In this episode, our guest is Joel Wood, the President of The Council of Insurance Agents & Brokers. He has been the top regulatory and government affairs officer at The Council since 1993. He came to Washington a decade earlier to work as a press and legislative director for Rep. Don Sundquist (R-Tenn.).
On the heels of the CIAB’s recent conference, Joel joined us to expand on his vantage point around affordability and access to care, which he discussed in his keynote address at the EBLF conference in Colorado Springs, CO.
Get more insights from our conversation with Joel, and read a few highlights from our discussion below.
The challenge of access to care requires new solutions
Costs are expected to rise another 6% in 2023. Accordingly, 7 out of 10 employers anticipate significant healthcare cost increases over the next three years. Budgeting is becoming very challenging. The rationale is to preserve the employee-provided group health insurance marketplace, and employers already think their healthcare costs are unsustainable. COVID-19 caused employers to refrain from introducing too much change in an uncertain period, and now people are just turning their attention toward benefits initiatives again. What can we do? It sounds simple, and it is: make life easier for customers. That's why the product Paytient offers in the environment of higher and higher out-of-pocket expenses for individual consumers is so welcome in the marketplace today.
False Summit
Having survived many battles over the ACA and everything that's unfolded since it, the ACA undoubtedly created access for Americans to healthcare—that's not under contest. However, it's almost like a false summit. We’ve helped people get access to insurance coverage, but we haven’t yet bent the healthcare cost curve. It has only gotten steeper, and we all know the things necessary to bring down the cost of health care. These are difficult politically: obesity, end-of-life issues, chronic illness, overutilization of specialists, etc. have lead to ever-escalating prices for insurance coverage. Specialty drugs, the need for more transparency in pharmacy benefits. These are all very, very difficult things to address.
The goal is that a consumer can afford, understand, and participate in their own healthcare. It's about quality and being an active participant in those choices. But it’s not happening today because in many cases, they have not been able to see the prices. It's like asking people to be consumers and buy something where they don't know what it costs, and they don't have money, and there is no store, so how is that supposed to work? That’s why price transparency and beyond that cost containment are the next summits we need to climb.
The 2024 election will bring practical solutions in focus
There's a huge gap between today’s reality and the philosophy of consumer-driven healthcare that won’t be bridged until we start asking our doctors how much that recommended MRI costs across the hallway compared to what I can go shopping for five miles down the road.
There are a lot more practical members of Congress than you would think who would like to try to resolve things with transparency and healthcare pricing. There are some other access-related issues, and I think one of the big things that we've got to get a handle on is the ever-increasing cost of specialty drugs.
What’s at the heart of the care affordability issue
I know that I talk so much about transparency. The other element I didn't mention is that all these machine-readable files are now available from providers. There are a lot of barriers to accessibility to those files right now just because they're so massive, but we're early in that process, and I think that there is an opportunity to unlock a lot of data-driven insights.
Insights for employer clients so that we get a better handle on ultimate costs and there are ways to fix the data. You know, standardization of terminology, for example, and making sure that payers include conversion of their prices since they're all expressed in different ways. But that's something you'll see play out, and again, we're very early in this process. But, I tend not to be the sky is falling on that the way many of the provider groups have said that they would be, and we're going to get a better insight and pricing in a way that ultimately can fully control pricing in the coming two or three years.
Listen to the full discussion via the podcast player below or by clicking this link. If you'd like to connect with Joel you can reach him via LinkedIn or learn more about CIAB at ciab.com.
