No one was more shocked than I was that the conversation you’re about to hear between myself and author Scott Hesier was fascinating. Scott recently released a book, Healthcare Is Making Me Sick: Learn The Rules to Regain Control and Fight For Your Healthcare. Scott has spent more than 20 years working as a consultant for clients in the insurance and healthcare system and is a founding board member and senior vice president of one of the largest employee benefit companies in the country.
Today, Scott is the founder of the website uncoveredhc.com–a site that arms people with the information they need to make smart and informed health insurance and healthcare choices. Scott understands the health insurance and healthcare system in a way that most people simply don’t.
In this episode, he provides some tips for listeners, provided in actionable plain-speak language, about what most of us are not doing that we could be to empower ourselves in the healthcare and insurance systems. He explains how we can make better choices in selecting our healthcare insurance plans, how we can maximize our coverage, how we can lower costs for treatment and prescriptions, and how we can generally make better choices that render better health results.
Scott Hesier: I started some 26 years ago with a firm. I was a partner and one of the founders of commercial insurance brokers, where I brought up the employee benefits practice. We became a regional company throughout the Midwest, and I did that for years with corporations of all sizes, from small employers to large mid-market, to Fortune 500s.
I did that for 26 years and had great success with saving employer’s significant money, and enhancing their programs, and meeting their objectives. What struck me, certainly after ACA, is that the employers potentially weren’t the best avenue to affect change for employees and get to employees what they really needed.
With that revelation, I started looking at a number of different things differently than I had for 26 years. I found a whole new market coming up in the healthcare arena that actually encouraged me and caused me to look differently and look more towards the consumer, with the goal being of empowering individuals to become consumers of healthcare, and enhancing their outcomes while lowering their costs.
A Passive Participant
Nikki Van Noy: I think that a lot of people feel like me, which is we don’t have a sense of control over our healthcare and insurance. Can you talk to me a little bit about how that might be a misnomer?
Scott Hesier: Well, actually, I don’t think it’s a misnomer. I think a lot of people don’t have control of their healthcare and they just go through the motions. When it happens, they’re very passive participants, and that, in essence, is the problem we have in this country.
We have a third-party dilemma, as I call it in the book. You’ve got major corporations, hospital companies, insurance companies, and the government sitting at the table along with pharmacy, all talking about their objectives. Their objectives are legitimate, how can they meet their goals, their money, and their profits.
But you and I aren’t at the table, but you and I are the people that are paying, we’re paying our taxes for Medicare and Medicaid, we pay in our premiums, we pay in our deductibles and co-insurances. So, the goal is how do you bring people to the table with heavy players like that? That intimidates 99.9% of the people out there.
What I want to do is flip what I did for years for employers and show people tricks of the trade and how they can become comfortable and get more knowledge. Francis Bacon said, “Knowledge is power,” and that’s the first step. What I see happening is unique, it’s kind of the perfect storm, that didn’t exist five years ago. You have Obama Care, which was a generalization of cost-shifting and it allowed employers to increase all their deductibles and co-insurance to their employees–you have to pay at the point of service more out of pocket.
You have transparency and the egg’s been cracked, there are companies out there that are providing healthcare data, what the costs are, and what outcomes are. It’s new and they’re not always as robust as we want, but they’re out there. People can get information now that they didn’t have before.
Then you have the pretty much ubiquitous acceptance and utilization of any kind of phone in your hand, that allows you to access data, readily and easily, and people are used to that. You start to put all those together, and you have motivation because there’s pain–you have to pay more, you have actual information out there that will help you understand what’s available, and what things cost, and things do cost differently, and then you have tools to access that information.
You put that all together and what I’m encouraging people to do at a macro level as we’re talking right now, is that there is information out there, there are tools out there, and you have the motivation to actually do things differently. I would add to that and say, there’s also a lot of people doing things that are reducing costs, and that’s what my book goes into.
It shows you people, average Joe’s, all the way up to Bezos, Buffett, and Diamond, that’s Amazon, Berkshire, and Chase, trying to do it differently. I want to help people walk through that and do it.
