The Healthcare Hangover

In this episode, Emma and David dive into the gut punch of losing a long-time client right before Thanksgiving. After saving them a jaw-dropping $85 million, the client still jumped ship, swayed by a new exec chasing the clout of a big-name broker. The conversation cuts into the disconnect between what employers think their employees want and what they actually need in healthcare. Emma and David don't hold back their frustration with the industry's obsession with flashy brands and so-called "free" services—distractions that mask skyrocketing costs and subpar care. Now stepping into a consulting role with the client, they hammer home the critical need for transparency and bold leadership from employer groups.The episode wraps with a direct challenge to employers: it's time to rethink your health insurance strategy and the brokers you're trusting with it. TIMESTAMPS:[01:15] Losing a major client and reevaluating their decision-making process.[04:08] Concerns about the client transitioning to a traditional broker.[12:00] The compensation structure for traditional brokers.[20:04] The potential resistance from large brokerage firms toward greater transparency.[27:20] Growing public dissatisfaction with large health insurance companies and the increasing shift away from traditional insurance models.QUOTES: "What's of the greater value, the $85 million or the couple hundred thousand dollars worth of free stuff you get every year?" -David Contorno"We have convinced employers that our value is not on what we can do to control healthcare costs; our value is on all the things that we put around that." -David Contorno"The perception of having a brand name really is more important than the value of not, and truly, if you are paying attention to the American public's reaction... they do not want big health insurance."- Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/ Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In this episode, Emma and David delve into the shocking assassination of Brian Thompson, the CEO of UnitedHealthcare, exploring its implications on the American healthcare system. They discuss the public's lack of sympathy for Thompson, highlighting how his leadership contributed to a significant increase in denial rates for healthcare services. The conversation reveals a growing awareness among consumers about the systemic issues within health insurance, as many express their anger and frustration over personal experiences with the system.Emma & David reflect on the morality of the situation, acknowledging the tragedy of Thompson's death while also recognizing that it has sparked a much-needed dialogue about accountability in healthcare. They critique the responses from UnitedHealthcare's leadership, particularly Andrew Witte, who downplays the public outcry and dismisses the concerns of millions affected by the insurance system. The episode emphasizes the need for change and encourages listeners to understand the complexities of healthcare access and the profit-driven motives of insurance companies. Ultimately, it serves as a call to action for both consumers and industry leaders to seek a more equitable healthcare system.TIMESTAMPS: [00:40] The assassination of United Healthcare CEO, Brian Thompson and the reaction of the public.[04:34] Denial rates under Thompson's leadership[09:25] Moral implications of Thompson's death[14:20] Quotes from Andrew Witte analyzed[18:12] United Healthcare's revenue and impact[25:27] Future of healthcare accountabilityQUOTES: "It took a millionaire executive of a large publicly traded company to die in a sensational fashion for it to really matter. Millions of people have died, but their deaths didn't garner the same attention." -David Contorno"When millions of Americans are taking to social media to celebrate the broad daylight assassination of a human being, there is a freaking problem." -Emma Fox"Andrew Witte is weaving a thread of truth in his lies. Yes, doctors over-prescribe and over-treat, but that does not justify the role that United Healthcare plays in denying care." -David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/THANKS!

In this thrilling episode, we dive deep into the drama of healthcare and politics, exploring how recent elections could transform the future of healthcare legislation. Our hosts dissect the heated debate around RFK's controversial healthcare nomination, questioning the leadership behind life-altering decisions for millions. We then shift to the inspiring rise of grassroots movements fighting for a people-first healthcare system, showcasing how citizens are driving real change. Ending with a powerful call to action, this episode is packed with tension, insights, and stories that will keep you hooked from start to finish. TIMESTAMPS [00:54] Political elections and their impact on healthcare, with a comparison to historical events.[02:25] The likelihood of bipartisan healthcare legislation lasting and the challenges of political compromise.[03:52] The frustration of political barter, where healthcare decisions are treated as leverage rather than focusing on the needs of the American people.[06:20] RFK's healthcare nomination and the emphasis on needing qualified individuals with clinical experience in decision-making.[16:15]  How grassroots movements are shaping healthcare conversations and their influence on policy reform.[19:43] Insightful take on the future of healthcare legislation and the power dynamics that continue to affect real change. QUOTES "It infuriates me that we have people making pretty substantial decisions about how to deliver and finance healthcare in this country who can't even tell me the difference between health insurance and health care. We're staunch proponents of putting clinicians in charge, or at least in an advisory capacity, to help us understand how this should work."- Emma Fox"We've gotten into this bipartisanship where you can't even see one bit of good in what the other side proposed. It's become an all-or-nothing thing, and that's a shame. If I get 80% of what I'm asking for, I'll take it and deal with the other 20% later. But no one settles for less than 100% anymore."- David Contorno"The more I figure out how healthcare legislation works, the more annoyed and angered I become. It feels like as much as we'd like for this to be about Americans, it's really not. It's about using the American people as leverage in political bartering."- Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/ Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com 

