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Rich Novack’s Comments GHAA Client Luncheon – 8/16/2017 – As interpreted by Victoria Braden & Jennifer Pender

Wealthy nations value health and are willing to pay for it – America

Medicare now balances budget by paying providers less re-negotiated every 2 – 3 years

If there is a big problem, we go to a big place for the answer – in the case of healthcare, the big place is the government. There is a race between private industry and Govt for the health care spending dollar. Govt won’t take over healthcare but becomes the single source of financing.

Future purchasing projection; move away from Employer based product to a Medicare type individual product, where there is a basic level of coverage provided and citizens purchase supplemental coverage (single source financing).

Individual would get a voucher and purchase health insurance, from a private vendor, base plan health insurance with a supplemental plan of your choosing (Insurance companies = private vendor)

Government collects money better than anyone else

Now until 2019, massive disruption in the market – The industry will adapt

Low inflation environment, pricing power is zero but health insurance premiums continue to increase

Higher the cost of care the lower the quality of care
Lower cost of care the higher the quality

There is a cross over people have concerning healthcare between a utility and a religion. If it is someone else’s care it is a utility, if it is your healthcare it is a religion.

Right now, health insurance companies are being regulated like a utility

80% of the country on employer plans are in a self-funded/level funded plan

BCBS is leaving the individual market in metro-Atlanta. This will leave 300,000 Georgians who have to make a change in their health insurance provider on 1/1/2018

Employers need a strategy; raising deductibles every year is not a strategy

One size does not fit all

Find a good agent – will take your experience and create a strategy

Get in a consumer driven health plan

Contingent to employees receiving company health insurance BENEFITS, employees must do any number of things the company asks them to do to qualify for the coverage. Said another way, “It is a benefit, if I am going to give you this benefit you need to do XXX for me.” If employee does not comply, they are not eligible for the company insurance coverage (or they would not receive the employer’s cost sharing contribution). Suggestions would be Health Risk Assessment (HRA), physical, annual treadmill test after age 40, colonoscopy.

Doctors do not start work until age 30 and do not start to make money until age 35

Only 60% of the current healthcare spending is within medical evidence based guidelines. 40% is care delivered outside of what is medically prudent.
This 40% is not fraud, abuse or waste.

There is enough money in the system today to make everyone happy

Medicare spending is $1 billion a day

Need to look at savings opportunities today as the low hanging fruit is gone