Nikki Van Noy: Let’s start off by talking about some of the information that’s actually available to me that I might not be aware of and where do I go to find that?
Scott Hesier: Okay. If I can take a step back and maybe talk about the continuum that I address, and then part of that is where you can go to find information.
Nikki Van Noy: Absolutely.
Scott Hesier: How do you approach this, how can you become a consumer of healthcare, if people have been historically passive? I looked at it and decided, let’s approach this like any other situation, or a school project you had, or business situation. How do you approach things? You sit down, understand who you are, what your objectives are, and after you’ve established your objectives, you research the market, see what’s available out there, then you talk to those people that you researched and you negotiate, and work with them and come up with an end solution.
We’re going to do exactly the same thing for healthcare. The first thing we do is we sit back and clarify that healthcare and health insurance are two different things because what I hear most times is, my health insurance or my healthcare is substandard–actually, they don’t’ say that, they say something far less pleasant.
What they’re saying is that their health insurance is too expensive, and that is not healthcare, healthcare is the services you’re getting from your doctor and providers, health insurance is how you pay for it. First, we have to talk to people about that and the difference between the two, and then what we do is understand who you are from a health perspective. You might do a health risk assessment and you get your health profile and your health history, and you get your family history, and you put that all together and you’ll start to have an idea of what you currently have, as far as conditions.
You look at your vital information and what you might have from family history, and once you have that, you have got a good idea of who you are. The next thing is we show people what common costs are. Everything from just visiting a doctor for the flu to having major brain surgery, all ranges of services. Now you know what it costs, and we sit back and say, can you afford that? How are you going to approach that?
Ninety percent of the people can’t afford a catastrophic event–they’re multimillions of dollars. You now understand that and when you go to the insurance market, you have a better idea of who you are and what plan is more appropriate for you. A lot of people make a totally different decision when they know all that information than when they go and just take either the lowest premium or the lowest deductibles and buy that and want to get done with it and move on.
Now you’ve looked on the financing side, we then say, you now know who you are from a health perspective, and let’s pick a doctor. Instead of just picking any doctor, somebody down the street, or somebody your mom told you about, or your neighbor, or your work compatriot, you can start looking up based on who you are.
What doctors treat what you currently have and what you might have in the future? You research them, and now you’ve got providers that are more aligned with you. You do that for insurance, general practitioners, and specialists. When you do that, then there are transparency sites that show you doctors and show you what their practices are, what their charges are, and the number of procedures they provide in certain areas.
The next thing you say is, I’ve picked a doctor, and now these charges are all coming in, which I expect from my doctor. There’s a checklist to help you know what you should be asking a doctor, here’s what a doctor should be performing for you, and if they’re not, they’re not the right doctor for you. You should find another one.
Then, from there, once you have a treatment plan, you need to ask them, what’s the most efficient way to pay this that gets me the best outcome–the lowest cost for the best outcome. That is a fair question to ask and again, if the doctors are good partners with you, they’re going to do that. We then talk about communicating with the doctor. Imagine going to the car mechanic, dropping your car off when it rattles, and you just say “Hey, there’s something rattling, I’ll see you in a couple of hours.”
They’re going to run every test they can because they have no idea what to do. It’s your responsibility to talk to the physician. We teach people how to talk to their physicians, we teach them about the world of the physician, how much time the physician has, what they’re really interested in and how you can best communicate your story to them. There are ways to do that, a checklist to do that, and training that we have.
We finally move to once you’ve done all that, you’re negotiating, you’re communicating with your doctor, you’re getting a better outcome, and you’re utilizing the system effectively. Then we talk about, well, what’s one way to manage all of this? One way is you buy insurance to do it. The other one is don’t get sick, and as crazy as that sounds, 50% of all of the claims in America are lifestyle based.
Which means that you and I have control over that. If we have control over that, we need to get off the preverbal couch and do some things about it. We walk through all that, about how to practice preventative medicine and where you can find things you can do to help make changes.