Hosts Emma and David pull back the curtain on the explosive $7.75 billion deal between Marsh and McGriff, unpacking what this massive consolidation means for healthcare costs, broker incentives, and the future of the industry. Is your broker really working for you? Or are big players pulling the strings? They dive into the controversial concept of employer 'Stockholm syndrome,' debate the value of wellness programs, and break down why traditional insurance might be failing us. With broker compensation models under the microscope and a fierce comparison of Medicare Advantage vs. commercial plans, this episode hits the heart of the biggest challenges in insurance today. Don't miss out on action-packed insights and the future of independent advisors in a world dominated by giants.TIMESTAMPS[02:13] Concerns about consolidation in the insurance industry[05:56] Criticism of large brokers' influence on healthcare costs[09:21] Financial incentives and Stockholm syndrome [16:13] Future of consolidations [18:51] Treating patients as numbers[24:48] Being swayed by incentives[27:50] Motivation behind charitable acts QUOTES “I think to deny the influence of financial incentives is to deny humanity. We've had it for years, not years, millennia. And we need to recognize these are the financial incentives.” David Contorno“Like at some point us folks who are independent, who are running family based businesses, who are giving advice as individual experts, who have paid our own way through certifications and education, and C.E. have done it all ourselves from our own pocketbooks to build these businesses from scratch. It lessens our ability to help and give incentives that are good when these big massive entities are buying each other and will, like I said this a few months ago, I've been saying this for a couple of years.”-Emma Fox“And I will say, listen, I'm a former carrier rep. I never knew that what I was doing was bad until I found out I did not go to work with this evil grin and this, ooh, I can't wait to see who I'm going to screw over today. That never occurred to me. I was very well trained. I was very well hypnotized by a lot of very important board meetings.”- Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In this episode, Emma & David break down the world of self-funding in healthcare, tackling the big myths and uncovering game-changing strategies. Employers often fear self-funding is too risky, but guess what? Many are already doing it through captives without even knowing! They'll explain the difference between fully insured and self-funded plans, clearing up the confusion.The conversation then shifts to cutting healthcare costs. From avoiding level-funded plan overcharges to leveraging free drug programs and direct contracts, they explore smart ways to save. But it doesn't stop there—they also shine a light on systemic issues in healthcare, like the urgent need for cost transparency to prevent crushing medical bills.It's a can't-miss episode for anyone looking to take control of their healthcare costs! TIMESTAMPS[02:20] How fully insured actually works[06:45] Who is paying the claims[09:27] What is level funding[15:40] What Emma & David actually do at E Powered[20:04] The common loss outcome[22:38] Transparency in healthcare costs[24:11] Advice for employers QUOTES “The difference though is that in fully insured you have no control over where the risk comes off your shoulders. You're forced to do with whatever the carrier thinks, and oftentimes that number is a lot higher than you would do on your own because they're aggregating multiple employers, sometimes thousands of employers, into this pool.”-David Contorno“I think the opposite is true. I think you're taking a far bigger risk being fully insured and allowing those people that representation to manage your health plan. I think that is far riskier and you have no control over it. You can't do anything. It's sort of like people ask me about the transparency data. Isn't it great that we have price transparency? I mean sort of, but not really because we're not doing anything with it or about it. And so I just get to see how badly I'm being screwed over. I still can't do anything about it. So you're absolutely right.”- Emma Fox“And I think we need to stop, like, putting our blinders on and pretending like it's not happening when it's, it's. The most common outcome is loss and more loss and more loss. Which is funny. It's not just funny, it's ironic when you consider how much loss comes from buying something that's supposed to protect your risk. Like make it make sense, I guess.” -Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In this episode of Healthcare Hangover, Emma and David dive into a head-to-head comparison of the healthcare policies shaping the 2024 election. They break down Kamala Harris's plan to expand the Affordable Care Act and continue Medicare price negotiations, while Donald Trump pushes for deregulation and more private Medicare options. But are either of them really addressing the root problem—runaway healthcare costs? The hosts dig into the facts, revealing the shocking truth: the U.S. healthcare system ranks last among major economies, with annual spending soaring past $4 trillion. It's a wake-up call that the status quo isn't sustainable.Tune in for a critical look at Trump's COVID-19 response, the future of universal healthcare, and why a hybrid system blending government-funded primary care with private insurance might be the answer. As the election looms, Emma and David challenge you to research the candidates, get informed, and make healthcare a top priority when you vote!TIMESTAMPS:[01:07] David's politically neutral LinkedIn post.[06:16] Addressing the issue if we don't understand the issue.[16:15] US healthcare system ranked last among 10 largest economies[18:44] Medicare in political crosshairs[25:55] Debate on universal healthcareQUOTES:“But at least before I could live in ignorance, right? Like, now I'm I'm aware that I'm being screwed when I'm in an insurance plan.”- Emma Fox“But the problem that we need to solve for, I think, as the number one problem is one of psychology, because hospitals bill at this fictitious, massively inflated starting price and the carriers are then able to negotiate a large discount off of that starting price, still resulting in the highest price not just paid for healthcare in the US, but the highest price paid in the entire world or all of humanity ever. But that methodology, that process of high starting price discount and still a higher ending price than any other way of paying for care leads people to think that the carrier is providing the value, that is that discount.”- David Contorno“You know, I think it kind of comes back to what you and I have chosen to do for a living within the bounds of our industry, which is there's a lot of our focus that ends up being on public health, because I think that, you know, I tell people this all the time when I. When I speak or when I write, is that you really have to understand the ins and outs of the public healthcare infrastructure or the public health infrastructure in order to understand how we're financing it from.” -Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In this eye-opening episode of Healthcare Hangover, we explore the powerful, emerging world of ketamine-assisted therapy. Inspired by the Netflix documentary How to Change Your Mind, the conversation kicks off with personal stories of overcoming anxiety and panic attacks, shedding light on the emotional breakthroughs that ketamine therapy can unlock.Our hosts dive deep into their transformative experiences, uncovering childhood traumas and family dynamics that have redefined their adult relationships. It's a raw and revealing discussion that brings to life the potential of this cutting-edge treatment.We also cover the nuts and bolts: what to expect in future sessions, why combining ketamine with psychotherapy is crucial, the cost of treatment, and how to find reputable providers. Plus, we offer some practical next steps, like exploring Enthea for referrals and reviewing your health plan for possible coverage.If you've been curious about ketamine therapy or are seeking new ways to manage mental health, this episode is a must-listen!TIMESTAMPS:[05:11] Experience of abuse and toxic resilience[08:48] What to expect with ketamine therapy[13:01] Detailed account of visualizations, emotions and “whooshing”[18:44] Childhood memories and their meaning as an adult[21:29] Expectations for future treatments[23:42] Accessing proper ketamine assisted therapy[26:03] Expected cost and durationQUOTES:“And actually, it's. It's been interesting being a child of abuse because in some ways it's given me this. This resilience that I don't think I would have had in any other sort of upbringing. But I talked about this a couple years ago at the women's leadership summit, that sometimes having this type of resilience can be really toxic.” -Emma Fox“I think everybody has trauma and I know I do, although I didn't really recognize it until I was 46, 47 years old. It was pretty recently, but I'm now seeing how deep it actually has affected me in a negative way for my whole adult life, young adult and current.” -David Contorno“So seeing that with some level of objectivity or some removal from the situation, even though it was my situation, has been very helpful in sort of processing it, which, I guess is the point, right?” -Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/ Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In this episode, David & Emma tackle the shocking truths about the U.S. healthcare system and how insurance, rather than providing financial relief, can often leave you paying far more than if you went without it. Our hosts dissect the myth of negotiated insurance discounts, explore real-world examples of inflated costs, and question why Americans continue to pay exorbitant premiums, deductibles, and co-pays while receiving subpar care. Featuring thought-provoking discussions on the hidden motives behind health insurance, ways to access affordable care, and how to break free from what we call "Stockholm syndrome" with traditional insurance. Tune in for insights, data-driven revelations, and actionable solutions to help you reclaim control of your healthcare decisions.TIMESTAMPS:[00:20] Health Insurance Misconceptions[02:27]Health insurance perceived differently compared to other types of insurance[04:14] - Insights from a hospital CEO about billing challenges and frustrations with payers.[07:09] - Exploration of the complexities of premiums, deductibles, and copays.[10:39] - Examination of U.S. health outcomes compared to other countries.[22:00] - Direct primary care as a potential solution in healthcare.QUOTES:"If you want different results, employers, employees, patients, do the opposite. Instead of following the traditional paths that have led to frustration and inefficiency in the healthcare system, consider taking a bold step back and re-evaluating how you approach healthcare and health insurance. Challenge the norms that have been ingrained in us and explore alternative methods that could lead to better outcomes for everyone involved." -David Contorno“And so another way to think about that is when you go and get care and you throw down your BUca based id cardinal that has a buccal logo on it, you are preordaining contractually, not subjectively, not hypothetically, but contractually preordaining you and your health plan to paying the highest price, not just in healthcare, not just in the US, but frankly, known to humans ever in the history of humankind.” -David Contorno"It is not impossible to build a health plan that allows an employer to pay 100% of the air quotes premium for that plan and make it so that there is no deductible and no out of pocket, and they would still save more money than signing that contract with a Buca." - Emma FoxSOCIAL MEDIA LINKS:David ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITE:E-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In this episode, our hosts dive into the systemic issues plaguing healthcare, from doctor compensation and broker commissions to the broader dysfunction of the benefits system. They reveal how misaligned incentives lead to inefficiency, frustration, and rising costs, all while touching on key insights from the recent Health Benefits Nation conference. Topics include the controversy around GLP-1 medications, BMI policies, and the struggle employers face in adopting innovative, cost-saving strategies. Listen to hear why Emma & David have concluded we ultimately need to shift from reform to rebirth in the way healthcare is structured and managed.TIMESTAMPS:[01:38] Discussion on compensation[05:01] Conference Insights[11:09] Importance of representation & transparency[14:49] - Employer responsibility regarding their healthcare plans.[22:20] Awakening brokers and consultants to the realities of the healthcare systemQUOTES:"At the end of the day, I think the entity, the stakeholder with the most leverage is the one who's the most quiet, which is the employer, because they're not only managing the dollars they're spending, but they're essentially responsible for managing the dollars that the employees are spending, whether it's the contribution out of their paycheck or their out of pockets." -David Contorno"And I think you're absolutely right. Severity is not so much of an issue. Really? Right? And so one of the talking points around, specifically around GLP one, because it was a big topic. And so it was a very big point of discussion. But someone brought up the rebates. And I said on the stage, I think you mean bribes, because rebates only benefit those that they get returned to." -Emma Fox"And so many have said that that awakening changed their path, and that's really what we need at the employer level, at the doctor level, and at the broker level, because if we can get a large enough group to change their path, then we can actually make a difference in how the system works."- David ContornoSOCIAL MEDIA LINKS:David ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITE:E-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In this eye-opening episode, David Contorno and Emma Fox dive into the harsh realities many face in accessing life-saving medications for chronic conditions. They share a heartfelt story of an 11-year-old boy desperate to help his mother, who lost access to her crucial MS medication due to an unexpected change in her health insurance plan. The discussion sheds light on the complexities of health insurance, the hidden options available, and how unaffordability can strike without warning. Emma and David provide practical advice on navigating these challenges, from leveraging manufacturer assistance programs to sourcing medications internationally. Join them as they unravel the tangled web of healthcare, offering hope and actionable strategies for those struggling with similar issues.TIMESTAMPS:[01:06] Story of an 11-year-old boy asking for help for his mother[04:33] High-deductible HSA plans vs. copay PPO plans[07:28] Manufacturer assistance programs, coverage issues, qualification requirements[10:33]How drug coupons work and their impact on self-insured plans[17:31] GLP-1 drugs (e.g., Trulicity, Ozempic) pricing and sourcing strategies[24:49] Importance of consulting doctors when considering medication alternatives[29:14] Emphasis on the responsibility of benefits consultants to impact company and employee financesQUOTES"It has these horrific downstream effects, like eleven year old boys who are asking practical strangers to help his mom. You know, it really hurt my heart."- Emma Fox"But I wanted to explain that because coupons are, if you're in a fully insured plan, I, when I say I don't care, I do care a little, but I don't care nearly as much as when you're in a self-funded plan." - Emma Fox"Imagine if you were compensated for figuring out the things that we're talking about here. [...] You're impacting the money coming into their house and the money coming out of their house to a very large degree." -David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In this episode, Emma Fox and David Contorno explore the intertwined complexities of fiduciary responsibility and the hidden costs in healthcare. As employers face increasing scrutiny under ERISA and rising lawsuits, the conversation unpacks the critical roles of pharmacy benefit managers (PBMs) and healthcare carriers in shaping healthcare pricing. They discuss spread pricing, the importance of transparency, and the evolving responsibilities of employers and advisors. With insider insights and real-life examples, Emma and David offer a comprehensive look at how to navigate the delicate balance of fiduciary obligations while exposing systemic flaws that burden both employers and employees.TIMESTAMPS:[00:28] David and Emma discuss the increasing use of the term 'fiduciary' in healthcare[04:36] Employers are fiduciaries for their health plans but often unawareFully insured plans & fiduciary duties[11:21] PBMS -spread pricing, revenue, lack of transparency[24:52]Recent lawsuits against Johnson & Johnson and Wells Fargo for mismanaging drug costs[26:38] Fiduciary responsibilities under ERISA[33:26] Payment integrity departments in carriers often lack true integrity[37:44] Younger generations may drive change in healthcare systemsQUOTES:"You have to choose the right consultant, and finding the right consultant can be really hard because... there are a lot of people that you can find on LinkedIn who are saying all the right things, but that does not mean that they are doing the right things."- Emma Fox“I don't know, but I think transparency, they say that a spotlight is the best disinfectant or transparency is what really opens it up. And I think that's what we need to focus on. We need to focus on, most employers can't even access the information they need to be a fiduciary. So we need to really talk about transparency.” -David Contorno"If you are an employer listening to this, it is now crucial that you make a right selection... you have to be brave enough to say that being with a bucca, being with the CEO, increases my risk of violating my fiduciary responsibility." -Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In this eye-opening episode, Emma Fox and David Contorno dive deep into the often-overlooked mechanisms that drive healthcare costs higher year after year. Emma shares her viral LinkedIn post about being "anti-BUCA" (Blue Cross, United, Cigna, Aetna) and the heated debate that followed. The conversation unveils the truth behind medical loss ratios, pre-certification practices, and the intricate systems that benefit insurers at the expense of employers and employees. Tune in to understand why challenging the status quo is essential for creating fair and transparent health plans.TIMESTAMPS[01.22] The anti-BUCA (Blue Cross, United, Cigna, Aetna) stance[04.42] David explains how pre-certification is used to control care and ensure claims go up[10.36] Discussed an article about Aetna's former medical director ignoring patient records[11.15] Correlation between premium increases and carrier stock prices[16.43] Higher standards their plans are held to compared to traditional carriers[19.19] History and purpose of pre-certification in healthcare[24.27]Story of a physician-owned hospital system preferring non-BUCA payers[28.47 The role of doctors in current healthcare systemQUOTES:"None of this is by accident. When I meet with employers and we talk about how we build health plans, we talk about medical management... the initial decisions are made by largely non-clinical administrative people who are following a series of checkboxes." -Emma Fox"You know, carriers put out messages that they provide great care, that they want costs to be lower, that they want to control costs, but that's not how they operate." -David Contorno"I feel like when I come in with the plan that I have demonstrated is higher quality going to lower out of pocket, it's going to save the money. I'm held to a much higher standard than Blue Cross and United is." -David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In this episode, Emma Fox and David Contorno dive into the whirlwind of 2024, a year that began with optimism but quickly spiraled into a series of unexpected health challenges. David opens up about his harrowing experience with chronic pain, a spiritual trip to Costa Rica that led to a cascade of health issues, and the discovery of acute kidney failure. The duo discusses the importance of understanding the risks of long-term NSAID use, the critical role nurses play in patient care, and the reality of navigating a flawed healthcare system. Tune in to hear about resilience, medical advocacy, and the next steps in David's health journey.TIMESTAMPS[00.49] David Contorno experienced a severe health crisis[02.25] Emma's point of view[05.52] Rushed to Mission Hospital ER in Asheville, NC[10.42] Diagnosed with acute kidney failure[13.42] Experienced frustration with hospital holding area[17.07] Learned about dangers of long-term NSAID use [18.09] Discussed potential need for back surgery[18.50] Mentioned the hospital's attempts to qualify David for Medicaid[19.47] Emma managed hospital paperwork and consent forms[23.39] Friends in the medical industry offered guidance[27.41] The community showed strong support during recoverySOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

