Problem: Consumers can’t negotiate fairly with big health care companies.
Solution: Health care consumers must negotiate together to get the best deal possible.
Health care is all about negotiation. Hospitals negotiate with insurers, drug companies negotiate with insurers, and more. The problem is that patients aren’t usually on the same playing field as these large, profitable companies.
In health care negotiation, big is beautiful. It’s why large companies get better rates and why both state governments and national health care plans like those in Canada get even better deals. Getting a good deal isn’t possible when you’re alone in an ambulance or emergency room, or even when you’re selecting an individual insurance policy when you’re not having a health crisis. So to increase their purchasing power consumers band together, whether it’s through their employer or when small firms cooperate for better deals.
This is the whole premise of healthcare.gov, the health insurance exchange that offers insurance policies to individuals and small businesses. Alone we get walked on by insurance companies, but together we can leverage a better deal.
The health insurance exchange has held down costs and provides access to affordable health insurance policies to consumers who otherwise couldn’t band together with other individuals to negotiate a better deal. But to go beyond Obamacare and improve our health care system, consumers need even more leverage.
How do we know this can work? Look at Madison. The state employee health plan negotiates with insurance companies across the state, and that spills over to everyone else. In Madison, public employees and their families make up roughly 25% of the insurance market. That is enough to demand better rates, better benefits and a better system for all consumers, whether they work in the public sector or the private sector. In fact, Citizen Action of Wisconsin’s latest report on insurance costs within the state show that the Madison area has the lowest cost for large group insurance as well as for those purchasing individual policies. Unfortunately, Milwaukee employers wind up paying about $1,600 more per employee per year than Madison employers.
In fact, the solution requires both the public and private sector and that solution is on the horizon. By 2017, healthcare.gov could bring individuals and small businesses together with large businesses and local governments to actually get our money’s worth from the health system. But we have to prepare now with hearings, legislation and a public awareness campaign.
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Politicians and insurers have long sought to keep us apart. Now that the Affordable Care Act is here to stay we can get better coverage together than we ever could alone.
Kevin Kane is the lead organizer at Citizen Action of Wisconsin and is one of the state’s noted experts on health care reform. The Shepherd ran his series Understanding Obamacare when the ACA was being implemented. The Shepherd and Citizen Action of Wisconsin will answer your questions about Obamacare during the next few weeks. Email your questions to editor@shepex.com.