And then we finally talk about alternative ways to provide insurance or creative alternative ways to fund healthcare situations. Ultimately, we also talk about retirement because what I find that is just amazing, is that most retirement managers do not talk about healthcare costs. Just one quick stat is that after 65 when you’re on Medicare, you should be expecting to pay between $125,000 to $150,000 out of pocket costs.
Most financial people do not talk about that–not all, but most. If you don’t put that in there, you are going to knock down your fund. We’re doing a continuum of the whole healthcare experience, walking people through it, and encouraging them to use some of the resources we’ve put in the book–the reference places, the transparency sites, the tools, the techniques, and the cheat sheets that we put together, to become proactive.
Then we give examples of people that do some of these things and are successful. That encourages people to look on their own.
Start at the Beginning
Nikki Van Noy: All this research you’re talking about–I felt so disempowered for so long, I do exactly what you were saying people do, which is I just go and find the cheapest thing and I’m done with it.
I don’t want to think about it and then I complain when I have to use it and it doesn’t work.
Scott Hesier: Exactly. I would suggest that maybe because you didn’t examine who you were before you started looking at it. If you sat back and said, here are my health situations, here’s my family health situations, here’s what I may have, here’s what I can expect potentially to pay next year and in ongoing years.
Now, when you look at a healthcare plan, you can say, “I may have to have a procedure that would cost $50,000. Mathematically, what’s the best program to buy?” It may be better to have a different deductible. Looking at it that way, you have your objectives established when you go look at healthcare plans. It changes the paradigm.
It causes you to ask more questions. It takes a little pre-work. None of this is easy. There’s another gentleman out there, Dave Ramsey, that talks about the same things. He puts it in a logically organized manner, and he says, “If you are disciplined and do it, you will have a different outcome.” That’s basically what I’m telling people, you have to start at the beginning, which sounds overly-simplified, but that’s the reality, start at the beginning with who you are. When you look at it, that will help you choose where you should go.
There are a lot of tools. If you’re with an employer, you should ask if they have calculators that help you make these decisions. Talk to your HR staff. If you are not, there are websites that can help you if you’re going to individually make choices.
There are concierge sites that if you buy into them, they will help you make those choices, or you can make them on your own. The biggest thing is, you want to be as close to devoid of emotion as possible, and everybody gets emotional about this.
When you’re looking at healthcare and you’re on health insurance, if you’re looking at your care and plan, there is anger, frustration, and a sense of betrayal. What you have to do is you have to remove all of that emotion and do the math. It’s just a math problem.
A Math Problem
Nikki Van Noy: If you’re really going to stop and look at yourself and your family history and think about what you can logically anticipate, that can be difficult for some people, I’m sure.
Scott Hesier: Excellent point, we can do this at the Ph.D. level, or we can do it at, 101 level. No one starts at a Ph.D. level, you start at the 101. You can interview your parents, your grandparents, and they’ll know what the grandparents had. Put that down, and now you have an idea of what you may or may not be susceptible to.
Was there diabetes in your family, was there cancer in your family, was there heart problems in your family and how many? It’s like any problem–if you look at the overarching problem, and you try to solve the whole thing at once, you collapse. Take it and break it into small parts and solve each one, one at a time, and then roll them all back up together.
Then the story’s told. At the same time, you know what your overall objective is, so break it into units and solve by unit.
Nikki Van Noy: Let me ask you this. This notion of empowerment with health insurance and healthcare is pretty novel to some people. Is health insurance as broken as we think it is or is the problem that we don’t understand where and how we’re empowered?
Scott Hesier: It’s not broken at all. I’ll give you a statistic on that from success–success is how well the stock is doing. Since the ACA went in, the stocks of the top four major health insurers, the lowest one went up 151% with the highest one being close to 300%.
While at the same time period, the SMP went up 91%. Health insurance isn’t broken at all from that level. I purposely say it that way to motivate people to say, “Enough is enough.” You understand what your objectives are. Now, to be very direct, one individual calling up is not going to change a rate with any of the insurance companies. There’s no leverage to do that. What you can do is buy the right insurance plan by knowing who you are.
