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Dear Everyone!
I wish you a Happy BETTER Year... considering the past one was not one of our best!
Everyone is talking about the financial markets and predictions so I figure that by now you are sick of reading about this issue.
Thus, I want to talk about health insurance. This edition of The Tattler has only one article. It's rather long, but I think it is important that you know Where I Stand on this topic.
Call or write me if you want to discuss, argue, or agree.
Oh... and click here to see my new "landing" page. I put up a 60 second music and slide show that I call "Preserve Your Memories." Let me know if you like it. Most everyone seems to.
-Al
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Where I Stand
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I had some correspondence with a mid-level manager of a health insurance company. It started out about a huge rate increase that one of my clients received and how she would have to drop the policy because she is a 62, out of work, on social security and her increase was $1200 a YEAR.
He presented his argument that what we have (or get) in life is dependent on the choices we make. He remarked that while it is too bad that this woman can't keep her health insurance, that's the way it is and there was nothing that could or should be done about it.
He wrote to me:
We live in a world where people make choices everyday, whether good or bad and when those choices catch up with you, people always want to believe it's the insurance companies fault. Of course, they never want to admit they were in total control of their destiny and future. They
never take personal responsibility for any of their actions. As stated by more than one doctor, people are willing to take pills as a temporary band aid to a health issue that can be solved by hard work and life-style changes... but the reality is there are a ton of people unwilling to do that. While there are those who unfortunately have been dealt a bad hand, most can do something about it but choose not to. Everybody can, not everybody will!
I wrote back:
At such a young age you have turned into a very hard-hearted soul. Are you telling me that some 50 millions working Americans are irresponsible? Are you saying that the reason my client has to drop her health plan is because she is irresponsible? You honestly defend the current system, one that prevents 40% of the population from getting proper health care?
Sure some are on welfare and sure, some are "moral hazards" (smoking/drinking) and sure some are illegal citizens, but in your heart of (cold) hearts you believe that the current system is good... even adequate?
It is OK with you that people lose their homes, their life savings, their retirement funds, their college funds because they lose their jobs and can't afford the exorbitant premiums that the private sector charges? You are OK with the waste and inefficiency of the current system?
Let me ask this. If this system is so wonderful and so terrific, why does an overwhelming majority of people want to junk it for ANYTHING other than what we have? You think they are all stupid? They are all irresponsible? They ALL want something for nothing?
Why is it that on every opinion survey people say that getting affordable health insurance is one of their top five concerns? No one seems concerned about getting affordable college education or affordable golf courses or affordable car loans.
Public opinion on this industry is not high. It seems (but probably not true) that everyone has been burned by their health insurance company at some point in their life. I've never met anyone who thought that they got fair value FROM their health insurance for the amount they paid in over the years TO their health insurance company. I've never known anyone who didn't feel that their health insurance company did all that they could do to weasel out of paying some part of a large claim.
The current individual coverage system is wrought with a bloated infrastructure, expensive inefficiencies, and impossible-to-understand nomenclature.
Compare that to Medicare. Have you ever heard anyone with Medicare and a Med Sup (which (horror of horrors, are government-designed and regulated) ever complain? You ever hear a senior citizen express a desire to dump Medicare? Of course not... because that system is centrally administered and for the most part IT WORKS. It's not perfect, but it's good enough such that no one wants to dump it.
But EVERYONE wants to dump the current system of individual plans. There is no political support for keeping the private health insurance sector. There is no single carrier in the country that anyone points to as being a model of client relations, efficiency, and most importantly FAIRNESS. (Kaiser is sometimes mentioned, but they are first and foremost a medical provider and not a financial entity... and they have their issues as well.)
If private insurance sector were as wonderful as you say it is, we would not be having this discussion and the National Association of Health Underwriters would not be fighting for its life.
I don't see myself as a purveyor of health insurance. I see myself as someone with the skills and knowledge to mitigate the effects of a bad system for the client. By using my services a client will have zero chance of being screwed by the system.
Of course the carriers would love for customers to bypass agents and go direct to them. But the truth is that the customers of this business need me (and agents LIKE me) a lot more then they ever did. I'm the only friend they have in this business. It is not the doctor, not the hospital, not the clinic, and not the carrier. I'm the only one who can help prevent the customer from being cheated.
Case in point that happened yesterday. Let's take a doctor who is not in the XYZ Insurnace network. Prospective patient calls the office.
"This is John Smith. Does Dr. Jones take XYZ insurance?"
"Yes, Mr. Smith, we take XYZ."
Patient goes to Dr. Jones and guess what? Jones takes the patient's card... but the unsuspecting patient gets balanced billed. (This happens every day in the ER.)