In episode 20 of The Healthcare Hangover, David Contorno and Emma Fox discuss alarming healthcare facts, including the US's high healthcare spending, lack of guaranteed health coverage, and avoidable deaths. They also touch on the impact of COVID-19 on life expectancy and vaccination rates.Tune in to gain insights into the healthcare system's financial challenges and the need for reform.TIMESTAMPS[00:03:08] Healthcare System's Avoidable Deaths.[00:05:45] Universal Healthcare Debate.[00:08:49] Life Expectancy and Healthcare Disparities.[00:12:00] Acceptance of Preventable Deaths.[00:17:33] Perverse Incentives in Government.[00:21:23] Little Community Making Big Waves.[00:23:54] Life-Changing Impact of Cost Savings.In this episode, David Contorno and Emma Fox discuss how the US spends a significant amount on healthcare, far exceeding the average spending of other developed nations. Despite this high expenditure, the country continues to experience a troubling number of avoidable deaths. Furthermore, David and Emma highlight the urgent need for systemic change in the healthcare industry, emphasizing the importance of accountability, responsibility, and legislative action to address disparities, improve access to care, and enhance outcomes for individuals. By advocating for reforms, engaging with policymakers, and prioritizing patient-centered care, the healthcare system can evolve to better serve the needs of the population.QUOTES"We've become accepting of hundreds of thousands of people dying every year, needlessly, unnecessarily, the huge majority of them could have been prevented. That's not even including those preventable medical errors, which is an even higher rate than that. Like we've become numb to death. Unless it's like our immediate family, We don't care about it anymore, which is right. No wonder we're not fixing our healthcare system because that involves caring about other people. And it feels like there's such a lack of that." - David Contorno"I think the key to finding something that's actually passable in this country is to make sure that both sides don't like it. If one side loves it and one side hates it, it's never going to get done." - David Contorno“I don't know what's going to happen if the administration changes hands. But I do feel at least that it's getting on some radars, you know, like some important people are realizing that we exist. And I think that's, the days when my optimism is lacking, I think those are the things that kind of lean on. And if I step out of this industry, I'm leaving that burden for somebody else to carry. And that's why I feel like it's a big responsibility.” - Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In episode 19 of The Healthcare Hangover, David Contorno and Emma Fox delve into the complexities of the healthcare system, touching on issues such as access to care, the influence of lobbyists, and the future of healthcare entities.Tune in as they explore the challenges and nuances of the healthcare industry.TIMESTAMPS[00:01:25] Disappointing Experience with Direct Primary Care (DPC).[00:06:55] DPC Values and Healthcare Choices.[00:07:58] DPC in Health Plans.[00:13:33] Our Healthcare System's Financial Incentives.[00:16:39] Influence of Pharmaceutical Lobbying.In this episode, David Contorno and Emma Fox discuss the importance of strategically integrating Direct Primary Care (DPC) into health plans to maximize its benefits and avoid diluting its value. They highlight the need to carefully assess DPC providers before including them in health plans to ensure alignment with the values and needs of the employees or members.Furthermore, David and Emma underscore the complex interplay of financial interests, lobbying power, and resistance to change that continue to impede efforts to improve the healthcare system in the U.S. Addressing these challenges will require a concerted effort to prioritize the well-being of individuals over financial gains and to advocate for reforms that prioritize preventive care, transparency, and patient-centered approaches.QUOTES"I think having a deeper relationship means that it gets a little more personal. I think it's okay to ask those things. So we try and get a broad spectrum of DPCs in the plans, at least as broad as we can so that people can find the one that they're most comfortable with." - David Contorno"I think a lot of people think that DPC is really for individuals or small groups. But there are ways, especially when you're assessing the tolerance of the group that you're representing and the DPC's value proposition, that you can marry those together with what looks like a traditional health plan. but provides this direct care component right up front. And I would say those are our most successful plans." - Emma Fox"For those of you that don't know, when you go to a DPC doctor, you never pay a copay, you never pay deductible, you never pay coinsurance. It doesn't matter if it's preventive or diagnostic. So there's zero barriers. There's no time barrier. There's no 3,000 other patient barrier, and there's no cost barrier to getting primary care. And one of the things that we've lost sight of is that primary care is called primary care because it's where we are supposed to go primarily." - David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In episode 18 of The Healthcare Hangover, David Contorno and Emma Fox discuss their recent trip to Dallas and a new project they've been working on. They also talk about the challenges of the healthcare system and the need for a holistic approach to fixing it.Tune in to hear their insights and find out how you can get involved in making a difference in your own community.TIMESTAMPS[00:02:43] Lack of Access to Healthcare.[00:08:14] Prescriptions and Financial Assistance.[00:11:45] Financial Assistance Programs at Nonprofit Hospitals.[00:15:02] Providing Healthcare to the Uninsured.In this episode, David Contorno and Emma Fox delve into the pressing issue of individuals in certain communities who are unable to afford essential medications and healthcare. They even highlight that as individuals age, they often require maintenance prescriptions for common health issues like blood pressure. However, the cost of these medications can be exorbitant, leading many to forgo necessary treatments and appointments.Overall, David and Emma emphasize the importance of understanding the various assistance programs available and the distinction between medical and prescription coverage. While some programs require individuals to be uninsured, others may still be accessible to those with insurance. Taking a holistic approach to healthcare is crucial, addressing the issue from all angles simultaneously to prevent the problem from resurfacing in more detrimental ways.QUOTES"The goal is to bring direct primary care into these communities for short periods of time, kind of like pop-up DPC, to serve these folks who don't have access to health care." - Emma Fox“the most common misconception around these programs when people find out about it, is that it doesn't matter if you have insurance. It is not for only the uninsured. It's also for the underinsured." - Emma Fox"I feel like I have the opportunity and our plans do that every day when I can get someone who does have a job who's clearly doing the right thing, but they still can't afford their medication or their surgery or their tests, and then I can get it done for them. that feels really good. And it doesn't feel like charity. It feels like getting them what they should have been entitled to anyway." - David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In episode 17 of The Healthcare Hangover, David Contorno and Emma Fox discuss their frustration with employers giving up on finding effective healthcare plans. They delve into the importance of retention rates in the industry and express their concerns with consultants who seem to be giving up too easily. Tune in to hear their passionate discussion about the need for persistence in finding alternative healthcare solutions.TIMESTAMPS[00:00:20] Employers Giving Up.[00:02:36] Leadership in Healthcare Financing.[00:07:57] Cancer Care Mistreatment Rates.[00:09:25] Failing Health Care System.[00:13:41] Employers and Healthcare Innovation.In this episode, David Contorno and Emma Fox express frustration with employers who are giving up on finding alternative healthcare plans. They believe that employers are too focused on retention rates and are not willing to put in the effort to explore and implement alternative options. Moreover, David and Emma believe that employers should dedicate the same effort to healthcare as they do to their core business. They argue that while the core business unit may be challenging and competitive, employers have had to make innovative decisions and value propositions to be successful in that area. Therefore, they suggest that employers should apply the same level of dedication and resource allocation to healthcare because it is equally important and costly. They believe that if enough employers prioritize healthcare and make informed decisions, it can lead to positive changes in the healthcare system.QUOTES“I think that they don't consider doing the hard thing when it comes to health care financing as part of their responsibility when it comes to being good leaders.” - Emma Fox"Nothing pisses me off more than an employer who's not willing to do the right thing because they're getting pushback from people who don't understand what the right thing is." - Emma Fox"Sometimes you got to make people emotional on this. And oftentimes it's just a negative emotion that's going to get them to change something considerably so radically." - David Contorno“Put the right insurance in place by asking the right questions, by working with the right people, by paying people in a way that's aligned with those outcomes. And if enough employers did that, the system would change.” - David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In episode 16 of The Healthcare Hangover, David Contorno and Emma Fox discuss their experiences with political influences in the healthcare system. They share their frustrations with trying to make change through traditional channels and how they found themselves in high-level political circles. They talk about their background in lobbying and the lack of impact they felt. Tune in to hear about their unexpected journey and their thoughts on the intersection of healthcare and politics.TIMESTAMPS[00:04:27] Politicians' Focus on Health Insurance.[00:07:27] Politicians' Misunderstanding of Healthcare.[00:11:38] Running for Office.[00:12:51] Pro-Life vs. Pro-Choice as Policy.[00:19:55] Holding Healthcare Entities Accountable.In this episode, David Contorno and Emma Fox have been grappling with the challenge of making a meaningful impact on the healthcare system through political influences. Despite their attempts to engage with political influencers, both individually and collectively, they have found it to be an ineffective endeavor. Moreover, David and Emma emphasize the importance of treating all individuals equally and ensuring that healthcare is recognized as a fundamental human right. They argue that while the government does not need to fully provide healthcare, it should play a role in guaranteeing equitable access to care.QUOTES"Insurance doesn't solve the problem. It actually makes it worse, at least as it exists today." - David Contorno“I was going to say is politicians don't seem to understand that. They have this idea that as long as someone has health insurance, they'll be OK. But it's never the case." - Emma Fox"Republicans are for less government, not more government. They're for less interference in our lives, less interference in how parents educate and with the lifestyles and the religious beliefs. I don't believe that I should be making the right medical choice for your children or any politician should. I believe that me and my wife love my children no more than anyone else. And we are best suited to make medical decisions for them above and beyond everybody else." - David Contorno“I think Republicans are actually a little bit more rebellious, especially in the last few years. But Democrats, they're very much a united front.” - Emma Fox“I have some ideas, some legitimate ideas that I think are very doable that would provide healthcare to some extent and also still maintain the privatized insurance market and the employer-employee relationship. And I think that there's a compromise out there that truly brings value to the country, to its citizens, to the doctors that are miserable.” - David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In episode 15 of The Healthcare Hangover, David Contorno and Emma Fox dive into the topic of GLP-1 weight loss drugs, exploring their effectiveness, financial implications, and the debate surrounding their accessibility for weight loss.Tune in as they navigate and share their insights through this issue.TIMESTAMPS[00:00:30]  Introduction to GLP-1 Weight Loss Drugs[00:01:00]  Weight Loss and Financial Perspective[00:03:00]  Personal Weight Loss Experiences[00:05:00]  Coverage and Accessibility[00:06:30]  Patient Assistance Programs (PAPs)[00:09:00]  Proposed 12-Month Program[00:11:30]  Additional Benefits of GLP-1 Drugs[00:13:00]  Employer's Perspective[00:14:20]  Pharmaceutical Industry Considerations[00:16:30]  Addiction AnalogyIn this episode, David Contorno and Emma Fox focus on GLP-1 weight loss drugs, as they share their experiences with employers interested in covering these drugs under self-funded health plans. They explore the efficacy of these drugs, emphasizing that they are not a silver bullet and require complementary lifestyle changes for sustained results.In addition, David and Emma share personal weight loss journeys and debate whether access to these drugs should be expanded to make weight loss more achievable for individuals struggling with obesity. They discuss the financial aspects, including the high costs and varying coverage percentages across health plans. They also address potential benefits beyond weight loss, such as reducing cravings for other addictive behaviors. Thus, expressing concerns about the affordability of these drugs and the pharmaceutical industry's motivations. QUOTES"It's very long term. It's not a silver bullet. You still need to do other things that if not done means you have to be in the medicine forever." - David Contorno“And the one thing that's bothering me is people claiming that these drugs are new, which is, I mean, some of them are new, don't get me wrong, but the formula has been around for a long time. We've been using these drugs to treat diabetes.” - Emma Fox"If this was available to me and I could have afforded it back then, I don't know why we wouldn't make it easier when I see people say that overweight people shouldn't have access to GLP ones." - Emma Fox"If you're an anti-GLP-1 person, I'd really encourage you to look at it from a more human perspective as somebody who was very, very overweight my whole life."  - Emma Fox"I think everybody is addicted to something. I have the luxury of being addicted to multiple things." - David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In episode 14 of The Healthcare Hangover, David Contorno and Emma Fox discuss the challenges and headaches of the healthcare system. They dive into the busy season and the lack of breaks they're experiencing. They also talk about their upcoming conference and the exciting topics and speakers they have lined up, including discussions on psychedelic therapy, infertility support, and the correlation between lack of healthcare access and gun violence. Tune in to learn more about the challenges and joys of navigating the healthcare system.TIMESTAMPS[00:00:45] Celebrating Jewish holidays.[00:05:09] You Powered Symposium and Puerto Rico.[00:09:42] Lack of Access to Healthcare.[00:12:41] Attending the Powered Symposium virtually.In this episode, David Contorno and Emma Fox delve into the challenges and frustrations encountered within the healthcare system. They discuss the perpetual busyness of the healthcare industry and the lack of breaks they experience. While the industry used to have a designated busy season known as the fourth quarter, they express that it now feels busy throughout the entire year. Furthermore, while they enjoyed meeting new people, they felt that the educational aspect was lacking. Consequently, they sought to create a different experience with their symposium. Their goal was to establish an environment where competitors could come together and teach one another, thereby diversifying their education, as it aims to unite individuals who are currently engaged, attempting, or aspiring to be part of the industry, fostering collaboration and mutual support in their respective fields.QUOTES“It (Symposium) can be a platform for teaching and learning. And I strive to teach and learn something every day. And so what it quickly became, even at the very first one, was just this getting together of people that actually felt like they're doing different things instead of saying different things and going back to the office Monday morning and not doing anything different.” - David Contorno“The best part of all of those conferences for me is the people, which is great.” - Emma Fox “I wanted to create something where people could still enjoy each other and each other's company and networking. But I really wanted to create an environment where we could have a bunch of competitors in the room. And instead of competing with each other, we could teach each other how to do what the other person does and completely diversify our education.” - Emma Fox “It's coming together of all the people that are doing it, trying to do it, want to do it, and helping us do it. And that's that's the goal.” - David ContornoSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

