Phil Hauck's TEC Blog

Friday, January 19, 2018

"This Health Insurance Mess ..."

The most recent St. Norbert CEO Breakfast & Strategy session featured Mike Hamerlik, CEO of WPS Health Solutions, headquartered in Madison but known up here for their Arise health insurance plan.  Bigger, they run a huge plan administration business for major parts of the government (VA, etc.), covering 22 million people and processing more than $100 billion.  Huge.

He talked about “the health care mess.”  Among his points:
•  We talk about access, how it works, and the payment system, but the real problem is cost.  We wouldn’t be in this unaffordability situation if costs had been better controlled.  (He didn’t explain how, or what we must do in the future.)
•  Health Care System?  It’s not a system, because the interactive parts aren’t working towards a common goal.
•  Competition doesn’t work to reduce prices because of the lack of transparency, so market-based solutions can’t work.  The total cost is shared (and hidden) by too many.
•  Demand is insatiable.  “Do what it takes.
•  The solution is somewhere in the middle.
•  ObamaCare is rich in benefits, including guaranteed issue which makes private insurance ineffective.
•  ObamaCare would only work under an insurance concept if everyone was required to pay, but the penalties were too low and the subsidies too narrow.  Too many people couldn’t afford it, which is why the Individual mandate went away.
•  It’s a death spiral.  As costs keep going up, healthier individuals figure out a way to opt out.
•  Drugs:  In 2000, drugs were 5% of the total spend.  Now they are 25%-33%.  We need government price controls.  The industry says that would impact R&D, but I don’t think so.  It’s the (third party payer) market that drives prices, not costs.
•  Some of his solutions:
— Measure and publicize Quality:  There are variations, and we need to know them.  That will bring rationality to pricing.
— Waste:  Correlated with quality.  There’s at least 20% waste in the “system.”
— Get employers out of the payment sequence.  Let families decide what they want.

Some good quotes:
•  In my position, when I go out in public, I feel like the fire hydrant at a dog convention.
•  Asking for questions:  Go ahead.  I’m your pincushion.
•  Congress:  Either they do nothing, or over-react.

On the EAA, Health Insurance Costs, Value, South Pole and Congress/Sex

On The EAA
Jack Pelton, CEO of the EAA in Oshkosh, spoke recently to a St. Norbert’s CEO Breakfast & Strategy session, and made these points.  He came to the job after several decades at Cessna, finishing as CEO.
•  When I took this job in 2015, it was with the understanding to rationalize our go-to-market and talent development strategies.  We had to re-integrate our mission and use it as a basis for developing a 10-year Vision and Strategies for what we wanted to accomplish in bringing value to our 210,000 members, and a talent development strategy to insure we have the right people to lead us.  My time is spent on having the right plans, and having the right people to execute them.
•  Our growth strategy is, first, to provide attention and services to every phase of private aircraft ownership.  As a result, we serve many different sub-interests within private aviation.  We have a central emphasis on youth at the level of our 800 chapters, trying to stimulate interest with free flights, and then helping educate them to get pilot licenses in their late teenage years.  Right now, we’re working with Marvel comics to create a comic book character, Aviar.
•  This shows up in our annual EAA Fly-in.  We make sure there is something going on for everyone.  That’s way we’ve grown from 21 aircraft and 150 people in 1953, to 10,000 aircraft and 290,000 people this past July … including 11,000 campers and 800 exhibitors.
•  When we hire someone, they know it’s not just for that job.  Our IT head is also in charge of all the parking and camping.  Our HR head is in charge of services for all the campers.
•  Second, we have to be on top of trends that will impact our industry.  Thus, we have a constant presence in Washington, DC to make sure new rules and regulations serve our members’ needs while protecting safety.  Drones?  We share airspace with them, so work collaboratively on the regulation proposals.  Next year we will have a drone race at the Fly-In.

Health Insurance Costs
On two sequential days recently, I heard venting from two friends … both pre-Medicare, both couples with no dependents, one self-employed and the other retired, both making more than $88,000 so no ObamaCare subsidies … who said they are being quoted annual premiums in the $20,000+ range … plus deductibles.  So, they will be paying around $30,000 before getting any insurance relief.  Barring something catastrophic, neither will come close.
This is the cost-shifting that is being required of insurers because they can’t break even with the ObamaCare subsidies and the probable decision to reduce payments to insurers for losses.
There’s going to be a major rebellion shortly.
About half of all households are employed by self-insured employers, who are achieving no increase to minimal increase.  Those making up to $88,000 get some subsidy (median U.S. household income is about $50,000)… a lot of subsidy up to about $30,000.  And a large number of both young and poor are paying the penalty rather than fund the insurers.  Result:  Cost shifting to everyone else, like my friends.
The concepts were poor back on March 23, 2010.  At some point, future lawmakers, the ones who will shortly replace the current ones, will figure out what’s right, what works.  It will have something to do with “one-size-fits-all.”

What Constitutes the Value You Provide Customers?
Can you define explicitly the Added Value you provide your customers?  What it is that they now can provide their customers that they can’t without your Value Addition?
It’s an important question for all employees to know the answer(s) to … because virtually everyone’s work should be aimed at helping provide that Added Value.  The only other work is that which is required for the enterprise to exist.
— Thanks for Michael Wentworth for this.

How High is the South Pole?
What’s its altitude, its “feet above sea level”?
Very surprising.  It’s 9,300 feet above sea level, due to the ice accumulation.  That’s oxygen deprivation area.
It also has only one day a year.  That’s right.  The sun becomes visible on March 21, and disappears on September 21.
The North Pole?

Congress’ Sexual Harassment Costs
Courtesy of my favorite Congressional watchdog, No Labels (, in the 20 years since 1997, Congress has secretly spent $17 million to resolve sexual harassment and other workplace claims filed by employees of Congress.  Doesn’t indicate how much is for sexual harassment, but those involved more than 250 individual settlements!
        Of interest:  There's now a bill pending that would require individual officeholders to pay their own claims, not the taxpayers.