wphillips.jpg“Revolutions are not made; they come.”

— Wendell Phillips, 1811-1884, Harvard Lawyer

It is interesting that the Wikipedia biography for Mr. Phillips says that he was a great advocate of the virtues of plain talk. And after the last two days, I think he’s right.

Are more bad days coming?

Coming back from the holidays, I fully expected my first days back to have to help out with all the traditional stuff that gets piled up in a growing psychiatric practice when it is closed for several days. Appointment requests, medication refill questions, medical record stuff, etc. However, I was under no illusion that my main role (as the insurance expert in an office filled with doctors, nurses and therapists who want to have nothing to do with anything remotely related to such things) would be to be the bad guy that had to remind people that they were going to have to meet their yearly deductible once again, therefore the payment for the days services would be considerably more than their December appointments.

What I did not expect was the considerable numbers of patients who have had SIGNIFICANT changes in their coverage (as in going from a moderate copay —as outpatient mental health benefits are never equivalent to medical benefits— with small or no deductibles to large deductibles plus a healthy percentage of the contracted rate).

Whoa! Screaming, wailing and gnashing of teeth. Not to mention accusations that I’m just plain out wrong. If it wasn’t that, then it was emploring questions seeking an explanation— “Why is it like this when they take so much out of my pay anyway?” Boy— its hard to offer comfort to people when they ask that!

In an effort to find some simple explanations that John and Jane Q. Public could grasp and understand (lets not hope for agreement— my goal was to just give them something to chew on), I did a little digging in hopes of finding some words of comfort from people who understand this phenomenon well.

Its not gold, but I think its worth something.

When I opened my e-mail this morning, I found a press release from VIMO. While I’ve been getting stuff from them a for a little while now and given their focus on the consumer/patient I thought the report they were releasing on healthcare spending accounts might be helpful.

While I had and will continue to have to struggle not to offer the information as a platitute aimed to passify (although, not a bad outcome when you are dealing with the 15th person for the day), I think the report makes some very salient points.

Private health insurance spending is also a cash flow that should rightly be viewed as a significant national asset….Private health insurance premiums are not–at the moment, at least– packaged into securites that are tradable in a fincancial market. The poing of this exercise, however, is simply to drive home the magnitude of private health insurance preimums as a source of wealth.

OK– this is a completely new way of looking at that section of your paycheck for most people. —- But that and $2.00 gets me a small coffee at the local cafe.

The main point is that employers are having to look at new ways to structure their health insurance because they are not able to bear the brunt of the costs and they understand that their employees cannot either. Subsequently, this shift in plans is the first step in creating a system that can take advantage of triple tax savings that were created with the implementation of the Medicare Modernization act. This is summed up well by the report by saying:

The moral of this story has two fundamental points.

1. Health insurance is a large and growing part of compensation and therfore;

2. Anything that affects the value of health insurance benefits offered to employees will have an especially large impact on compensation since the wage and salary components of compensation are relatively stagnant.

Yeah— I know, it is still a hard sell. The people I worked with today, still aren’t really buying it. However, I am always amazed at how a little education and an effort to understand does soothe the soul. The news may not be good, but trying to connect and understand the problem does a lot.

On the flip side, I don’t really think that the people I talked to today realized that they had come of age, so to speak. Today, they made the great leap from passive patients to consumers, from whom action is now required. No doubt when they realize that, another wave of irritation and anger will emerge.

Right now, they surely don’t the changes they are seeing, but perhaps they will develop a tolerance once they have the “simple speak” knowledge and tools that take a lesson from our Mr. Phillips and give consumers a better handle the demands of these changing times.. Lets hope those get here quick or else I’ll have many more bad days ahead.