The “Go Anywhere, At Any Time, At Any Price” mind-set common to most plan members all across the Fruited Plains tugs at the Motherhood instinct of most Plan Sponsors who often rely on the advice and guidance of their HR department.
“We want only the best for our employees!” is the corporate message.
How do you argue against that you ask? Well…….that’s easy peasy. Armed with common sense, reason and logic coupled with a strong dose of critical thinking will put you on the winning side every time.
This can’t continue. It’s discriminatory. It’s incompatible with traditional American business practices. It’s unaffordable. It’s insanity.
Peter and Paul are both on the company’s Reference Based Pricing Expense Account. Their company issued credit card pays for Peter’s stay at Motel 6 at $55 per night and pays for Paul’s stay at the Ritz down the street at $1,000 per night. Anyone see a problem with this? That’s what status quo health plans do all the time. No one cares what it costs when using Daddy’s credit card.
Discriminatory? Of course it is. Health insurance indemnifies the insured against loss. If Peter is indemnified $4,000 and Paul is indemnified $450 for the same MRI the plan, by definition, is discriminatory. One is indemnified more than the other for the same benefit. This is common under managed care plans. Reference Based Pricing plans, on the other hand, where all providers are paid the same, have rectified that problem. Every provider is treated equally. Every insured is too.
The “Go Anywhere, At Any Time, At Any Price” mindset should be replaced with “Go Here, Here, and Here At Anytime, For Fair, Reasonable and Transparent Pricing. Go anywhere else and the difference is on you.”
Much to Paul’s surprise he was balanced billed. His employer deducted $945 from his paycheck to cover his share of his Hotel Ritz bill. “I thought I had Hotel Insurance!” grumbled Paul. “Whatever happened to “We want only the best for our employees. This is so unfair it isn’t fair!”
Peter didn’t have that problem.