In episode 13 of The Healthcare Hangover, David Contorno and Emma Fox discuss the deceptive practices of hospitals and the importance of consumer education in the healthcare system. They dive into topics such as the lack of transparency in hospital pricing, the need for consumers to ask the right questions, and the benefits of direct primary care. Tune in to hear their insights on this issue in the healthcare system.TIMESTAMPS[00:01:37] Self-Professed Healthcare Quality Metrics.[00:06:07] Misleading Hospital Billboards.[00:07:30] University of Pittsburgh Medical Center (UPMC) and Healthcare Quality.[00:11:29] Deceptive Drug Advertising.[00:14:28] Joining the (AFCA) association.In this episode, David Contorno and Emma Fox discuss the importance of advisors in the healthcare industry, including solution providers, advisors, and doctors. They also highlight the recent federal laws that require advisors to disclose their compensation, urging advisors to comply with this requirement. Although enforcement of this law appears to be lacking, they maintain that it is still the right thing to do. Moreover, David and Emma emphasize the significance of educating consumers and empowering them to advocate for themselves within the healthcare system. They believe that many people are unaware of or fail to recognize the deceptive practices prevalent in the healthcare industry. Thus, stressing the importance of asking the right questions and being well-informed about appropriate tests and treatments.QUOTES"One of the things that we identify is that frequency is a big indicator of quality and not just high quality, but it's also a good indicator of reasonable pricing because they're efficient at doing it because they do that type of procedure so frequently." - David Contorno“That's one of the reasons why we heavily promote direct primary care. Even if you're not an employer, just for yourself, it's really worth the 40, 50, 70 bucks a month that gives you access to a doctor that you can ask those questions to even in a crunch situation.” - David Contorno“Just because it says it somewhere, just because it's in the paper, just because there's a magazine or an ad or a billboard doesn't mean that what it says is true.” - Emma Fox“The only thing that we do is validate that you are disclosing your compensation. Period. That's it. It doesn't even matter if you're a commissioned advisor, as long as you can prove that you disclose the amount of commission in every contract that you're executing.” - Emma FoxSOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/