An agent like me tells their clients not to ask if they take XYZ Insurance but "Is Dr. Jones IN the XYZ network with a negotiated contract?"
Who's best interest is it to dupe the client? Answer: Both the carrier AND the doctor. This is the system you defend?
And I don't suppose you want to talk about post-claims underwriting? How well has that worked for the industry? How many fines has each carrier paid in trying to weasel out of paying what they owe?
Is there fraud? Of course. There will always be fraud... just as guilty people get past the justice system on technicalities. But our industry makes it their "mission" to hire special investigators to find even the slimmest omission on an application (like the client who has cancer but forgot to mention the ingrown toenail he went to the doctor about nine years ago) so that the carrier can claim "fraud" and avoid paying.
I don't know what kind of indoctrination kool-aid they give you guys in your company meetings, but in real life, in today's world, health insurance carriers are perceived as "evil" and there is not a scintilla of support for this sector of the insurance industry.
I don't know what kind of system we are going to get from the new administration but if I'm put out of a "job" AND it is a system that will assure access to adequate medical coverage for everyone, I'm fine with it. I'll sell more life, DI, LTC, etc.
My crystal ball tells me that after all the debate and yelling and screaming this winter and spring when the new administration takes up the issue, that the compromise will be to OFFER everyone who does NOT want employer-sponsored insurance... Medicare. A year from now, when you get your IRS tax booklets and forms in the mail, there will be a Medicare card attached.
I see this as an interim measure... say for three years while they figure out a better plan and create the infrastructure for it (single payor?)
Why Medicare? Simple. The computer systems are in place, the rules are in place, and adding another 70 million people is not that big a deal.
Cost? Well... if we end both wars, end agricultural subsidies, cut the military budget by 33% and end all the pork spending, we will have plenty of money to fund health care for everyone. They do in the UK, in France, in Germany, etc. We can do it here if there is the political will... and for the first time in 15 years (since Hillary-care) I think that will is there. I know you and industry associations and all the carriers are not part of that "will" but this time I don't think all your money and lobbying can stop the train.
I remember a couple of years ago we sat down and had a similar discussion and you suggested that I should not be as outspoken because a lot of the "big" brokers would not "like me" and would not refer their life or DI business.
You were partly right. A lot of agents in the area will have nothing to do with me. One woman who owns a large agency thinks I'm a disease!
The rep of a large carrier would rather have root canal than talk with me.
The rep of another carrier thinks I should be exiled to Botswana!
I went to the Kaiser Christmas party a couple of weeks ago and no one would talk to me or my wife. We sat at a table alone. We were shunned. The Kaiser rep gave me nothing more than a perfunctory greeting (I send Kaiser enough group business to have at least earned that!)
Two years ago you were right. But there are more and more agents in this community... probably a majority... that agree with me that change is necessary... then who agree with you that we have the best system on the planet.
Most of us are successful in our practice... without the "love" of the big "let's defend this system to our dying breath" brokers.
Clients are CALLING me (us) for individual coverage or REFERRING me for small group because OF my reputation of being a "client guy" and not a "carrier guy." The clients love me because I put THEM first... and the carriers love me because I write a fair amount of business (but more life and DI these days than health due to the difficult underwriting climate.) Some of the local agents "hate" agents like me... but that's because they don't understand politics. The lesson was first written around the year 1470
The political philosopher Niccolò di Bernardo dei Machiavelli said that it is best that "the prince" (in this case, the major brokers/carriers) be loved. If he can't be loved than he should be feared. But he should never be hated.
"As Princes cannot escape being hated by some, they should, in the first place, endeavour not to be hated by a class; failing in which, they must do all they can to escape the hatred of that class which is stronger (139)."
You saw the election results. Who is the stronger "class?"
Well, I don't expect you to answer this missive... and I don't have the time to continue the dialectic. You and I will just have to agree to disagree and wait to see how it all shakes out.
The next round of coffee is on me!
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Well, that's a wrap for this issue. I hope you've found some of the info above useful and interesting. If you have questions about life or health coverage, safe-money annuities, or employer group benefits just give me a call or send email.
Sincerely,
Alan N Canton
InsuranceSolutions123 Agency
InsuranceSolutions123.com
916-962-9296
CA License # 0F31110
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Al Canton, Owner
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I'm Al Canton, owner of the Insurance Solutions Agency.
Everyone promises the best service, etc. So I won't bore you with that message.
Bottom line, I know health insurance, disability, Medicare, life, and annuities.
Most importantly, I'm honest. I will not put you in a product just for the money. I've lived in the Northern California area for 35 years and I've built my reputation on integrity and honor.
It's that simple.
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