Controlling costs will require health plans to build small, tight, highly-managed networks of excellent providers. The current PPO (better known as APO’s – All Provider Organization) system simply does’nt work.
Employers could offer two plans: One that provides inexpensive comprehensive cover and makes economic sense and one that provides expensive comprehensive cover that makes no economic sense.
The benefits under both plans would be identical.
The “entitlement crowd” can buy up (in other words, pay for) the outrageously expensive comprehensive cover that makes absolutely no economic sense while the remaining participants enroll in the employer paid inexpensive comprehensive cover that makes economic sense.
This is how to control group medical costs.