I’ll give you an example, I had a former associate who we put in an HSA program in probably 2005. She had serious chronic health conditions that caused her to be on medications and miss work and a ton of different things, and she was an incredibly dedicated individual. She saw the health savings account program coming in and was panicked that we were taking all of her benefits away, but she sat down and did the math. She realized the way we had structured it, that if she took the higher deductible, she was going to get a lower premium, and that she was going to max out. She was going to have enough healthcare claims that she was going to go through that deductible.
At which point in time, her benefits would be 100%. It was more cost advantageous to her over the year to take the significantly higher deductible plan, but it provided a cash flow problem. She wouldn’t have the cash upfront, so she came up with really creative things. One being she used credit cards and also, she went to her doctors and asked for a payment plan and her doctors agreed. They stretched out her payments, so she wasn’t getting hurt on a cash flow basis. She was doing that for the whole year. The other thing she did, she looked at it and realized that some of it was lifestyle-based. She aggressively went after her lifestyle, did a number of different things that were successful, and was able to change her medications. In essence, she saved some money on what she was doing and felt a lot better anyway.
Nine months through the year, she’s was doing pretty well cash flow wise, and she still owed the doctors money. So, she went to them and said, “If I gave you cash now, will you give me a discount on the remaining amount that I owe you?” They said yes, and she put everything I’m talking about all together and had control of her life. It wasn’t like insurance got cut in half or she found a miracle cure.
What she did is she understood her situation, she did the math, she was proactive about things she could control, and she had some tools to work with. She was in control.
High Deductible Plans
Nikki Van Noy: Now, let me ask you. Since obviously, you have discussed this with many people, is this woman’s scenario fairly common? Are most doctors willing to work with patients in that way?
Scott Hesier: High deductible plans have been around since 2014 with the ACA. That was the legitimization of cost-shifting to employees and individuals. Most people on healthcare.gov programs have large deductible plans and that’s just the nature of the premiums, unfortunately.
But because of that, the provider community knows that people are coming in, and having to pay huge chunks of money out of their own pockets. This is where we talk about how to talk to your doctor. We take each one of these segments, if you go in and if you talk to your doctor, and you have a relationship with your doctor, and you are explaining to your doctor everything health-wise with you so they can treat you well, and part of what you’re asking about is cost. You are upfront with them and diplomatic about how you say, “Doc, you’ve got to help me because this is all on me. How can we find the best, effective care?”
I find most doctors will help you, they’ll find different drugs, they’ll find different treatments, and they’ll work where they can. Again, not in every situation. There are unique illnesses that there’s only one source of the drug, or there’s only one procedure they can do, and there’s not a lot you can do about that.
Doctors will work with you and what I would suggest is, if they won’t, you have the wrong doctor. You need to create a partnership with your general practitioner internist. They’re the gatekeepers to the whole system, they’ll get you into the specialists faster, and they know where to go.
They’re the first line of partnership and we strongly recommend getting a very good relationship with them. If they’re partnering with you, they should be able to help you. I’ll also say, a lot of them don’t know about a lot of things I have in the book. I would share it with the doctors.
The whole idea of the book is to collaborate with everybody. If we all start sharing information, we can get a movement going with this and actually have better outcomes. I’ve always said if I start an idea and I plant this seed, the idea will be so much better after ten other people look at it and tweak it in their own ways.
Lower Cost Prescription Drugs
Nikki Van Noy: In terms of prescription drugs and bringing costs down, are you looking for generic forms or are there any other ways through which you can alleviate those costs a little bit?
Scott Hesier: Think about this, almost everybody spends infinitely more time buying their phone, researching, comparing, and analyzing than they do their health. Health is the largest asset that you ever will have. It is your life. So, it is such a huge disconnect for me why people don’t spend more time doing that. It is going to take effort, and like any new effort and when everything changes, it will be uncomfortable. I have example after example of people getting different outcomes.
