The Grass is Greener on the Other Side of The Fence – The Age of the Golden Goose

In the early 1980′s, group health insurance rates began to skyrocket. Medicare and Medicaid, signed into law by President Johnson in 1964, was beginning to have an unintended financial impact on the health care delivery system. Cost shifting to private pay plans began, health insurance rates began to climb. to new highs.  Insurance companies embraced a new concept called “Managed Care”. PPO’s and HMO’s fought for market share.

As medical insurace premiums rose, insurance companies realized tremendous and lucrative cash flow opportunities. If an insurance company could make 2% on the float, it would mean millions, if not billions of dollars in profits. More insurance companies entered the health insurance market. Prudential and Aetna for example, redirected their profits by entering, for the first time, the health insurance market. And, more insurance agents, especially property & casualty agents, joined in the feeding frenzy seeking 15% commission on health insurance sales.

There was never a better time to become an independent health insurance broker. The sky was the limit, the market wildly free and unfettered, with unbelievable financial rewards for those that worked hard and long hours, day after day. Competition amongst insurance brokers was intense and fratricidal. Greed became a driving factor and honorable business ethics became uncommon.

After nine years working for a health insurance company, I stepped out into the brokerage world seeking my fortune. It would be an interesting learning experience, frought with dangers and rewards. I was entering  unchartered waters, complicated by the good old boy system of alliances and unspoken codes of  questionable ethics of underground operatives on the dole.  I was about to make more money per year than I ever dreamed of making. Although I was “just an insurance agent”, I was to make more money than the owners of the companies I help to insure. 

But, I was about to be hit with a seemingly unsurmountable roadblock.

Editor’s Note: This article was written by Molly Mulebrier of Dime Box, Texas. This is a fictional account of the experience of a health insurance agent.

“Money will buy anything” is the mantra of key political contributers in deep South Texas. And so it seems. “Hussein threw McAllen under the bus” has exaserbated local politics – will the defunct and nearly extinct Republican party of deep South Texas seize the initiative and make new polical allies with rich physicians and their political hacks?  Read all about it here – http://www.nytimes.com/2009/07/30/us/politics/30mcallen.html?_r=1&src=twt&twt=nytimes

http://www.snopes.com/medical/drugs/generic.asp

Office Visit for a total of $35 – heck of a deal when we are seeing office visits costing anywhere from $65-$190 through insurance programs. Dr. Posada publishes his prices and takes cash or credit card only. He does not accept insurance, nor Medicaid or Medicare. Cash only please! affordable-clinics.

If Brownsville Independent School District, Cameron County and the City of Brownsville would bid out for physician services rather than rely on boggus savings touted through PPO networks, the taxpayers would save millions of dollars a year.

In the late 1970′s, the company I worked for experienced an internal political shift in power. Politics are found in all organizations it seems. A new President was selected by the Board, and heads began to roll shortly thereafter. “New Blood” was needed in management, a new direction was charted and the ambitious new President had high expectations of increased market share.

The old and balding Senior Vice President of Sales was sacked. A new, young ex-car salesman from East Texas was selected to lead and command the troops towards a rolling conquest of the state, the goal of which was to increase market share from 23% to 25% within the year.

How to accomplish this? Easy, pay the sales force huge sales bonus based on net-gain in each territory, and “buy business.” That is when I realized I was sitting on a gold mine. I read the new sales incentive bonus program and realized right away that I did not have to even write a new group to get the bonuses; all I had to do was gerrymander my existing book of business. But, what really made my day was the new business rates we were getting from underwriting. We were buying business, no one could compete with our rates. We were giving the insurance away for pennies on the dollar. I became an order taker, a well paid order taker. My income rose to over six figures, and I was “made.” Customers were happy too, at least in the onset.

Eventually this strategy could not sustain itself and all hell broke loose. Member hospitals, all on an annuity contract with my company, began having cash flow problems due to slow (and incorrect) claim payment. Members were having difficulty getting their claims paid. No one was happy, and those of us in the sales division took the brunt of our customers anger every day. Instead of devoting time to selling new business, I was spending all my time as a roving customer service rep. Competition woke up and began making significant in-roads in the market. It was not fun.

Management decided that the sales force was paid too much money and the compensation formula was changed. A quick study showed that my six figure income would now drop down to where I was in the early 70′s. My customers were not happy, I was not happy.  It was time to move on.

Editor’s Note: This is a fictional character and is not intended to represent any one individual.

These websites publish the prices of procedures, which help when negotiating your medical bills:

www.healthbluebook.com, www.changehealthcare.com, www.outofpocket.com, www.myhealthscore.com

These websites offer bill-negotiation services:

www.myinsnet.com, www.medicalcostadvocate.com, www.billadvocates.com

Excellent article in Forbes, August 3, 2009 issue:  cut-your-doctor-bill

There is always a silver lining it seems. Perhaps the illegal drug trade is a good thing? A quick check at the Cameron County, Texas website under prison population, you can view pictures and the status of all 900+ inmates. Over 95% of the inmates are in for drug related offenses. With that many “druggies”, it would seem Cameron County could benefit from drug traffickers Robin Hood approach to neighborhood health care.

drug-gang-clinics

 Bruno, 1924-1938

Pet health insurance, thus far, has escaped the scrutiny of Washington’s Communist Cadres. There is no Pet Health Insurance Czar yet, not even a hint that one will be appointed anytime soon. So, what’s up with that?

Any history buff will tell you that the first pet insurance policy was written for a dog in Sweden in 1924. His name was Bruno. And in 1947 the first pet health policy was written in Britain with sales taking off rapidly. Today the UK has the most mature pet insurance market in the world, with over 18% of pets insured. Yet Jolly Old England has not extended their government safety net to man’s best friend. This is an obamanation indeed. Are not all of England’s four legged creatures entitled to health care?

And what about the USA? The first pet insurance policy sold in this country was to cover TV’s heroic dog Lassie. The underwriter, of course, was Lloyds of London of Great Britain. Today, pet health insurance in the United States is becoming popular with dog and cat lovers of all socio-economic levels.

Pet health insurance is a bargain these days. Premiums as low as $10 per month. And, you can take your animal to any licensed vet – PPO’s have not entered the scene yet. Group policies are available too. But, many Americans simply cannot afford coverage even at these rates. Yet, all American pets are entitled to health care, are they not?  We need and must demand that the federal government at least mandate better benefits, or implement a national pet health insurance plan at best. Animals have rights too!

And what about food insurance? When are we going to get that? We are all entitled to food, aren’t we?

Repealing the laws of supply and demand?

http://www.americanthinker.com/2009/07/welcome_to_mexico_gringos.html - This article is “right on.” We have been predicting this for the past six months and have even started a medical tourism company to assist our clients in seeking affordable and easy access medical care in expectation of when the communists (democrats) expand our national welfare state to include “free” medical care for all.