The healthcare system is often a source of frustration for many, with a lack of respect and transparency being at the forefront of these grievances. David Contorno and Emma Fox, two advocates for healthcare reform, share their perspectives on this issue. They express their frustration over doctors' overbooking, rising rates, and worsening benefits, attributing these issues to unrealistic productivity standards imposed by the systems doctors report to. They believe that this lack of respect for patients' time and the absence of transparency in pricing are driving doctors, especially primary care physicians, away from the traditional healthcare system. Contorno and Fox emphasize the importance of patients taking control of their healthcare decisions, encouraging them to ask questions, seek second opinions, and be informed consumers. Join David Contorno and Emma Fox as they delve deeper into these issues on this episode of The Healthcare Hangover podcast.Timestamped Outline:(00:04:10) Lack of Communication and Respect in Healthcare(00:07:49) The Burden of Healthcare Delays on Working Individuals(00:10:08) The Impact of Overbooking on Patient Care(00:16:13) Taking an active role in healthcare decisions.Social Posts:

The topic of promoting transparency and ethical conduct in healthcare benefits advising is a critical one in today's healthcare industry. David Contorno and Emma Fox, both advocates for this cause, believe that by verifying the transparency and ethical conduct of benefits advisors, employers can be directed to the right advisors, ultimately solving issues such as bad insurance and inflated healthcare costs. Their experiences have led them to launch an association aimed at creating a population of advisors who are ethical and transparent in their practices. They emphasize the importance of advisors and organizations being transparent about their fees, costs, and contracts with clients, acknowledging that while not all brokers are unethical, there are some who engage in unethical practices. Join David Contorno and Emma Fox on this episode of The Healthcare Hangover podcast as they delve deeper into this important topic.Timestamped Outline:(00:01:22) Transparency and Ethical Conduct in Healthcare(00:04:23) The Impact of Financial Transparency on Professionals(00:08:06) Uncovering Unethical Broker Revenue Practices(00:12:57) The Importance of Transparent Broker Fees(00:18:01) The Role of Brokers in Providing Unbiased Recommendations(00:26:21) Employer Health Plan Analysis and OptimizationSocial Posts:

The American health insurance system, a complex and costly issue, is a topic that has been the subject of much debate and controversy. Many Americans struggle to afford health insurance, and the system is largely profit-driven, with pharmaceutical companies and insurance providers reaping billions in profits. However, there are alternatives and potential solutions to these challenges. David Contorno and Emma Fox, both experts in the field, argue that the system is flawed and in need of alternatives. They believe that insurance should not cover primary care or physical therapy, as these services could be paid for in cash at a much lower cost than insurance premiums. They criticize the current system for being profit-driven and advocate for building health plans that prioritize cost containment and incentivize high-quality providers. They also question the role of insurance carriers, suggesting that they serve no purpose, and that the intention of insurance should be to protect individuals from catastrophic loss. Join David Contorno and Emma Fox on this episode of The Healthcare Hangover podcast as they delve deeper into the challenges and alternatives in the American health insurance system.Timestamped Outline:(00:00:34) The High Costs of Health Insurance(00:05:03) The Impact of Charity Care Programs on Nonprofit Hospitals(00:09:14) The Impact of Healthcare Costs on Bankruptcy(00:12:22) Maryland's Successful Healthcare Cost Reduction Experiment(00:21:05) Inflated Bills and Decreased Quality of CareSocial Posts:

In the complex world of healthcare, issues of inauthenticity and deceptive practices are becoming increasingly prevalent. David Contorno and Emma Fox, seasoned professionals in the industry, offer a unique perspective on this issue. They express their frustration with individuals and companies who claim to support certain healthcare practices without any substantial experience or evidence to back up their claims. Their insights stem from their extensive experience and continuous learning in the healthcare field, which they believe is crucial to navigate the complexities of the industry. They offer their Certified Health Value Advisor course as a solution for those seeking to enhance their knowledge and expertise. Join David Contorno and Emma Fox in this episode of The Healthcare Hangover podcast as they delve deeper into these issues and offer valuable insights and solutions.Timestamped Outline:(00:00:02) direct primary care benefits(00:01:46) Certified Health Value Advisor Course(00:05:06) Congress reforms(00:14:54) bad players in the industrySocial Posts:

In this thought-provoking podcast episode, hosts David Contorno and Emma Fox delve into the flaws of proposed healthcare reforms. They express doubt about the effectiveness of Health Savings Accounts (HSAs), cautioning that they can lead to higher out-of-pocket costs and discourage necessary care. The hosts also point out the lack of employer contributions to HSAs in many plans. Furthermore, they criticize expanding waiver authority under the Affordable Care Act (ACA) to the state level, arguing that it may hinder healthcare access. They also question the idea of allowing state healthcare exchanges to offer a wider range of plans, asserting that it is not the exchanges but the carriers that limit variety. The hosts argue against low-cost catastrophic care plans and the idea of placing more responsibility on patients to navigate the system. They stress the need for comprehensive and effective healthcare reform that prioritizes affordability, transparency, and patient choice. The podcast suggests potential solutions such as expanding telemedicine reforms, granting nurse practitioners an expanded scope of practice, and recognizing medical licenses across states. However, they express reservations about reversing restrictions on physician-owned healthcare facilities. The podcast underscores the importance of addressing payment processes, improving access to care, and ensuring that healthcare facilities maintain a clinical focus.Episode Outline:(00:00:02) Repackaging HSA Plans(00:04:43) Issues with HSAs and Proposed Healthcare Reforms(00:09:41) Flaws in Proposed Healthcare Reforms(00:14:31) Improving Healthcare Choices(00:19:38) Misconceptions about Healthcare CostsQuotes:(00:02:57) I want people to know in no uncertain terms that I think HSA compatible health plans are the most damaging strategy that my industry has ever put upon the unsuspecting American public.(00:05:48) But the problem is those tools are not available to consumers.(00:13:47) The American healthcare system will remain broken until patients see prices before they receive care, not weeks after when their insurance company or the government decides what they will pay.(00:14:47) We disagree on choices for all. We offer reforms that expand consumer choices while improving the incentives embedded in our healthcare system.(00:23:03) We need to get away from what's currently available and start building something that's alternative.Social Post:

The podcast episode "The Dangers in Healthcare" explores the alarming trend of violence within the healthcare system, citing a specific incident in Portland where a security guard was shot and killed. The hosts discuss how hospital administrators often encourage staff to placate aggressive visitors and patients to avoid negative reviews, impacting federal reimbursement rates. They also delve into the connection between gun violence and the lack of affordable healthcare, suggesting that financial implications contribute to people's fear and defensiveness. Another episode discusses the frustration and anger that arise from denied healthcare claims and the lack of understanding in the current healthcare environment. The hosts shed light on the role of insurance carriers in denying claims and the financial incentives behind it. They also highlight issues with medical management in insurance plans and the prioritization of profits over patient care. Additionally, the podcast touches on the frustration individuals face with insurance coverage and healthcare expenses, and the increase in lawsuits related to these issues. Lastly, the hosts discuss the evolving landscape of healthcare referrals and the need for collaboration between different stakeholders.Episode Outline:(00:00:02) Violence in Healthcare(00:04:32) The Impact of Denied Claims(00:08:50) Issues with Medical Management in Insurance Plans(00:13:08) Insurance Coverage and Healthcare Expenses(00:17:18) Change in Healthcare ReferralsQuotes:(00:03:43) There's a lot of gun violence in the US. It doesn't really matter what side of the fence you sit on. I don't think you could possibly deny that we have heightened gun violence in the US. And you and I have talked through how much of that is related to the lack of affordable and accessible health care.(00:07:18) I think it was done by the insurance industry for the purpose of making it difficult for people to access high value care that is relatively inexpensive, therefore making it more likely that you're going to need low value care that's very expensive.(00:12:00) Every stakeholder in this country has fallen in love with their captor, which is the insurance company.(00:15:23) I do think that there are more people that are waking up to hold on a second, this is the big bad monster under the bed. I still don't think it's enough, though.(00:17:57) But it really is great to really build a health plan with a doctor involved at every step along the way.Social Post:

In this podcast episode, hosts David Contorno and Emma Fox expose the frustrations and unethical practices of UnitedHealthcare, one of the largest healthcare insurance providers in the US. They share personal experiences and highlight UnitedHealthcare's dominance in the market, prioritizing their own interests over those of employers and employees. The hosts discuss the rigged profit strategy of UnitedHealthcare and its manipulation of revenue and costs. They also emphasize the need for transparency, accountability, and reform in the insurance industry. Overall, this podcast sheds light on the challenges faced by individuals and businesses dealing with UnitedHealthcare and calls for action to disrupt the profit-driven healthcare system.Episode Outline:(00:00:02) UnitedHealthcare's Impact on the Healthcare System(00:04:06) UnitedHealthcare's Profits Soar(00:09:05) UnitedHealthcare's Profit Strategy(00:13:35) Manipulation of Healthcare Costs(00:17:54) Profit Motivation in UnitedHealthcareQuotes:(00:02:54) When I started to talk about these alternative plans, the carriers, and not just United, but certainly United, rightfully understood that if this picks up steam, that it's not good for their interests.(00:04:57) I don't believe that brokers are inherently unethical people. I do believe that the landscape we've been given to conduct our business is unethical.(00:10:54) They also figured out a way to make money from every single tax paying American because the second place that their profit came from was the Medicare side. The government side of the house, which is fully funded by taxpayers.(00:15:07) You can't convince me at this point that these people are not criminals, that they're not just thieves.(00:18:12) The medical loss ratio provision, which is an incentive for costs to go up to fully insured carriers, does not apply on the Medicare side. On the Medicare side, the lower the costs are, the more money United makes. On the commercial side, the higher the costs are, the more money United makes.Social Post:

In a lawsuit that has shed light on the risks associated with self-funded healthcare plans, Kraft Heinz has accused Aetna and Willis Towers Watson of failing to act in a fiduciary capacity and protect them from overcharging for inpatient open heart surgery. Fraud, Waste, and Abuse (FWA) is an ever-present issue in the healthcare industry, and Slingshot Bills can help detect it. As employers look for attractive options to insurance for their employees, it is essential that they are aware of their rights and make sure their insurance companies are acting in their best interests. Not only does this ensure that employees are getting the most out of their healthcare plans, but it also safeguards employers from overspending and ultimately getting taken advantage of.Episode Outline:(00:00:02) Kraft Heinz Lawsuit(00:03:58) Carrier Fraud Incentives(00:08:13) Kraft Heinz Lawsuit(00:12:36) Fraud, Waste, and Abuse(00:16:47) Self-Funded PlansQuotes:(00:03:41) If they're looking to make an example, if they're looking to be the face of other employers, mostly smaller employers, who are struggling even more with this than they are, who don't have the sophistication to understand they're getting screwed, nor the resources to do anything about it, even if they did, then we have a shot.(00:07:32) But think about this dynamic even more. If they allow fraud, waste and abuse, that means the hospital is getting more money, which is keeping the hospitals happy.(00:11:45) If you are acting as one, then you are one. And if you agree to be held to the same standards of care, then you have to be held to the same standards of punishment when it doesn't occur.(00:16:31) We don't give our plan partners enough credibility, but yeah, we've partnered with some fantastic people and organizations in the industry.(00:17:26) Don't, uh, don't get yourself up in a lawsuit, but sue when your employees are being taken advantage of and that's what they're doing.Social Post:Are you tired of the same old healthcare conversations? Tune in to the Healthcare Hangover podcast with David Contorno and Emma Fox to hear a fresh take on the healthcare industry. From discussing the multi-layer problems of lawsuits against Aetna to the incentives for fraud, waste, and abuse, you won't want to miss this episode! #HealthcareHangover #Aetna #Fraud #Waste #AbuseAre you tired of being taken advantage of by healthcare providers? Tune into the latest episode of The Healthcare Hangover to learn how employers and brokers can help protect you from medical billing errors. 97% of hospital bills have errors, and we'll discuss the responsibility of Willis Towers Watson and how they could have prevented Kraft Hines from meeting their fiduciary responsibility. Don't miss out on this important conversation! #HealthcareHangover #MedicalBillingErrors #FiduciaryResponsibilityAre you curious about how to save money on healthcare costs? Tune into the latest episode of The Healthcare Hangover podcast to learn how Kraft Heinz is trying to get paid and how you can audit your own healthcare plan for fraud, waste, and abuse. David Contorno and Emma Fox discuss how to lower the severity and frequency of claims and how to save double digits on healthcare costs. Don't miss out on this valuable information! #TheHealthcareHangover #HealthcareCosts #FraudWasteAndAbuseBlog Post:Kraft Heinz is currently in the midst of a lawsuit filed against their insurance company, Aetna, for not acting in a fiduciary capacity. This is a complex situation that has been in the news recently, and it is important to understand the implications of the lawsuit for employers and healthcare consumers. David Contorno and Emma Fox plan to write to Kraft Heinz and convince them to let David give expert testimony before the trial begins. They have done an analysis of their clients' fraud, waste and abuse percentages, and they have found that on average, 10% of total spend in a plan is fraud, waste and abuse, and their average fraud, waste and abuse was 0.8% of spend. This is an order of magnitude of about 92% better or less than the average plan. The average error in billing results in a $2,000 overpayment per error, while their plan was $180 per error.Aetna is responsible for acting as a fiduciary for their clients, even though the client is self-funded. Carriers look for improper claims and identify fraudulent, wasteful, and inaccurate claims. When carriers find an overpayment or a claim that shouldn't have been paid, they pay themselves a finder's fee and only give the employer a portion of what they recover. Hospitals have more leverage over carriers than brokers or employers do, and certainly more than patients do. Carriers don't want to hassle the hospitals and don't want to have to ask for money back, so they have audit restrictions. Most provider contracts at the hospital level have audit prohibitions. Pediatricians have to put more information on a claim form for a Strep test than a hospital has to put for a weeklong. Kraft Heinz is claiming that Aetna engaged in fraud or concealment to prevent and interfere with Kraft Heinz's efforts to investigate and understand Aetna's conduct. They were looking for a big claims dump to see what was being billed, what was being allowed, and if it was in line with the terms that they're supposed to be. Every decision that's made in a company's 401k must be for the benefit of the participants and must not allow the employer or other participants to abuse the plan. Kraft Heinz is looking to make an example and be the face of other employers, mostly smaller employers, who are struggling even more with this than they are. Willis Towers Watson is mentioned in the complaint, but they are neither the defendant nor the plaintiff. Willis Towers Watson did not have a fiduciary responsibility but could have prevented Kraft Hines from meeting their fiduciary responsibility. The Administrative Services Agreement between Kraft and Aetna stated that Aetna would discharge their obligations with the level of reasonable care which a similarly situated service provider or plan administrator under ERISA as applicable, would exercise under similar circumstances in connection with fiduciary powers and duties. Aetna agreed to observe the standard of care and diligence required of a fiduciary under ERISA section 404 AIB. The outcome of the lawsuit will depend on who is driving it at Kraft Heinz and how much they know about what's going on, as well as their motivation in doing it. Kraft cannot have a Kraft employee on the jury due to a conflict of interest. Employers should be running checks and balances to ensure their employees are not taken advantage of. David and Emma suggest using Slingshot Bills to analyze self-funded plans.Empowered has been tackling healthcare for five years and has found a sweet spot in what works and what doesn't. 97% of hospital bills have errors, which are always in favor of the provider. Healthcare can be complicated and there is always a hangover. Employers should take the time to thoroughly understand their healthcare plan and make sure that they are not taking advantage of their employees. This episode of the podcast provided helpful insight into the complexities of healthcare and the importance of staying informed.Episode LinksConnect with Emma FoxWebsiteEmma's WebsiteConnect with David ContornoLinkedInWebsiteOther MaterialsThese materials help you promote your podcast. Quotes can be used for audio & video grams or quote cards. Blog and social posts will help your website and social media presence.

