Up­com­ing open en­roll­ment of­fers op­por­tu­nity for more Amer­i­cans to pro­tect health, wealth

Modern Healthcare - - COMMENT - By Chip Kahn In­ter­ested in sub­mit­ting a Guest Ex­pert op-ed? mod­ern­health­care.com/op-ed. View guide­lines at Send drafts to As­sis­tant Man­ag­ing Editor David May dmay@mod­ern­health­care.com. at

“The great­est wealth is health.” It’s a quote at­trib­uted to the an­cient Ro­man poet Vir­gil, and a rather ap­pro­pri­ate no­tion as our na­tion pre­pares for the fourth open en­roll­ment pe­riod un­der the Af­ford­able Care Act, which starts Nov. 1.

More than 2,000 years af­ter Vir­gil spoke these words, they still do a pretty good job of de­scrib­ing why our na­tion’s health and wealth go hand in hand. We are un­doubt­edly a stronger and more pros­per­ous na­tion when our fel­low cit­i­zens ex­pe­ri­ence the wealth (in all of its mean­ings) of health.

Ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, the unin­sured rate in our coun­try is at a record low of 8.6%. This num­ber shows that mil­lions of Amer­i­cans are now ben­e­fit­ing from the ad­van­tages of be­ing in­sured—from free pre­ven­tive care to ac­cess to the most ad­vanced life­sav­ing med­i­cal tech­nol­ogy and health pro­fes­sion­als.

It is clear that Vir­gil’s words are more than an ar­chaic cliche, as new mod­el­ing re­leased last week by the re­search firm Avalere shows that quite lit­er­ally health cov­er­age can have a pro­found im­pact on your fi­nan­cial wealth but also im­por­tantly on your per­sonal “wealth” best ap­pre­ci­ated as health se­cu­rity.

The Fed­er­a­tion of Amer­i­can Hos­pi­tals asked Avalere to an­a­lyze the real, pock­et­book value of in­sur­ance. Re­searchers used a se­ries of case stud­ies based on fa­mil­iar health events to de­ter­mine the true fi­nan­cial ben­e­fits of cov­er­age. The num­bers were stag­ger­ing. The study shows the ex­tent that in­sured in­di­vid­u­als spend a lot less out of pocket than the unin­sured, with ex­am­ples of cov­ered costs for those with ben­e­fits rang­ing from $8,800 for treat­ing a bro­ken leg to just over $90,000 to fight breast can­cer.

The study, ti­tled Demon­strat­ing the Value of Health In­sur­ance, con­cludes, “These case stud­ies demon­strate how unin­sured in­di­vid­u­als place them­selves at eas­ily avoid­able fi­nan­cial risk by fore­go­ing in­sur­ance and the read­ily avail­able sub­si­dies that make cov­er­age more af­ford­able.” The full study is avail­able at avalere.com.

Im­por­tantly, Avalere re­searchers touch on some­thing that is a lit­tle harder to quan­tify—the afore­men­tioned health se­cu­rity. Sim­ply de­fined, it is the peace of mind you have know­ing that your in­sur­ance pro­vides reg­u­lar ac­cess to care and pro­tec­tion from un­fore­seen med­i­cal events.

These are com­pelling pro-cov­er­age ar­gu­ments—psy­cho­log­i­cally, phys­i­cally and fis­cally—but they still haven’t been enough to con­vince some to get cov­ered. For many, the im­me­di­ate needs of to­day con­tinue to out­weigh the unan­tic­i­pated events of to­mor­row.

The good news is they no longer have to choose. Even if an em­ployer doesn’t of­fer cov­er­age, the ACA pro­vides op­tions, sub­si­dies and tax cred­its that make cov­er­age more af­ford­able and gives con­sumers choices.

HHS Sec­re­tary Sylvia Mathews Bur­well said last month that mil­lions of peo­ple could pay pre­mi­ums of less than $75 per month, about the cost of an av­er­age cell phone plan.

So the ques­tion re­mains: Why aren’t peo­ple jump­ing at this chance to buy health se­cu­rity? The truth is it’s of­ten hard to look past the monthly price of a pre­mium and ab­sorb the real, tan­gi­ble pro­tec­tion that health in­sur­ance pro­vides to a fam­ily. It will take time to in­te­grate the real value of health in­sur­ance into the think­ing and bud­gets of fam­i­lies across the na­tion.

We must con­tinue to make the ev­i­dence avail­able so that the choice is clearer.

That is not an easy task with the neg­a­tive noise that con­tin­ues to sur­round the ACA mar­ket­place. Head­lines about the sta­bil­ity and af­ford­abil­ity of the mar­ket­place of­ten dom­i­nate the news cy­cle. There is no doubt that change is dif­fi­cult, es­pe­cially when it in­volves peo­ple’s health­care. I have been in­volved in shap­ing health pol­icy for more than 30 years and I have seen the ups and downs. Each time we sur­vive the uncer­tainty and in the end pa­tients ben­e­fit. This will be no dif­fer­ent.

Health in­sur­ance is ul­ti­mately a ve­hi­cle to help peo­ple achieve health and se­cure their wealth. Next month, mil­lions of peo­ple will have the op­por­tu­nity to make a po­ten­tially life-chang­ing de­ci­sion. I hope they will dis­re­gard the noise, fo­cus on the facts and re­mem­ber the words of Vir­gil—“The great­est wealth is health.”

Chip Kahn is pres­i­dent and CEO of the Fed­er­a­tion of Amer­i­can Hos­pi­tals.

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