As we all know, the issues are complex. A major challenge is who will pay for the increased cost of coverage. The public wants care but doesn’t want to pay for it. Should we have the $250K+ earnings pay for it? Should we tax health benefits, which effectively increases the tax on the middle class? Universal coverage will inevitable increase taxes over the long term.

The public plan option is another sticking point. Obama wants a public plan alternative for those that can’t afford coverage. It’s basically an expanded Medicaid option. Some don’t believe the government is as efficient, effective, and innovative as the private section at running a health plan. Furthermore, health plans worry that it’s not fair for to compete against a government run plan. The American Medical Association (AMA) is also weary of an expanded government run program because of the low reimbursement rates from Medicare and Medicaid. Despite all these challenges, coalitions and all impacted groups from pharma to health plans to providers want to see change.

In addition to all these challenges, Obama wants to fix health care without increasing the deficit!

All this momentum is encouraging and hopefully we can materially increase coverage. While increased coverage will reduce the cost of health care (e.g., use of preventative care, fewer ER visits), more will still need to be done. We believe that until the health care market becomes more of a consumer market, costs will continue to rise faster than inflation. We know other countries which offer universal coverage still suffer from increased cost of health care. Until the incentives are aligned the cost of care will continue to increase.

HealDeal was started to create a free market for health care services. This free market rewards providers for quality work and patients for smart shopping and health behavior. Like others in the health care business, we’re willing to change our business model to accommodate increased coverage but the core reason for our existence will remain the same: bringing free market transparency to health care.

This article has become a ‘must read’ in the White House, reports The New York Times, as the President summoned his aides to discuss the little town in Texas. It is great to witness the sensitivity of Washington and the political will to fix the current overwhelming healthcare system.

I am writing this blog as a physician who is concerned about the Healthcare order in the country and would like to participate in the Healthcare reform. I have been working actively to innovate a simple solution that addresses a big part of the puzzle, mainly the healthcare cost. After many years of research and experience of being the first face of medicine, aka Primary Care Provider, I have come to the conclusion that there are 3 main reasons of rising the healthcare cost:

1. Lack of an open healthcare market- because of third party payer or Insurance industry, ‘the patient’ doesn’t know or doesn’t care about the price of the test, hence doesn’t question the need and the cost of the test. This leads to over utilization of tests and treatments, complications and disparity of costs of same tests/treatments.
2. Poor care in the End of Life - over utilization of expensive medical tests and treatments for patients who only want to pass away respectfully at home. Data shows 95% patients want to die at home but 75% of patients die in healthcare institutions.
3. Unnecessary Medical law suits- leading to defensive medical practice that causes unnecessary testing and treatments and also leads to rising overheads for the physicians.

HealDeal addresses the first problem by removing the middleman - i.e. insurance industry. This online platform connects the patient directly to the Doctor to get a price information for a medical service, this helps the patient to manage and stretch their healthcare dollars, and that forces the cost disparity to resolve and fair market competition to happen. This way the doctor also participates in improving access to healthcare for the uninsured patients.

Archana Dubey, MD

Some people will tell you this is because health care is so complicated, but that argument doesn’t really make sense. Computers are very complicated but people still shop based on price and quality to find value. People don’t even understand the details of how computers work but they still shop on price that’s to companies like Dell.

Why can’t the purchase of health care services work the same way? It can if we let it and it’s starting to happen. We are seeing announcements almost weekly of public and private organizations offering pricing information from CMS to health plans to retail clinics to startups. The most recent news is the state of California’s launch of a web tool to compare prices for surgeries (www.oshpd.ca.gov).

HealDeal was founded on price transparency and is excited to see how this growing trend can enable consumerism to transform the health care system. Stay tuned…

“To have an epidemic with millions of people who may not go to the doctor because they can’t afford to pay remains one of the unique challenges of our system.” said Dr. Georges Benjamin, executive director of the American Public Health Association, “The person I’m most worried about is the one who decides to delay getting care, and does it in such a way that they infect others or put themselves at greater risk.”

Public health experts say obstacles to getting medical attention are counterproductive if you’re trying to stop an infectious disease in a highly mobile society like the United States. It is especially a challenge when one in seven people lack health coverage, who delays treatment or utilizes crowded Emergency Rooms, hence making the epidemic worse.

HealDeal is a solution that improves access to doctor care early in the process, helping patients to get tested early and treated in a timely manner.

Archana Dubey, MD

This is the vision proposed in a recent article in Fast Company, “The Doctor of the Future.”

This article profiles a new medical portal Myca  and a new health service, Hello Health  that runs on it. Essentially, Hello Health is a web storefront and social networking site focused on health care. The thing that makes this so interesting from a cash-pay perspective is the business model. Hello Health takes only cash, you have to subscribe to the service for $35 per month and pay for visits and other services as needed. Hello Health does not bill or take insurance claims. The subscriber can elect to submit receipts to their insurance if that insurance allows out-of-plan physician visits.

The other end of this cash pay system is about knowing how much the subscriber should pay for other services, even services not offered by Hello Health. Hello Health will provide the subscriber with information on how much should be spent on a given service and recommend providers in the area.

This is evidence that the health care market is changing. Providers will be competing on a more level field where patients armed with information about the market will be making more informed decisions. These patients will be supported by medical groups and physicians that understand the needs of patients who are managing their own health care dollar. The doctor of the future will be online and ready to provide patients with recommendations for their health care and their spending for health care.

Fortunately, there is a positive, market-drive trend. Healthcare is slowing but surely becoming more retail which is giving more people access to care. Retail clinics have raised a substantial amount of health care venture money in the last several years and they are growing in popularity. Quick Health has opened several retail clinics inside pharmacies around the San Francisco Bay area. I’ve visited most of them and found them to be busy and serving an unmet need. Many of them offer service in Spanish and English to patients that do not have insurance. Minute Clinic and RediClinic are other popular retail clinics in other parts of the country.