You will start finding through the transparency tools out there, that services, everything from MRI to knee surgeries, are dramatically different in different locations. So maybe you want to start going to a different place. When you have this kind of information, and you go to your doctor and talk about it, now you have a real dialogue. If you do it your own way diplomatically, they need to respond because they are in business. If they don’t, then maybe drive three hours to a different service. I just had an MRI. In the location I was in, it was going to be 2,500 bucks. I drove for three hours and got it for 400.
There are knee surgeries–a total knee replacement is $68,000 in San Francisco. You can go to Phoenix and get them for about $40,000 less. To go back to your question about RX, you know that is in the press all the time, and there is not enough time to talk about all the things going on with RX, because there is a lot. But what is important is that there are tools out there. There are discount cards out there that I thought were a hoax throughout my whole career. I thought, “Those aren’t real,” let me tell you, they are real.
You can go get deeper discounts off of your drugs than even your healthcare carrier, who gets discounts already. I have seen people go in with a topical cream for pre-cancerous skin. $200 to their healthcare, one drug discount card brought it down to 150, another one got it down to a 100, and now you just have to show your card, and it is free with a coupon that you get over the phone or your computer.
There are also many different tax-free’s if you have chronic conditions. I have listed out twelve or more and how you can get better pricing by buying differently using these coupon tools. There is also a service out there, called the Patient Assistant Program and it is a program where manufacturers offer deep discounts on single branded drugs. They are not generic. They are a single source and you can only get them for these certain situations.
There was an individual on a blood thinner called Eliquis. It is $430 a month through their carrier, and they got it for 10 bucks a month. Now, that doesn’t happen all the time, but there are these websites, one of them out there is RX Hope. There are over 350 drugs that have programs. You have to qualify for income, or you have to qualify as a high deductible plan, and you may or may not qualify, but it is certainly worth the phone call.
Then to your point where you asked about generic. You always want to try generic. So, you try that first, but there are ways now to go and comparison shop what the costs are. You can go to different pharmacies in the same city and get different prices with the same drug. You can also go to the big box stores, they are trying to entice people to buy other things and they give some drugs away for free, and a number of drugs for only four bucks.
They aren’t common, but if you start to become a shopper you can find it. So, if you are willing to move around your city, you can find different costs at different pharmacies. Then the last thing that a lot of people don’t know is to talk to the pharmacists. One of the drugs I was on and got a significant reduction on the pharmacist said, “Oh, your insurance plan won’t take that coupon if you do that.”
I looked at him and said, “Oh yeah they will” and he said, “No, they won’t.” I said, “No, what they won’t do is I can’t run it electronically through your system, but I can get a paper form and submit it to my carrier, and they’ll take that form and they’ll apply it to my plan.” I saved $150 and that pharmacist looked at me and he said, “I didn’t even know about that.” I basically did a seminar for four people standing around me on how they can save on other drugs.
That is a big area, and I am glad you asked because the other thing is the pharmacy is usually where people first encounter the healthcare system. You or I go to a doctor because we are not feeling well. We want instant gratification now, and what does that represent? If a doctor says, “You need to go lose some weight, Scott, and you know you should eat differently, and you should exercise.” You say, “Doc, that’s going to take six months and I have got to make that happen myself.” What do we want? We want a pill, so they script a pill, and it makes us happy, and we leave. So, a lot of this is on us too, and we have to recognize that.
Nikki Van Noy: There is a lot to be said for it being on us. I have said this time and time again, but it can feel so disempowering and out of your control. That is just a novel concept that any of this stuff can in any way be on us.
Scott Hesier: Well, it’s the definition of insanity. If you’re miserable now, confused, bewildered, angry, whatever, and you keep doing the same thing, do you think anything is going to change? I just encourage people that if you are not happy, let us do something about it. The encouraging thing is there are things to do. So, again, get off the couch and try some stuff, but don’t tackle the whole world.
You just went to the doctor and got a drug, let’s try that. Can you get it cheaper? Because here’s what happens when somebody gets it cheaper, they are elated. They got a win. They go to the win column, they put a one, and that encourages them to try it again. All I am asking is people not to attack this whole thing. Where are you in the continuum, let’s take that section and apply some principles to it and see if you can get a small little win. If you get a small little win, let us take another step next time and keep building it.
