You think your insurance denied your claim?

It didn’t.
Your employer did.

Here’s what most people don’t know about how health benefits work…

A 🧵 Over 65% of employer-sponsored plans are self-funded.

That means:

The employer pays the claims.
The employer designs the plan.
The employer benefits when care is denied.
2/

Healthcare is inelastic, so prices don't matter!

Stop right there.

Let’s discuss basic economics that the healthcare industry doesn't want you to understand.
🧵👇

#healthcare 2/ Elasticity 101:

🍷 Wine = Elastic
(Price goes up, people buy less or switch to beer)

💧 Water = Inelastic
(Price goes up; you still need water to live and put out fires)

Simple, right?

Now, let's expose the big #healthcare lie...

𝐅𝐨𝐨𝐝 𝐡𝐚𝐬 𝐛𝐞𝐜𝐨𝐦𝐞 𝐩𝐨𝐢𝐬𝐨𝐧.

Personal responsibility.
It's a noble idea.
A cornerstone of society.
The bedrock of success.

But what happens when the game is rigged?
Welcome to the Food industry.

A thread...🧵 𝟓𝟎% 𝐜𝐡𝐢𝐥𝐝𝐡𝐨𝐨𝐝 𝐨𝐛𝐞𝐬𝐢𝐭𝐲 𝐢𝐧 𝐭𝐡𝐞 𝐔𝐒.
Let that sink in.

Half of our children.
You are carrying more than just backpacks.
Carrying a lifetime of health issues.

Now, look at Japan, 3% obesity.
Oh, and the bad EU, 11%.

The food industry hates Americans.

#2

𝐓𝐡𝐞 𝐌𝐢𝐧𝐢𝐦𝐮𝐦 𝐋𝐨𝐬𝐬 𝐑𝐚𝐭𝐢𝐨 𝐌𝐢𝐫𝐚𝐠𝐞
Perhaps someone in the government forgot how math works...

85%.
That's the magic number.
The number was that was going to stop those greedy insurance companies...

A thread 🧵 ... 𝐖𝐞𝐥𝐜𝐨𝐦𝐞 𝐭𝐨 𝐭𝐡𝐞 𝐰𝐨𝐫𝐥𝐝 𝐨𝐟 𝐌𝐢𝐧𝐢𝐦𝐮𝐦 𝐋𝐨𝐬𝐬 𝐑𝐚𝐭𝐢𝐨.

2010. The Affordable Care Act drops a bombshell:
Insurance companies must spend 85% of premiums on... wait for it... healthcare.

Revolutionary, right?

But here's the plot twist:
It wasn't.

#2

Trends in Health Insurance Premiums: 2000 to 2022

Over the past two decades, the costs associated with health insurance premiums and deductibles have significantly increased. This data examines the trends in single— and family premiums and deductibles from 2000 to 2022.

A 🧵.. 1/Single Premiums
In 2000, the average annual single premium was $2,471. By 2022, it had more than tripled, reaching $8,133. This represents a substantial increase in the financial burden on individuals purchasing health insurance.

What is a Relative Value Unit?

How are RVU's calculated?

Who determines the value of an RVU?

Why do the AMA and CMS control the process?

A thread... 🧵 1/ Let's dive into RVUs - What are they? Who invented them? How are they calculated? And who determines their value? 🏥💰🤔

🚨 BREAKING: Medicare's Most Brilliant Plan Yet! 💰

1/ In a stroke of pure genius, Medicare has decided to pay health systems a staggering 10 TIMES MORE than private practice physicians for the same services! 🤑 2/ Why, you ask? It's simple: BIGGER IS BETTER! 💪 The logic is so flawless, it's no wonder our healthcare system is the envy of the world! 🌍

1/ The Unholy Alliance: How Lawmakers and Lobbyists Sabotage Patient-Centric Healthcare Reform 🏥💸 #HealthcareReform #PatientFirst 2/ Healthcare reform has been a contentious issue in the US for decades, but lawmakers consistently oppose legislation that would benefit patients. Why? The influence of powerful lobbying groups and campaign contributions. 🤝💰 #LobbyDollars

1/ Attention physicians! 🩺 Are you tired of insurance carriers reaping the rewards of your hard work? It's time for a change. 💡 #HealthcareRevolution 2/ Take a page from Apple's book 📱 They opened retail stores and took control of the customer experience. The result? A tech empire. 👑 #VerticalIntegration

Why is healthcare expensive?
A thread by your favorite accountant. 🧵 1/ The healthcare industry is witnessing a significant consolidation trend, with large health systems acquiring smaller medical practices, including orthopedic clinics. But what are the financial implications for patients and payers? 🏥💰

🚨 The Anti-Kickback Statute: Unintended Consequences for Private Medical Practices 🩺
A thread on how a well-intentioned law has inadvertently harmed independent physicians and fueled the growth of large health systems. 🧵 1/ The Anti-Kickback Statute (AKS) was designed to prevent fraud and abuse in the healthcare system by prohibiting the exchange of anything of value for referrals. 🚫💰

🚨 The 1997 Balanced Budget Act: A Silent Killer of U.S. Healthcare 🩺

A thread on how a seemingly innocuous decision has led to a critical shortage of physicians and skyrocketing healthcare costs. 🧵 1/ In 1997, Congress passed the Balanced Budget Act, which included a little-known provision that capped the number the budget for residency funded by Medicare. 🎓

The fiduciary duties of a self-insured employer health plan are enormous.

97% of self-insured employers do not comply with these duties.

Here they are. Once you read them, you’ll have a better idea! Fiduciary obligations are duties that a person or entity has to act in the best interest of another party. In the context of health plan assets, fiduciaries typically include administrators or other individuals who manage the plan. These obligations can vary depending on specific… twitter.com/i/web/status/1…

Lets agree to stop using the phrase “insurance card” or referring to healthcare benefits as “insurance”.

The term “insurance” makes it sound as if a magic fairy princess is paying for medical treatments.

Healthcare is not “insurance”. Government doesn’t use an “insurance” product to pay for treatments.

Self-insured employers don’t use an “insurance” product to pay for treatments.

HealthShare organizations don’t use an “insurance” product to pay for treatments.

Last week we paid $8,900 for an ACL repair in Virginia Beach, VA.

The patient had a deductible of just under $4,000.00. Giving employees a raise is a big deal!

I cannot give Everyone a raise, however I can give a good number of employees around the US raises.

We paid $3,150 for a Carpal Tunnel release in Evanston, IL.

The employer gave the patient the option to travel less than 2 hours and have the procedure paid in full or go to the hospital chosen by her physician, #Ascension and pay her deductible. The employee chose not to stay in Wisconsin.