A few words for the 2020 presidential candidates...

Quality control?

If I could meet with the 2020 presidential candidates, I would ask them how they foresee correcting current legislation (or introducing new legislation) to retain the accessibility to care that the ACA provided, but help control the costs of health care without compromising the quality. I’d be curious to know if any of the candidates know what the average quality of care is in the United States compared to like countries, and if they believe paying for care based off of a multiple of Medicare can be a sustainable part of the solution for the long term.

Emma Passé, COO, E Powered Benefits

Due diligence

I would ask, are we sure “Medicare for All” wouldn’t mimic Mexico’s health care? Medicare for those who cannot afford it, and private coverage for wealthy Americans?

Adam Hall, employee benefits consultant, The Olson Group

The student loan issue

The one question I’d ask the presidential candidates and members of Congress is regarding the taxability of student loan payments made by employers as a benefit. While student loan payment plans have been touted as “the hot new benefit” for the last couple years, the participation in these programs has actually lagged behind the hype. Reports I’ve seen suggest participation only inching up to just over 5 percent of employers currently offering them. That said, it’s been my belief that the taxability of these payments has been the primary hindrance for more explosive growth. Additionally, employers not only have to make the contributions, but often have to pay setup fees, as well as monthly participation expenses. This can be costly, requiring buy-in not only from HR, but also the CFO or finance team.

Kevin Kennedy, benefits consultant, TriBen Insurance Solutions

The cost of freedom

To the Democrats:

• Socially, one-size-fits-all programs from other countries (like Canada, where I’m from) won’t fly with the American independent-thinker.
• Independent-thinkers vote, and they don’t want to be told what to do.
• Decide who you think is falling through the cracks of the current model, and expand funding just for those folks.

To the Republicans:

• Talk about Medicare for All as a one-size-fits-all approach to health care. The American independent-thinker doesn’t want that.
• Be honest that there’s not a country in the world that has a single-payer system that gives its people health care with anything close to the control we have here in America.
• Design a health care approach that provides Americans a safety net for those in need, but all others will have the freedom to choose their benefits. Be direct about the fact that more choices and options will cost more, but that they will be free to choose.

Reid Rasmussen, co-founder & CEO, freshbenies

How do you measure success?

When I met with one of our reps from North Carolina in February he told me he thinks that our health care system is improving. I told him that I wasn’t so sure. I would ask the candidates, how would you measure the success of our health care and health insurance systems? Is it that we are spending less money on health insurance and health care costs per family per year? Is it that members are getting easier access to care? Is it that we are having better outcomes?

Rachel Miner, founder and CEO, Thrive Benefits

Focus on the product

Stop focusing on the cost/price of health insurance and how people pay for care, and start addressing what we all pay for actual care. I would also tell them that solutions already exist that have been proven in the market, so we don’t need single-payer. We need to scale solutions that are already proven to work, beginning with public sector employers.

Josh Butler, president, Butler Benefits & Consulting

Let’s talk price

I would inquire about their stance and support for Medicare for All, given the current climate and focus on health care in America. I am bewildered at times by the lack of focus on price transparency. We are the only industry where an individual does not know the true cost of services or products rendered before purchase.

While there have been some marginal efforts to bring about better price transparency, a greater focus needs to be placed on legislation and laws that will enable true change. Medicare for All is a great headline, but it takes away from the discussion of what we can do today to start the shift in this broken system. While price transparency is not the end-all be-all answer, it’s a part of the start of a broader discussion.

Anthony Kai Williams, employee benefits advisor, PSA Insurance & Financial Services

Accountability in question

Who is accountable for deciding what care and procedures are approved? When the financials are finite, sacrifices will need to be made. Are you willing to be the one who makes that sacrifice?

Joseph Hopkins, director of business development, Premise Health

Price check

Can we get a price before services are rendered?!

David Contorno, founder, E Powered Benefits

Socialized skeptic

The U.S. already has socialized medicine: Medicare/Medicaid, the VA and Indian Health Services. All have tremendous amounts of fraud and waste.

Craig Becker, benefits consultant, Becker Consulting

Keep it private

Implementing a form of single-payer in the U.S. would require a complete restructuring of a health care system. Having a chance at sustainability would require attacking industry stakeholders who have grown to represent 18 percent of GDP, and more than $1 trillion per year in wasteful health care spending. The largest of these cost-driving stakeholders have historically been untouchable.

You know who doesn’t care about these stakeholders or the money they spend? The private-sector innovators who are attacking cost-drivers at every turn. It’s significantly more likely that a clutch of driven data scientist-entrepreneurs working on a price transparency and outcomes efficiency platform will deliver more meaningful reform than could ever be accomplished legislatively.

Scott Wham, director, compliance services, Kistler Tiffany Benefits

Thanks, but no thanks

You can keep Medicare for All! Why do you think wealthy people from other countries pay to come to the U.S.? I don’t want to have a number and have to wait months on months to get a surgery I may need right away. Let’s disrupt 160 million employer-provided insured so 150 million people can give us all bad health insurance? Will Congress be in the wait list?

Pat W., director of human resources, Philadelphia Youth Network

Knowledge is power

I would say that you need a national data warehouse with all carriers’ commercial de-identified claims. And most importantly, no restrictions or limits on how the data can be used. Then you can back into the provider contracts and compare providers bill codes for like conditions.

Leon Wisniewski, senior data analyst, Certilytics

Passing the buck?

How would Medicare for All reduce costs? Medicare along with Medicaid (both government funded) has created the phenomenon of cost shifting. What happens when there is no more private insurance to shift the costs to? Rationing, waiting for care, low quality docs and facilities, lack of services overall? I could go on, but you get the picture.

Mark E. VonMoss, manager financial services division, The Insurancecenter

Read more: 

• Why single-payer may be closer than you think (and what to do about it)
• Political experts dissect current political climate in U.S., 2020 expectations
• Getting down to business on health care reform