Healthcare transparency is essential for patients to make informed decisions, yet price disparities in the industry remain a major issue. In this podcast episode, we explore how financial incentives and contracts between hospitals and insurance companies can misalign the incentives of brokers, employers, doctors, and patients. We discuss the importance of understanding the influence of these incentives and the need for accountability in developing an equitable healthcare system. Through transparent communication and a focus on an equitable system, we can help ensure that patients receive the care they need and deserve.Episode Outline:(00:00:02) Healthcare Transparency(00:04:42) Price Disparity in Healthcare(00:09:37) Health Insurance Incentives(00:14:21) Doctor Compensation Metrics(00:19:05) Incentive MisalignmentQuotes:(00:03:21) The thing that boggles my mind about healthcare is that in most of healthcare, neither the consumer, which in healthcare is the patient, nor the provider of the goods or services, which in most cases is the doctor, neither one of those parties know what the price is going to be until long after the services are already rendered.(00:09:10) You might only be paying a copay or you might only be paying your $200 and $5500 out of pocket that's falling off of your coinsurance. And they have no idea until they get the EOB what the build charges were and what the allowed charge was. So I think they're so disconnected from how much health care actually costs.(00:12:23) But I'm going to put it really bluntly and I think I got this from Dave Chase, this little metaphor here. But imagine for a minute if fire departments only got paid when there was a fire, they would want as many fires to occur as possible. And the bigger the fire, the more money they get.(00:17:22) And not only that, I think to deny that you're influenced by the financial incentives is to deny you're human. I mean, we've operated on financial incentives long before currency even existed.(00:21:08) I challenge you, if you are not already, if you're a consultant, even if you're a patient, if you're an employer, figure out what you can do. What one thing can you do differently to turn that incentive around?Social Post:Are you tired of feeling like you have a healthcare hangover? We've all been there. That's why we created the Healthcare Hangover podcast. We dive into the headaches we've been encountering in the healthcare system that are leaving us feeling a little hungover. In our latest episode, we talk about the importance of healthcare transparency. We heard a story about a patient who was charged $475 for an X-ray at a hospital, when they could have gotten the same X-ray at a chiropractor's office for less than $75. We also spoke with a hernia surgeon who was able to do the same procedure for $7,200 instead of the $20,000 quoted by a local general hospital. Tune in to the Healthcare Hangover podcast to learn more about the importance of healthcare transparency and how it can save you money.Are you curious about how doctors are paid? Tune in to the latest episode of The Healthcare Hangover podcast to find out! From patient volume to RVUs, David Contorno and Emma Fox break down the complex system of doctor pay and how it influences health care decisions. Plus, they discuss how traditional brokers are put in an unfair position and how financial incentives can be used to deliver better outcomes. Don't miss out on this eye-opening episode! #TheHealthcareHangover #DoctorPay #HealthcareAre you tired of the broken healthcare system? Tune in to the latest episode of The Healthcare Hangover to learn how the system was designed to benefit certain people and how you can help turn the incentives around! From the perverse incentives of commission-based compensation to the Cigna CEO's 20 million dollar salary, David Contorno and Emma Fox will take you through the details of the current system and how you can help build an alternative. Don't miss out! #TheHealthcareHangover #BrokenHealthcareSystem #IncentivesBlog Post:The healthcare system is broken, and it's time to start fixing it. In this episode of Healthcare Hangover, hosts David Contorno and Emma Fox explore the lack of price transparency in healthcare, and how providers are taking advantage of patients by charging them more than necessary. Insurance companies make money by renewing plans every year, regardless of how much they pay out, and people often think that more expensive care results in better outcomes, which is not true. Unfortunately, people often cannot afford their out-of-pocket costs, leading to debt or even lawsuits. Insurance companies do not provide any positive benefits to doctors, employers, or patients, and people have been led to believe that they need health insurance to get quality health care, which is false. The hosts also discuss how fire departments operate on a fixed budget, while health care systems make more money the sicker people are. Health insurance companies have a massive workforce that they pay very little to, and they have bonus programs for brokers that are available on their websites. Hospitals are not changing their practices due to lack of consumer demand, and MRF (Machine Readable File) is not human readable, requiring a middleman to translate the data. Additionally, hospitals often put programming on their website to prevent spiders from finding the data. David Contorno and Emma Fox also discuss how cash prices are almost always the lowest prices on hospital spreadsheets, and the disparity between prices for the same procedure from different carriers is outrageous. Commercial carriers pay the highest reimbursement rate to hospitals, and patients are disconnected from the cost of healthcare due to copays and coinsurance. To illustrate this, David Contorno visited a chiropractor for an X-ray of his shoulder and was asked if he was okay with the price before the X-ray was taken. The X-ray cost $75 at the chiropractor's office, but the same X-ray would have cost $475 at Atrium, the hospital system next door. Michael Reinhorn, a hernia surgeon in the Boston area, charges $7,200 for hernia surgery, while a local general hospital charges $20,000. The hosts also compare the healthcare system to the veterinary system, noting that veterinarians often give customers options and prices up front before giving any treatment. Doctors, on the other hand, are typically paid based on two metrics: patient volume and RVU (Revenue Value Unit). Patient volume is the number of patients seen in a day, with some doctors having minimum patient volume requirements of up to 30 patients per day. RVU is a measurement of how much revenue a doctor is helping generate for the health system, often in areas outside of their office. Doctors are incentivized to prescribe opioids to deal with pain, and to send patients to the most expensive care, regardless of whether it is the appropriate treatment. The most likely outcome of back surgery in the US is a second back surgery. Additionally, traditional brokers are paid more when they retain their book of business and cross-sell additional products that benefit the carrier they represent. Healthcare and health insurance employees often think they are doing good, even though the results they keep delivering are bad. The company bills their clients and has a performance bonus for achieving the client's goals of paying less for healthcare. Ultimately, the hosts conclude that people should focus on changing one thing at a time to build an alternative system that is more affordable. The Cigna CEO made 20 million dollars last year, and the sicker people are, the more money they make. It's time to start demanding more transparency and accountability from health insurance companies, and for patients to take control of their own healthcare. We have the power to create a system of trust between providers and patients, and to make healthcare more affordable and accessible.Episode Links:Connect with Emma FoxWebsiteEmma's WebsiteConnect with David ContornoLinkedInWebsiteOther MaterialsThese materials help you promote your podcast. Quotes can be used for audio & video grams or quote cards. Blog and social posts will help your website and social media presence.

