o 80 percent. That's how much of the average health care premium goes toward paying claims – in other words, the actual cost of medical care. Solutions that focus only on the 20 percent portion that insurance distribution, profit and retention represent are not going to do anything to wring expenses out of the system and drive costs down. Real reform has to address the cost of medical care, not the cost of insurance.

o 60 percent. That's how many of the uninsured in America are working for small businesses that have not been able to find a way to provide health benefits to their employees. Unfortunately, small businesses have the least power to lobby for the types of reforms that could make a difference. For example, two years ago a bill that would allow small businesses to band together to buy insurance at group rates was hailed as the end to a decade-long stalemate when it was voted out of a U.S. Senate committee and sent to the floor. Despite its potential for reducing the number of uninsured, the bill died and no progress has been made since.

For years, individual states have tackled the health care problem, focusing on accessibility and affordability. The results speak for themselves: growing numbers of uninsured and skyrocketing costs.

Service Matters
Clearly, the size and complexity of the health care problem make wholesale reform unlikely, especially in the short term. So what should agents focus on that can help them guide their customers and win their loyalty? Becoming a consultant rather than a salesman – someone who can help customers understand their options instead of someone who simply runs a spreadsheet to find the lowest cost.

Here are three things agents can explain to customers:

1. Today's trends. Regardless of who the voters sent to the White House, there are three trends that can be expected to continue. Employer-provided health benefits will become more customized and diverse, but the country's job-based system for health coverage is not likely to disappear. Consumer-directed plans and options will continue to grow as employers shift costs and decisions to their employees. And the pressure will increase for health care providers to deliver cost transparency so consumers can make smart choices about their health care.

2. Tomorrow's changes. Although large-scale reform is not in the cards, there should be movement on many issues at the periphery of the health care dilemma. Two to watch for: new tax incentives that will encourage the purchase of health insurance, and provisions to allow small and single-employee businesses to pool together and access more affordable coverage.

3. The importance of focusing on the bottom line. The siren song of "deep discounts" can make the large insurers sound appealing. But a 25 percent discount when costs are marked up 150 percent is hardly a bargain. Customers who learn to focus on claims management, behavior modification (wellness incentives and disincentives), audit trails and other cost containment techniques soon learn the difference between supposedly "low-cost" premiums and the high-value health care that can be delivered at an economical price.

Health benefit options are growing, but not every innovation is going to be a good fit for each customer. Agents who work closely with third party administrators can find the right tools to help their customers pick and choose what will work best for not only their budgets, but also for their employees. A pharmaceutical audit may show that prescription costs are soaring because the insurer is not monitoring fulfillment rules. A review service that catches duplicate billings and unwarranted charges can keep premiums in line by lowering claim costs. A side-by-side comparison of the costs and benefits of limited medical plans vs. mini-meds may help companies avoid unpleasant coverage-limit surprises for their workers.

The days when Henry Ford delivered Model Ts in any color, as long as it was black, are long gone. Similarly, health care benefits no longer come in simple flavors like vanilla and chocolate. The agents who emerge from today's turmoil with a solid sense of what is on the horizon will be a valuable ally for their customers. By sorting through options to find the right fit for each customer and then delivering solid advice as part of their service, agents will find success at their door.

Samuel H. Fleet is president and CEO of AmWINS Group Benefits of Warwick, RI, a leading wholesale broker of comprehensive group insurance programs and administrative services. Sam can be reached at [email protected].