Is your insurance company making you healthier or keeping you sick?
Is the high cost of insurance upsetting you?
Are your insurance premiums rising every year?
Have you noticed that more comes out of your paycheck to cover insurance each year?
Are you tired of high prices and reduced coverage?
What if paying higher premiums was attached to worsening health?
If you could ensure that higher premiums or co-pays guaranteed better health, perhaps you’d be okay with paying more.
But the fact is: You’re paying more and getting a lot less.
Do you think your health insurance company cares about your health?
Proof of this would be support of doctors and procedures that actually reverse chronic health conditions.
The cost of heart disease and diabetes alone is forecast to bankrupt the U.S.
The cost of conditions that experts claim will “bankrupt” our country’s healthcare system, are our leading killers, heart disease and diabetes.
Looking at those two diseases, if your insurance company truly wanted you to be well and lessen the financial burden on everyone, they’d be in support of, and leading the way for, treatment that fully and truly reverses such conditions.
Such treatments have been proven in research to not only reverse the two major killers, but they negate the need for expensive drugs and surgeries.
If your insurance company supported such a regimen you would know for sure their main concern was your health, right?
Does your insurance company support natural regimens that reverse degenerative disease?
Have you found them in support of inexpensive dietary and lifestyle changes that really work?
If you’re not sure of the answer, I can tell you it’s a definite no.
Your insurance company absolutely does not support inexpensive, natural treatments that reverse degenerative diseases.
Have you ever wondered why they don’t?
Have you wondered, as I have, why insurance companies won’t get behind programs that really work, really get people off drugs and really reverse disease?
Did you know they are opposed to any type of health care that reduces one’s need for traditional, drug-oriented medicine?
We just asked a lot of questions.
Here’s your answer…
You’ve heard the expression “follow the money”? It’s often the answer to issues that don’t make logical sense and it’s the answer here as well.
When you follow the money you learn that your health insurance company’s bottom line improves when you are ill and diminishes when you’re healthy.
Let me repeat that since it doesn’t intuitively make sense:
Your health insurance company’s profit booms when you are ill and lessens when you’re healthy.
It’s perplexed me for years
For years I’ve been pulling my hair out trying to figure out why I, and my team here at Root Cause Medical, wouldn’t be an insurance company’s “dream team”.
We get patients off drugs; we heal them from life threatening degenerative diseases, all at a mere fraction of what traditional medicine costs.
Why wouldn’t insurance companies love what we do?
Why, instead, would they continue to overtly thwart our efforts to heal by slashing reimbursements and disallowing care? Something they do year after year.
Your health insurance company profits more when you’re sick
First, let’s acknowledge that insurance companies are very clever.
When the Affordable Care Act (ACA), also known as Obamacare, came into existence, insurance companies were initially up in arms.
They whined and railed about their ability to stay in business, how their profits would be cut to ribbons, and patients would suffer.
When the ACA did pass, the insurance industry went into action and boy, did they make lemonade out of lemons.
How insurance companies circumvented the intentions of Obamacare
Here’s what they did to counter what Obamacare intended:
Obamacare mandated that insurance companies utilize 80 – 85% of their premium income for patient care.
This percentage is called the Medical Loss Ratio and previously insurance companies had averaged about a 70% utilization level, leaving 30% for profit.
Now, with Obamacare, their profit margin would be cut down to 15 -20%.
As a frame of historical reference, in 1993 health insurers who weren’t yet for-profit, spent 95 cents out of every premium dollar on medical care. Their Medical Loss Ratio was 95%.
3 steps insurance companies cleverly took to increase profits
Facing a reduction of profit from 30% down to 15 or 20%, insurance companies made some decisions:
The First Step: Insurance companies realized they had to increase the size of their overall pie and do it quickly. According to the author of An American Sickness, “a new perverse motivation to tolerate big payouts” developed.
One real-life example cited in the book was a drug costing an insurance company $19,000 per month that suddenly skyrocketed to $131,000 per month, when the patient’s doctor changed hospitals. The drug was the same, the dose was the same, the only thing that changed was the pharmacy dispensing it.