Nikki Van Noy: So, talk to me a little bit about retirement and health insurance. The numbers that you mentioned earlier in this conversation are staggering. How can people get creative with that especially if you’re living on retirement income?
Scott Hesier: It all depends on where you are in the cycle. You know if you are towards the end, it’s obviously harder than if you start out earlier. You want to talk to a financial advisor. There are certain tax-deferred and tax-free vehicles through an employer, or on your own, that you can work with and then there are premium reduction programs.
Through an employer, they are pretty ubiquitous, and everybody uses them, meaning you pay your premium pre-tax versus after-tax, and the government will let you do that.
There are HSA’s, and if you get an HSA, you can save money. The money that is in that account is tax-deferred and if you build up X amount you can invest that money. So, that can be a vehicle, kind of another 401(k) type that you can put money in pre-tax.
You can take taxes off your healthcare expenses over taxes of an individual and more people do that. There are creative ways to look at different forms of life insurance. You could sell your life insurance plans. Now I am talking more about situations where you get in an unexpected situation and you don’t have the cash. You can sell any kind of life insurance policy out there from term insurance, to whole life insurance, to permanent insurance. You can sell those. You won’t get a great price, but it is an asset that people forget about.
I talk about credit cards. How many credit card offers get mailed to you in a month? A lot of people get a lot of them and I suggest taking one of them. That is a nice line of credit that you can get, put it in a drawer, and that’s your healthcare.
What you don’t want to have is have a health condition and your cognitive reasoning drops by 70%. Then add to that, financial pressures that will further confuse the whole situation. You should only be thinking about your health.
Nikki Van Noy: That is the best argument for opening a new credit line I’ve ever heard.
Scott Hesier: Right, imagine getting a stage four cancer diagnosis and a $6,000 bill when you don’t have the money. The average American can’t find an additional $400 to spend. So, how are you going to come up with $6,000? You’re worried about your kids and your family, what you are going to do about your job? So, let us take that off the table. You are going to have to pay that back but deal with your health right now.
With permanent or whole life insurance, that’s a vehicle that you can put money in. They will provide pretty good dividends and you can borrow against that. It is an asset and it is all tax-deferred. Talk to your accountant, bring some of these ideas up and some of them won’t like this but you should say, “I might have to spend $125,000. Are you going to help me?” Again, nothing is perfect, but we have got to do things differently.
Have a Plan in Place
Nikki Van Noy: Why do you think that this incredibly significant cost is not coming up with financial planners, especially as people plan for retirement?
Scott Hesier: After 65 I would surmise it to the idea that Medicare is there and that takes care of everything. That would be my guess. If you are working and employed, you have a healthcare plan, so people think you are covered there. You have got to come up with deductibles out of pocket, which are now significant. I think part of it is looking historically at it. Deductibles weren’t as big of an issue, but since 2014, people have huge deductibles. They have huge out of pocket costs, $5,000 to $6,000. For a family, it could be $12,000. Those are numbers that shift the playing field. I think it is just people catching up with it, meaning the industry is catching up.
The good ones are, but not everybody. A lot of financial plans are robo-plans. They are programs that have certain formats. If you fall into a certain format, that is how they are going to invest for you.
Nikki Van Noy: This is backing up to an earlier point that you made but you were talking about how people can use concierge site as they are finding their correct plan. To me, that seems like an easy solution. Is there a reason why that is not at the top of your list?
Scott Hesier: I am trying to motivate people to no longer be a passive participant and be proactive. What I want people to do is to understand the whole process and what it takes and then, given their own circumstances, they may be too taxed to do it themselves. Then you could buy a service that helps you do it. If you are learning piano, you have got to learn the basic scales and chords and everything else before you can just jump into a song.
And if you don’t know those and you just learn one song, that is the only song you are going to play. But with that said, there is a large segment of people that may be just overwhelmed, and they can’t.
I provide a concierge service where people pay on a monthly basis that will help them, at uncoveredhc.com. There are others out there. You should look at all your resources. What I am really trying to encourage people before they spend any money elsewhere is to do it yourself. Because if you do it yourself, you are empowered.
