Acquisitions and mergers in the healthcare industry as of late. Might seem like boring old business news, but there is a lot of meaning behind these moves. For example, CVS recently acquired Aetna, a historical 1st for a pharmacy to purchase a pharmaceutical company. Cigna is now acquiring Express Scripts, an online pharmacy. Most recently, Walmart (the nation’s largest physical retailer and grocery store), is moving to acquire Humana, a for-profit insurance company that works closely with Medicare. Even Amazon, the nation’s largest online retailer, is attempting to jump into the healthcare game – with a goal to revolutionize coverage for their 1.2 million employees and possibly create a new “Amazon” policy that would give you better costs and benefits than any third party or federal program.
It’s safe to say that the health care business is in the process of consolidation. Why? Because there is MASSIVE profit to be had in this space – i.e., there is a LOT of money in sickness and disease management (not a lot, mind you, in health and disease prevention when comparing gross annual profits).
The US “healthcare business” amasses trillions of dollars in profits annually. Just last year, US Pharmaceutical Sales were $453 Billion (up 73% since 1997) and US hospital profits were $387.3 Billion (up 63% since 1997). These numbers dwarf those of the complementary and alternative medicine (CAM) category – which did $199 Billion in 2017 (services include anything and everything from acupuncture, massage, chiropractic, homeopathy, Chinese medicine, etc).
Why should you care about what Walmart or the other companies are doing?
The Medicare market is ever-expanding (P.S., its not going bankrupt, nor is it bankrupting America for that matter. If anything, it’s a massive profit churning medical cash cow!) For the next 20 years, an average of 10,000 Americans will turn 65 every day, becoming medicare eligible! Thats 3.6 million NEW medicare members annually (72M over 20 years) and Humana is the 2nd largest provider of Medicare Advantage plans – the additional private insurance the majority of retired Americans acquire.
It’s no wonder Walmart is hungry to buy Humana. It’s a growing business and significant profit off their purchase! Plus, Walmart is soon to become the nation’s largest pharmacy – thanks to highly successful marketing campaign “$4 Generics.” You need to know about this because with each merger comes higher prices for the end user.
What you’re really buying
I think it’s safe to say you understand the idea that the “insurance card” you carry isn’t really “health insurance.” Its “sickness/accident insurance.” Break your leg while surfing with your family at the beach – after a quick deductible and coinsurance, your bill may easier to swallow – but how many of us have been there only to find out that our “coverages” were actually “conditional.” The issue, in my opinion, isn’t the presence or lack of insurance coverage, it’s the outrageous fees the “business of healthcare” is capable of charging as there isn’t much regulation when it comes to fees.
My story
It happened to me recently. My son, Gavin, who at the time of writing is 16 months old, was playing at the local playground with my daughter, Ava. They were running circles around the play set and, as luck would have it, Gavin tripped – smashing his forehead into the base of the play set, splitting his skin open and ultimately requiring a trip to the 24-hour urgent care down the street. Upon entering, they did a fabulous job! We were greeted by lovely receptionist who recognized the urgency (there was blood everywhere so it wasn’t hard), escorted us to an exam room where a RN and PA quickly jumped in to help us. Within 15 minutes, we were cleaned up, sterilized and “skin glued” – a no-stitch method of closing skin lacerations. As we were checking out I asked them “How much do I owe you for today?” Response: “We won’t know yet until everything is noted and billed out. You can pay $99 today, which we will apply to your bill, and we will you know if there will be anything else due once everything is charted.”
How can you not know the costs of todays services? Imagine going to a fancy restaurant, ordering an appetizer, entree, dessert with coffee and the check arrives stating “please pay X tonight and we will bill you for the rest later once we determine what you had and by the way, you obviously enjoyed everything!”
Friday (2 weeks later), the bill arrives -$648.00! $377.00 for the skin glue applied to a 2.5cm or less incision, $37.00 “after hours charge” (they are open 24 hours a day!?!), $234.00 for a 15-min new patient consultation (we have never been to this urgent care before). No worries, my insurance should cover this?! – NO! the total charges are less than the deductible – so amount paid via insurance, $0.00.
Thankfully I prepare for moments like this via a Health Savings Plan, but do you see my point about it being BIG BUSINESS? 15 min! Plus, we were never told, nor shown up front, what the fees for service are. We were not asked if we wanted to discuss alternatives, or less-expensive treatment options, like perhaps a different glue? BTW Did you know the ingredients of medical grade skin glue are 90% the same as Crazy Glue, which you can get 5 small tubes for $3.00 at any hardware store? I am sure you have been in or heard about similar or even more expensive situations than this. Again my point, “health care” is a high profit driving business and it shouldn’t be called “health care.” Lets call it as it is – care for when the unexpected accidents happens.
Disease care vs healthcare
The challenge is Americans have become brainwashed into believing that disease is an emergency – and please understand me when I say it’s not an emergency because it takes YEARS for disease to develop. It may be an emergency due to years of neglect, but its not an emergency by definition. Cancer, heart disease, Multiple Sclerosis, high blood pressure, etc. don’t just appear out of thin air. If you wait until your diagnosis is made to do something about your health, it’s often already too late, and that’s one of the main reasons our “health care” system is doomed – it was never meant to be “health care.”
Only you can be your own health care system by engaging in a lifestyle that is conducive to natural healing through continuous maintenance and care of the only “vehicle” you have – your body. Disease formation or removal is in your control and I encourage you to learn and apply everything you can about how mindset, nutrition, detoxification, physical fitness and chiropractic care is the real definition of health care; otherwise known as self care. Best to take control of health yourself and leave accidental emergency bumps, scrapes, broken bones and life’s “oops” to the medical system – they are phenomenal at putting those things back together again, for a price.