People like retail clinics because they make health care more transparent and are customer focused. They can see the prices before they receive treatment and they can receive treatment with or without health insurance. In addition, retail clinics are convenient. You can just show up to a pharmacy that has a retail clinic and signup to see a doctor or nurse practitioner. There usually isn’t a long wait and even if there is a line you can shop for other things while you are waiting.

Like retail clinics, HealDeal is making health care more retail oriented. By visiting HealDeal, patients or consumers can see the cost for treatment without any commitment to purchase. Furthermore, the customer does not need insurance to access this service. People or consumers want value in healthcare like they find in any other industry (particularly those without insurance) and retail oriented approaches are starting to give consumer the tools they need to make value assessments.

The health care cost is taking a toll on our health and wellbeing.

More than half (53%) of the American households cut back on their health care secondary to cost concern, reports Kaiser Family Foundation survey of February 2009.

One in four put off the health care they needed, 16% delayed care for a serious medical illness.

One in five didn’t fill prescriptions.

One in six skipped their medications to make it last longer.

One in five experienced serious financial hardships secondary to their health care expenses. 12% have been reported to collection agency.

HealDeal is envisioned to bring transparency and fair market practices to health care. Patients who are self pay will be able to manage their health care dollars effectively. As Mr. Dave Mandelkern, CEO of QuickHealth, says ‘One of the myths of the self pay market is that the consumer is not savvy enough, its just that they don’t have the tools to manage their health care expenses’. Here at HealDeal we work hard to bring these tools to our self pay consumers.

Archana Dubey, MD

In other words, you are “willingly uninsured”! The Young Invincible along, with many other self employed people in the US are willingly uninsured or underinsured. They can afford the premiums but would rather take the risk and save that money for something else.

As Young Invincible you also have not one, but two top honors:

First: you are the nation’s largest group of uninsured— there were 13.2 million uninsured nationally in 2007, or 29 percent of the population, according to the latest figures from the Commonwealth Fund, a nonprofit research group in New York.

Second: you are the insurer’s top choice as a target customer. You are least likely to use services the health insurer will have to pay for. Your health premium goes a long way in paying for health services utilized by the “high risk” population, the older and the not so healthy.

This is how the insurance system works. The healthy pay for the sick, in the hope that when they, the healthy, get sick the next set of healthy people will pay for them.

As a Young Invincible whether to get health insurance, and if you do decide to, what type of health insurance you should get depends on your risk tolerance, your health condition, and your employment status.

We at HealDeal believe that there should be alternatives available to people without health insurance or government coverage. If you passed the “Young Invincible” test, you fall in that category and you should also have the choices and power to demand better value from your health care spending $$$. That’s why we build this platform, to empower you the same way the insured folks are.

We would love to hear your opinion. After all, you are the generation that will be shaping the future of healthcare in this country. Send us an email at feedback@healdeal.com or post it right here.

A recent article in the New York Times illustrates an important problem of the auto industry bailout. By not addressing the cause of high costs in health care coverage the bailout discussion focuses only on finding the money to cover the expenses. The article was focused on General Motors need to restructure its debt obligations. One looming debt is a $10 billion payment next year into the UAW Health Care Trust. “G.M. has the most at stake with the U.A.W. Its future obligations for retiree health care are estimated at $47 billion, and by next year it is required by its contract to contribute more than $10 billion to the trust set up in 2007.” 

The article goes on to state, almost off handedly, that GM has already cut health care benefits to over 100,000 nonunion retirees. That is a quarter of the retired GM workforce.  The Unions for their part are trying to protect the “jewels’” of the UAW contract, one of which is health care for life. 

Any government bailout of the auto industry should focus in part on reducing the cost of health care. It is unconscionable that the federal government would take tax payer’s money to provide assistance to the auto industry and not require a restructuring of the health care system for retired workers. 

Several people have suggested solutions to health care reform related to the auto industry bailout.  One suggestion from David Yen , a bankruptcy attorney, supports giving the unions tax credits tied to the union health care bill rather than direct cash payments. This solution, while right in intent, would not address the problem of rising health care costs, as there would be no incentive for the unions to secure the best value in health care services. As we have seen with Medicare, benefits without incentives to reduce costs inevitably result in higher costs overall. 

Clearly, it is a high probability that if GM goes out of business or is restructured under bankruptcy the health care provision will be eliminated. It would seem in the UAW’s best interest to work the problem from the cost reduction end and provide assurances to GM and the government that their retired members will reduce the health care burden by taking measures to reduce costs. Those measures could include, bargaining for health care services as a group, providing their membership with cost comparisons of service providers, or instituting health improvement measures such as smoking cessation and healthy lifestyle programs for their members.

Without addressing the high cost of health care the auto industry bailout will only be perpetuating the current health care pricing system that ignores transparency, price comparisons, and cost reductions in favor of “business as usual.” This country can no longer afford “business as usual” health care.

The article also notes not surprisingly that not all providers offer the same discounts and that one may have to ask for the discounted price to get it. Like other consumer markets, those that do their research can find a bigger deal for their health care. Unfortunately, price shopping in this industry is difficult and time consuming. It is challenging to call multiple providers to request prices and furthermore you do not always know if the same services are included at each provider.

HealDeal may be able to help. HealDeal offers pricing information from a growing list of providers and standardizes the services to help you shop for health care. Using HealDeal, you can go to one place to compare provider prices and locations, hours, languages spoken, etc. If you are paying out of your own pocket, do a little extra research on HealDeal to make sure you are not missing out on a discount.