If you are empowered, you are more in control, and you’re more satisfied with your life. The other thing we talk about is a couple of catastrophic situations and that you are not going to think straight in a catastrophic situation. So, what I really want people to do is sit and practice so that if they do get in a catastrophic situation, they are more prepared.
If not, maybe that is the time where you buy one of these services. What I always say is that you need an advocate. If you are going into a serious medical situation, you need an advocate. That can be your spouse, or that can be a partner. That can be a neighbor, or that can be a business associate. Or it can be one of these services, but you need an advocate to hear what you can’t hear.
Everyone has to decide what makes the most sense for their health situation, but what I am trying to talk about is if you can start to train yourself to be aware of who you are, of the tools that are available, so that in non–emergency situations, you can deploy those, you will have better outcomes. Whereas if it is an emergency situation, no question, you do what you have to do.
There is also telemedicine. This is a whole other burgeoning field of finding ways to communicate with physicians and clinicians in non-traditional manners. It is either by telephone or texting and it is an enormously fast-growing area of the industry.
There was a person who had an earache on a Saturday night at two in the morning and went to the ER and had a $2,000 bill over an earache. I asked them, “How about telemedicine?” They had never heard of it. They could have made a call, got an Amoxicon script, gone down to a walk-in 24-hour Walgreens or CVS or whomever, and gotten the medicine in them. And spent very little. Amoxicon is four bucks and the phone call is $45 and you can call at two or three in the morning.
There are tools out there and there are avenues to pursue that are producing different outcomes. I run across them now almost once a week. It is very encouraging. Who will survive is yet to be seen, but they are out there. With one-sixth of the economy being healthcare, you’ve got Silicon Valley chomping at the bit to get involved.
The Amazon’s of the world, they want to bring automation and technology to make all of this easier to do and give better access.
Take the Initiative
Nikki Van Noy: Is there anything else in, either the healthcare or health insurance industries, that is promising and that we can all feel really good about?
Scott Hesier: The transparency sites are out there, and I have listed a number of them in my book. You can pull them up and you get prices for services, and some of them you can get information about doctors and how many procedures they perform in that area, which is an indicator of how good they are, or not. If someone has performed a thousand of those procedures, they probably have little experience. If someone has only performed five, you have to consider that.
It may be because that person who performed five may have been the top student at John Hopkins, and studied at Mayo, and is the best person in the world doing that procedure. But start looking at factors and come up with your own conclusions. Those tools are out there, and when you have those, you can start an intelligent conversation with your providers. They have to respond and when they respond, you give more information, and you are starting to be involved in the decision process. That gives you, in essence, control and it will give you better outcomes.
I helped a couple that unbelievably both got cancer in the same year and were devastated. I helped them get onto a concierge plan with their existing carrier, and then started walking them through everything, and then helped them look at the couple of doctors that have been recommended.
We looked at the doctor’s outcomes and their qualitative scores and said, “Yeah, here is the ranking of them. You have a couple of good ones and you are making good choices.” They were so relieved. So, knowing that they were making good decisions really, really helped them.
I want to segue with that a little bit to say what encourages me every day is talking to people like that.
The demand is so overwhelming for people to deal with this because of the frustrations they have. Just giving people a little bit of help makes them feel tremendously better. I look at that and to me, coming from the world I was coming from, it’s pathetic that people aren’t trying to solve this in a greater level because the demand is off the charts. If we can reach people and start getting them more involved, they can start feeling better themselves.
Nikki Van Noy: Anything else you want to share with listeners that we haven’t gotten to yet Scott?
Scott Hesier: You know I’d obviously love them to buy the book and read it, but I’ll also say that they can do it themselves if they take the initiative. That is what I’d ask them to do, is take the initiative. Change their paradigm–there are better outcomes out there. There are tons of stories of people doing it. If you take the initiative and you have a positive outcome, tell two or three other people. Tell people about it, and about how you did it.
Tell them it can work because if we can all do this, we can improve the nation’s healthcare, not just our own.