going to build a marketing organization, consisting of average people, you know, the ones being suffocated by the elephant, big enough to flip the healthcare industry on its head!  That’s how we will solve the healthcare problem.  We, the small people, are the economic engine of this great country.  It’s time we get educated and tap into a virtual healthcare solution WITH THE RIGHT MOTIVES!

In closing, to see our true motives, revisit our Team Vision Statement.

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