January 2019 Edition. Volume XIX

If you were an employer and someone promised your workers better care, more comprehensive services, quality of care monitoring, and lower premiums wouldn’t you jump at it?  Well, they did.  Unfortunately employers didn’t pay much attention to the trials and tribulations suffered by their employees at the hands of managed care from 1988 until the present.  Now they are surprised that the premiums are beginning to rise…………..


These data succinctly relate the saga of the employers modern “Faustian” adventure with managed care.  In Minnesota, the “home” of managed care rate increases for the year 2000 are being estimated as an average rise of about 15%.   Now employers are caught between a rock and “a hard place.”  Because of the high employment rate and fear of losing good employees firms are reluctant to pass on the increased health care costs to their workers.  The Mercer study (reported in the Minneapolis Star Tribune, December 14, 1999) found the the PPO health care organizations (with their high deductibles), with the relatively most generous health plans for their employees (allowing some freedom of choice of physician or hospital; but not necessarily providing coverage for treatment recommended), were the only ones passing on some cost to employees.

Even with the more liberal PPOs the preferred provider part of this means that a “preferred” network has been established for the client.   Most physicians resent the term “provider” because it connotes and implies a “commodity.”  Physicians would like to feel that there is more to being a physician than simply providing a commodity.  The practice of medicine is said to represent one of the world’s two oldest professions.  If “preferred Networks” continue both will then be in the commodity business.

What is the status of health insurance at the turn of the millennium.  What is the Report Card on this?  Can employers still achieve better care, more comprehensive services, quality of care monitoring, and lower premiums?  Of course they can, they have only chosen the wrong model.  Clearly, employers need to begin to start to pay attention to prevention and health maintenance and take hard look at  better models such as HSA’s.

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