What's been going on? While PPACA/Obamacare is attempting to provide Health Insurance to the entire population - to the profit of Insurers - what is being done to provide access to affordable healthcare to the U.S. Population—very little!


Here's the Reality! The Health Insurance Plans being offered through PPACA/Obamacare will leave most people – Employees and Individuals - with high out-of-pocket expenses, including paying for Doctor's office visits, high deductibles, and unaffordable co-pays. No one will be guaranteed access to Doctors or Healthcare in a timely fashion. With the glut of newly insured Americans and a shortage of Physicians, Doctor's office visits will be more difficult to schedule and the Emergency Rooms will remain over-burdened and expensive! What are Americans going to do when they are ill or hurt and need a Doctor's advice and expertise?

Adding to the problem, it is estimated that 70% of Doctor's Office visits are unnecessary and that “More than two-thirds of the 6.5 million emergency room visits for people under age 65 are avoidable” according to the American Academy of Family Physicians (Academy). The Academy goes on to point out that more than 40% of all ER visits are unnecessary, wasting money and time. This cuts into the Doctor's and the Worker's productivity. The Academy predicts the shortage of family doctors will reach 40,000 in the next 10 years which could limit accessibility for patients.

What are the problems? The above topics boil down to two major problems that PPACA/Obamacare fails to address. (And there are actually Strategies and Solutions available!)

  • People need immediate, affordable phone consultation access to emergency-trained physicians for non-emergency and emergency health problems – accidents and illnesses, even if they have a pre-existing condition.

  • An efficient and cost-effective system is needed to reduce unnecessary utilization of Healthcare Services by providing subscribers immediate phone consultation access to trained emergency Doctors. The result? Most illnesses and accidents will not require an office or ER visit which saves both Employees and Employers money with decreased use of services that are not necessary. This system must provide a verifiable ROI to gain Employer sponsorship and participation.

Strategies and Solutions! Can you imagine? While PPACA/Obamacare has been busy promoting Insurance Plans, what we really need is a Plan that provides immediate access to trained emergency and non-emergency Doctors at an affordable price for Employers with verifiable cost-savings. The strategies should include:

  1. The utilization of next generation advanced Telemedicine, TeleHealth, and Mobile Health

  2. A plan that encourages “Call the Doctor First” utilization to eliminate self-diagnosis and delayed care

  3. A Plan that has no charge per call with no limitations or exclusions

  4. A Plan that provides for emergency and non-emergency care for accidents and illness, including pre-existing conditions

  5. A Plan that substantially reduces the unnecessary utilization of Doctor's office and ER visits

  6. A Plan that will send a Medical Report to the subscriber's physician

  7. A Plan that can include family members

  8. Access to a network of emergency trained physicians on call 24/7

  9. A flat, affordable monthly fee - with no per-call charges - that encourages – rather than discourages utilization

  10. A service that can include a medical kit including prescription medications specific to each participant

  11. A Plan that follows-up to assure proper care was received

  12. A Plan that provides Cost-Saving (ROI Calculators) – to accurately demonstrate the Health Plan Savings on Fully Insured or Self-Funded Plans and Workers' Compensation

The Bad News! Our original due diligence was disappointing. We found that if you want the intended results, you need to scratch below the surface claims of the Telemedice Plan providers and Plans. As the industry has developed many business models have been created that fall short of their claims to provide timely patient access to a Physician. Our initial research could not find a company or model that delivered the desired outcomes that we listed above. Buyers Beware! Most Telemedicine plans do not provide immediate Doctor access, or a return on the investment dollars by reducing the use of the Employer's Healthcare Plan, or the care that is promised! The Plans are provided at a minimal – or no cost – but do not help reduce Healthcare Utilization. You get what you pay for!

The Good News! Following our initial research, we did find one Telemedicine Company that stood out from the others. It meets the 12 Standards listed above and more. Their Plans are the “Gold Standard” of Telemedicine; the Plan is designed to put the patient's needs first, not the convenience of the doctor's schedule first. And the Plan has over thirty years of field experience. This one specific company delivers measurable savings – generally 20-40% - to Fully Insured, Self-Funded, and Workers' Compensation Plan Designs. Estimated savings, utilizing ROI Calculators, are based on national statistics, thirty years of Client data, and even the Employer's Specific Data.

Your Call To Action -- Avoid a Crisis - Generate Health Insurance, Healthcare, and Workers' Comp Savings! Call – 216.577.5579 / Email – max@benefitplace.biz

For the Plan Design, see the BPTradeShow Exhibitor Booth – Go To – BPTradeShow.com

For the Impact on Employer Groups, see - http://agents.getmedcallassist.com/agent/philip-eide/groups/

For the Impact on Individuals, Families, Groups, and All Pricing, see - http://agents.getmedcallassist.com/agent/philip-eide/families/

You need to be a member of Global Risk Community to add comments!

Join Global Risk Community

Votes: 0
Email me when people reply –

[Free COVID-19 Framework] What's the path to recovery look like?

We created a free presentation (attached), which discusses both global and organizational impacts of the COVID-19 pandemic, along with critical actions organizations should take immediately. This presentation introduces a framework that helps regions and organizations navigate a path to recovery via 9 potential scenarios. These scenarios capture outcomes related to GDP impact, public health response, and economic policies. The presentation also breaks down 6 immediate and critical actions…

Read more…
3 Replies · Reply by Boris Agranovich Jan 2
Views: 70

If risk management is about decision making, are current risk management solutions irrelevant?

Now that the updated COSO and ISO risk management standards emphasize a connection to enterprise objectives and decision making, does this mean ERM and GRC solutions focused on risk registers and regulatory compliance are missing the true value of risk management?Will current risk management solutions evolve to integrate more decision support functionality or will standalone prescriptive analytics and other technology solutions take a more prominent role in enabling risk-informed…

Read more…
3 Replies
Views: 43

A question related to classification of instruments between trading and banking book.

We have an interesting question from one of our members.       "We usually perform OTC FX transactions with clients backed-to-back on the market (with Banks). Now we are going to perform a FX swap (i.e. Spot + forward) JPY/EUR for the Bank account for 1 week at the longest. The purpose is to get EUR place @ CB for LCR compliance purpose (no trading purposes). Bank's Management think that this should be considered as a trading position and therefore be classified within the Bank's trading book.…

Read more…
4 Replies
Views: 105

Plunging oil prices: curse or blessing in disguise?

The recent sudden crash of oil prices has had a major impact on the world economy, leading to many troubled faces in the international arena. The Russians fear the effects of yet another powerful hit on their economy, Venezuela seems to be considering default and the Americans are weary of the consequences for its young and emerging shale oil industry. And then you have the Middle East, where the smallest match is enough to ignite the largest fire. But are these worries really justified or…

Read more…
1 Reply
Views: 18

Introducing the Global Risk Series - Book 1 Risk Management How Tos

Dear GlobalRisk Community member, Our community’s mission is to foster business, networking and educational explorations among members. Learn from some of the top experts in the industry as they clearly explain how to approach the most important Risk management concepts. Check out their expert tips and use the link at the end of each article to navigate back to the website to leave your comment or ask a question. Some of the topics include: How do you Explain Risk Appetite?  How to Prepare a…

Read more…
12 Replies
Views: 216

    About Us

    The GlobalRisk Community is a thriving community of risk managers and associated service providers. Our purpose is to foster business, networking and educational explorations among members. Our goal is to be the worlds premier Risk forum and contribute to better understanding of the complex world of risk.

    Business Partners

    For companies wanting to create a greater visibility for their products and services among their prospects in the Risk market: Send your business partnership request by filling in the form here!