Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno.
The Paradocs Podcast with Eric Larson
Release Date: 10/29/2021
The Paradocs Podcast with Eric Larson
Vaccine mandates, mask mandates, boosters, and variants have been a constant source of debate and controversy with the pandemic. My guest today is Dr. Monica Gandhi, an expert in immunology and infectious disease who runs the HIV clinic at UCSF. She has been a fairly prominent voice in support of the mask and vaccine mandates in her home state of California and city of San Francisco. She returns from her visit in June for SARS-CoV-2 in which she guessed that it wouldn't evade the vaccine or prior infection (spoiler alert: she was right). Do Vaccine Mandates Make Sense? Dr. Gandhi is...
info_outline Episode 153: Crowd Health is Go Fund Me for Health Care on Nitro with CEO Andy SchoonoverThe Paradocs Podcast with Eric Larson
What happens when you take Go Fund Me and put it into an ecosystem of likeminded folks who want to build a community to care for each other's health care expenses? You get which draws upon some of the concepts of crowd funding for one time health care expenses within its community. By taking people from all over the country and putting them into a community where there are expectations of caring for others, Crowd Health offers a solution to paying for health care expenses without breaking the bank. Is Crowd Health Insurance? If you've been paying attention to the US health care...
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info_outline Episode 151: Health Care for Those Who Don't Earn High Wages with Dr. David BergThe Paradocs Podcast with Eric Larson
One of the scariest times for many workers is being presented with a bill for medical services. Even if they have insurance "coverage", the deductible or co-pay might be more than they can afford. For hourly workers in entry level jobs or low skilled positions, medical bankruptcy is a real fear. While barely making ends meet an additional bill for an ER visit or doctor's office stop can send you to collections and destroy your credit. Unfortunately, a lot of Americans are in this exact spot as they earn a living working these low paying jobs but have little medical security even if...
info_outline Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno.The Paradocs Podcast with Eric Larson
When you run a business, one person you usually meet and hire is a health insurance broker. In theory, these brokers work with the employers to secure the best deals for health insurance to meet the company's health care objectives. However, in practice, the brokers serve as a sales force for the insurance companies who lavish them with bonuses, trips, and gifts. The seedy underbelly of the health insurance broker industry is that they are really not working to save money or get deals for their clients - the checks are written by the insurance carriers and that's who they answer to. Who do...
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info_outline Episode 145: Surgery without Insurance with Dr. Keith SmithThe Paradocs Podcast with Eric Larson
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info_outlineWho do the brokers work for? You or the Carriers?
I spoke to Katy Talento in episode 111 who runs a business where she unbundles health insurance for employers and helps them run an efficient and less expensive health care plan. One of the problems she saw is that insurance carriers bundle all these services and then charge a very large administrative fee to run the plan. Also, their plans rarely save you money as they build in enough profit to cover the agents who sell those plans - the brokers.
That's the world that David Contorno is trying to combat with his company at ePowered Benefits. The business was founded with the intent of looking at real ways of not just unbundling but finding high quality and inexpensive ways to receive care. As Contorno said, "The only way to pay less for health care is to pay less for health care."
Health Plans Are Gimmicks
Through his 18 years of experience in the health insurance broker field, David points out that most of the various plans sold by insurance carriers are really just gimmicks that don't really change the cost of care. Whether it is an HMO, PPO, of some hybrid FFS plan - it ultimately just ends up being the same in failing to control costs. The reason is that the care comes from the same hospitals and with the same contracts no matter how they make the employers and employees pay with copays, deductibles, and coinsurance.
Even HSAs (health savings accounts) which are held up as a way to control costs by putting the patient in charge, rarely bring about the cost control as advertised. This is primarily because even using an HSA and picking where you get your care still is within the framework of hospitals, insurance contracts, and provider networks which all have massively marked up prices. Only by leaving the insurance network entirely can one see real savings.
Why Don't the Brokers Work for You?
Simply put, the work that health insurance brokers do is to carry water for the insurance carriers. The carriers are the ones who pay their bonuses, provide them with expensive trips to Tahiti, and give them sales targets for selling their plans. The checks aren't written by employers but by the insurance carriers. So naturally, the brokers respond first and foremost to what the carriers want. This doesn't make them bad people but understandably their incentives are not aligned with those you'd hope.
The reason most brokers don't even know they're working for the wrong people is best summarized by the quote from Upton Sinclair, "It is difficult to get a man to understand something when his salary depends on him not understanding it."