The insurance continued paying, not commenting at all about the exorbitant price increase.
The higher payout actually helped the insurance company in two key ways:
- Their need to pay 85% of their premiums towards patient care was helped along with the higher price.
- While they must reach the 85% threshold, they are not penalized for making money while doing so.
How does your insurance company make more money by paying a higher price for drugs?
The Second Step: Your insurance company receives legal rebates (about 30%) for the total cost of the drugs you are prescribed, therefore the more drugs you are prescribed the larger their rebate – another revenue source.
In the above example they agreed to pay out over $110,000 more per month for a single patient’s drug. Sounds ridiculous, but their rebate rose from $5,000 to $39,000 per month. And that example is for a single patient.
Raising your premiums and deductible handles their shortfalls
The Third Step: Another tool they use to increase the overall size of their income is to raise your premiums, increase the amount of your deductible, and raise the co-insurance percentage. All things you have been experiencing the last several years.
Remember when your plan covered 90% and now it covers anywhere from 60% to 80%?
Author Rosenthal had this to say: “In order to make sure their 15 percent take is still sufficient to maintain salaries and investor dividends, insurance executives have to increase the size of the pie.
To cover shortfalls, premiums are increased the next year, passing costs on to the consumers. And 15 percent of a big sum is more than 15 percent of a smaller one.”
While 30% towards profit pre-Obamacare sounds a heck of a lot better than 20%, it’s not really if you increase the overall size of the pie. Your insurance company needed to increase their total cash flow to compensate for the reduced percentage allowed for profit.
e.g. 30% of $300 million is $90 million.
20% of $500 million is $100 million.
Your insurance company just earned an extra $10 million despite the rules of Obamacare.
How your insurance company increased their profits despite Obamacare
Yes, the percentage is lower but the profit is higher. Insurance companies aren’t stupid. They found a way to successfully increase their profits despite Obamacare and you’re the one feeling the pinch – it’s your costs that have skyrocketed
Barry Cohen, owner of an Ohio-based employee benefits company: “while to some extent insurers do better if they negotiate better rates for your care that is true only under certain circumstances and in a limited way.”
“They [insurance companies] are methodical money takers, who take in premiums and pay claims according to contracts — that’s their job. “They don’t care whether the claims go up or down 20 percent as long as they get their piece. They’re too big to care about you.”
You can get out of the trap of “funding” your insurance company’s profits with your ill health.
Let me be clear; I’m not saying that you shouldn’t have insurance coverage; I believe everyone should. But a high deductible plan that you have “just in case”, will be there for you in case of a crisis.
You need to come to grips with the fact that your insurance company is not in the business of making you healthy – but we are.
Root Cause Medical Clinic specializes in, and achieves, the reversal of many chronic health conditions: from heart disease to type 2 diabetes, from chronic digestive issues to fatigue and hormonal imbalance. We get the job done if you’re willing to make diet and lifestyle changes.
Our success rate is about 85%.
We don’t just hand you a pill; you are an active participant in regaining your own health. And we’re right beside you, helping you all the way.
Would it surprise you to learn that in just a few short months you could reverse a chronic disease that had plagued you for decades?
It sounds incredible; but guess what, your body IS an incredible machine. It’s ability to heal and repair with the right help is rather amazing, and personally I never tire of watching it perform its miracles.
Contact us today for a Free Consultation and let’s get started.– Call (408) 733-0400.
If you are not local to us you can still receive help; our Destination Clinic treats patients from across the country and internationally.
We help the world’s busiest people regain, retain and reclaim their health, energy and resilience.
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To reclaiming your best health,
Dr. Vikki Petersen DC, CCN
Certified Functional Medicine Practitioner
Founder of Root Cause Medical Clinic
Author of “The Gluten Effect”
Author of the e-Books: “Gluten: What You Don’t Know May Be Killing You”, “5 Simple Ways to Regain Your Health”, and “Hiatal Hernia, Many Symptoms, One Cause”