Healthcare Blog Post Part 2 – You Get the Most Out of What You Don’t Pay For! By Benet Heames

 In Blog

Guest blog by Benet Heames

According to the Centers for Medicare & Medicaid Services, “Health spending is projected to grow from 17.5% of our National Gross Domestic Product (GDP) in 2014 to 20.1% by 2025.” In 2014, the 17.5% was $3 Trillion of our National GDP.!

The rise in our healthcare expenditures over the next 10 years is something we will all be paying for, either through insurance premiums, taxes, or from one’s actual expenses for care. Unfortunately, the entire healthcare model in America is not what you would call “price transparent.” This is one of the major flaws in a system that has been slowly built since WWII.

There are a number of reasons why price transparency is lacking in our system, but it does relate to the fact that we have a third party payer – either an insurance company or Government program – paying a majority of the cost of the care we receive. Going back to the 80’s and 90’s, consumer’s were covered under insurance plans that paid full cost from day one. The consumer had no idea what the cost was and was not on the financial hook for a procedure. Thus, the consumer said yes to most procedures whether needed or not, irregardless of the actual cost of the procedures! Think of this model like an all you can eat buffet, but for your healthcare needs.

The reason for these first dollar indemnity plan designs stemmed from employers trying to use these benefits to recruit/retain employees, and insurance companies trying to win business with richer plan designs and lower premiums. Clearly, this is not sustainable…

Unfortunately, these plans led to high utilization across all services that simply were too expensive to continue. The mid-90’s saw many health insurance companies going out of business or merging with other systems. Eventually, the remaining and now larger insurance companies had to create other plan designs and networks that had cost containment, so they created Preferred Provider Organizations (PPO’s) and introduced deductibles and co-pays to help contain some of the cost.

Strangely enough, today we are seeing mega-mergers between our largest health insurance companies (Cigna + Anthem) along with increased complexity and compliance due to ACA Reforms. It all comes down to how you will be spending your healthcare dollars…

Today, you will recognize the Consumer-Driven Health Plan (CDHP), which incorporates a rather large deductible up front. It is called consumer-driven because it is up to the consumer to determine how to spend your money – so be aware of what the cost actually is! You are on the hook and it is OK to ask, “what is this going to cost?”

The bigger question will be, can your Doctor give you the real time cash price for what the service will cost?

Healthcare is not an “all you can eat – or pay for” buffet!

Wednesday’s Workout

Running skill sessionB)
1 Snatch deadlift (55-65% 1RM Snatch)
2 Squat snatches
3 Overhead squats
20 Skater hops
–Unbroken rounds–

10 Single-leg Lateral hops-R
10 Single-leg Lateral hops-L
10 Alt Balancing tripod transitions

Thursday’s Workout
Front squat (Use True 2RM)
75% x 3
80% x 3
85% x 3+B)
E2MO2M 12
1: 20 Handstand pushups
2: 20 Kipping pullups
3: 20 Thrusters (35-40%)
–1min Cap each round–

Then, FQ
1250m Run



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