The US healthcare system is plagued by corruption, and Pharmacy Benefit Managers (PBMs) are taking advantage of it. Express Scripts, the largest PBM, is sending out letters to dozens of clinicians and provider practices warning them of fraud, waste, and abuse for off-label prescribing of FDA-approved drugs. PBMs are making more money than the insurers that own them, and they engage in spread pricing and clawbacks. To become a good consumer of healthcare, David Contorno and Emma Fox suggest price shopping pharmacies, exploring manufacturer assistance programs, using coupons, and international sourcing. Consumers should also be their own advocates and ask their doctor what other options are available.Episode Outline:(00:00:00) Express Scripts Fraud(00:18:21) Prescription Drug Costs(00:04:45) PBM Profits(00:13:56) Pharmaceutical Pricing(00:09:29) Negotiating Drug PricesQuotes:(00:07:57) It's a long game, right? It's expensive right now. I get that. But if we're able to cure obesity along with who knows how many other comorbidities, what does that look like ten years from now, right?(00:21:31) Be your own advocate, because at the end of the day, you're the only one who pays clinically and financially for not being an advocate for yourself.(00:03:17) But I wish we could find something where literally they were defrauding people. I think that's ultimately what they're doing.(00:13:17) Every single other country negotiates drug pricing. They say you cannot bring that drug into this country unless you agree to this price. And not only does the US. Not do that, but there's a federal law that says we can't do that.(00:15:59) The hard part is not having coverage for it, because if you have coverage, but a deductible you can't afford, you don't qualify for this program.Social Post:Are you tired of the healthcare system's corruption? Tune in to the Healthcare Hangover podcast with David Contorno and Emma Fox to learn about the shady practices of PBMs (Pharmacy Benefit Managers). Did you know that PBMs are making more money than the insurers that own them? Or that Express Scripts alone manages the pharmacy benefits for nearly a third of the US population? Don't miss this eye-opening episode and learn how to fight back against the healthcare system's corruption. #HealthcareHangover #PBMs #HealthcareSystemAre you tired of the healthcare system telling you what you can and can't do? Then you need to listen to the latest episode of The Healthcare Hangover podcast! In this episode, David Contorno and Emma Fox discuss the frustrations of dealing with insurance companies and how to get around them. Did you know that you can get the same medication for up to 70% less by importing it from a different country? Tune in to find out more about how to get the most out of your healthcare experience! #TheHealthcareHangover #HealthcareSystem #InsuranceCompaniesAre you struggling to afford your medications? Did you know that there are ways to get name brand drugs for free or at a discounted rate? On the latest episode of The Healthcare Hangover, David Contorno and Emma Fox discuss how the Part D law and Prescription Assistance Programs can help you get the medications you need at a price you can afford. Tune in to learn more about how to get the best deal on your medications! #TheHealthcareHangover #PrescriptionAssistancePrograms #AffordableMedicationsBlog Post:The US healthcare system is in a state of disarray. Pharmacy Benefit Managers (PBMs) are taking advantage of this by sending out letters to dozens of clinicians and provider practices warning them of fraud, waste, and abuse for off-label prescribing of FDA-approved drugs. Express Scripts, the largest PBM, alone manages the pharmacy benefits for roughly 100 million people. It's no surprise that PBMs are making more money than the insurers that own them. They get an admin fee every time a transaction is processed, mark up the drugs, and do clawbacks. Optum, which is owned by UnitedHealthcare, accounts for the majority of their profit.Doctors are outraged that a PBM would have any right to tell them how to make clinical decisions for their patients. Alex Lickerman supports GLP-1 for weight loss, and it is effective. However, GLP-1 is a lifelong medication, and there are some concerns about it, such as muscle mass loss. Education is missing from these medications. Express Scripts is accusing some providers of falsifying diagnosis of type two diabetes in order to get through the prior authorization process.It's up to us to become good consumers of healthcare. David Contorno and Emma Fox suggest price shopping pharmacies, exploring manufacturer assistance programs, using coupons, and international sourcing. Consumers should also be their own advocates and ask their doctor what other options are available.Membership with a PBM such as Drexi can be a great way to save money. Drexi does not do spread pricing or clawbacks, but requires a small monthly fee. When using the Drexi card, the system looks like the consumer has insurance, but the insurance is not paying for anything. Manufacturer assistance programs and coupons are also a great way to save money. It's important to price out pharmacies as prices can vary widely. Employers are making choices for their health plans that can affect the cost of prescription drugs. The US healthcare system makes money when people are sick, unlike other countries. This is why the pharma industry charges high prices for drugs because they can and still make a profit. However, there are Prescription Assistance Programs (PAP) for name brand drugs for those who don't have coverage. Income limits for PAP vary by drug and number of people in the household. Good RX and Script Co offer discounts on drugs even if you have insurance.Express Scripts is threatening doctors for trying to get cheaper drugs for patients. Pharmacists have had their clinical roles stripped away due to PBMs deciding what is covered and what is not. Pharmacists can help those without insurance get name brand drugs for free or at a discounted rate. Doctor tweeted a pediatric oncologist in Texas saying he was "sick and tired of these insurance companies telling me what I can prescribe and what I can't prescribe." Insurance companies don't tell doctors what they can and can't prescribe, they just tell them what they're willing to pay for.Pre-certification and prior authorization are two processes that doctors and patients have to go through. Doctors are burned out because they're "sick and tired of insurance companies telling me what I can do and what I can't do." People can import medications from other countries, such as Canada, UK, New Zealand, or Australia, which are 40-70% less expensive than in the US.At the end of the day, it's important to be an informed consumer. Ask your doctor what other options are available, look into manufacturer assistance programs and coupons, price out pharmacies, and explore international sourcing. It's also important to be your own advocate and fight against the corruption in the US healthcare system.Episode LinksConnect with Emma FoxWebsiteEmma's WebsiteConnect with David ContornoLinkedInWebsiteOther MaterialsThese materials help you promote your podcast. Quotes can be used for audio & video grams or quote cards. Blog and social posts will help your website and social media presence.

In this podcast, David Contorno and Emma Fox explore the US healthcare system and how it affects employers and patients. They discuss how insurance companies, brokers, hospitals, and drug companies all benefit from higher costs, and suggest that people should be aware of both sides of the equation and how it affects their pocketbook. To illustrate this, they share their experience of finding medical care in Venice, Italy, where they encountered a security guard at the doctor's office and were charged only €25 for a minor surgery that would have cost $300-$400 in the US. They encourage patients to take responsibility for their own healthcare decisions and research their options as much as they would research a car purchase.Episode Outline:(00:16:56) Healthcare Hangover(00:00:00) Healthcare Hangover Cure(00:04:28) Finding Medical Care in Venice(00:08:40) Medical Care in Venice(00:12:50) Health Care CostsQuotes:(00:00:40) Hope is not a strategy. They need to do something.(00:19:47) People are losing their lives. They're losing their sanity, they're losing their homes, they're losing their security anytime that they have to engage with the US healthcare system.(00:11:40) And I left feeling, like, so in disbelief, like that's how easy it could be. And I think probably the closest experience I've had to that here in the US. Is probably with direct primary care.(00:15:56) But it doesn't have to be this way. I want everyone to know the reason it's this way is because every entity that employers and patients rely upon to manage the cost of health care benefits from health care costs going up, most brokers are paid commissions, so as the premium goes up, how much money they make goes up.(00:07:22) I'm like, I don't even know how long this tick has been in there. I could have picked it up in England. Now we're in Italy, and I just knew that we needed to do something.Blog Post:Have you ever been in a situation where you needed medical care, but were unable to access it? David Contorno and Emma Fox, the hosts of the podcast "Healthcare Hangover", know this feeling all too well. In the podcast, they explore the US healthcare system and how it affects employers and patients. The US healthcare system is a complex web of insurance companies, brokers, hospitals, and drug companies, all of which benefit financially from higher costs. David and Emma suggest that people should be aware of both sides of the equation and how it affects their pocketbook. To illustrate this, they share their own experience of finding medical care in Venice, Italy, where they encountered a security guard at the doctor's office and were charged only €25 for a minor surgery that would have cost $300-$400 in the US. The hosts of Healthcare Hangover believe that employers need to demand better, not just ask, pray, or beg. The best time to come to brokers is the easiest renewal, when the increase is lower than expected. Insurance carriers make more money when costs go up, not down. Employers think something will change, but don't know who has convinced them of it. It's important to understand that insurance companies are highly profitable and deliver shareholder profits almost like no other industry can. Insurance companies are making money and not paying out anywhere near what they're collecting. This means that patients can run the risk of something not being approved or covered by the insurance company and getting billed the full amount. Employers who are self-funded may have stop loss insurance, but they are the ones paying for it. Legislation has been trying to fix the "surprise medical bill" issue of people being out of network and getting a much bigger bill. Most brokers are paid commissions, so as the premium goes up, how much money they make goes up. Carriers are held to the medical loss ratio provision of the Affordable Care Act, which means they can only retain 15% of premium for their overhead and profit. Unfortunately, employers are struggling to keep up with their financial responsibility of the health plan, leading to degraded benefits, skipped bonuses, and degraded pay raises. Brokers, carriers, hospitals, and drug companies all benefit financially from health care costs going up. It's the doctors, patients, and employers who are literally footing the bill for the US healthcare system. That's why it's so important for patients to take responsibility and research both the quality and cost of care they are about to receive. Employers are becoming more aware of what is happening behind the scenes in the healthcare system. Direct Primary Care is a movement that is gaining traction in the healthcare system. Patients should not trust healthcare providers blindly, as they have financial incentives to dish out care. Poor decisions made in the healthcare system can have long-term consequences on a patient's quality of life. David and Emma's experience in Venice is a great example of how researching your healthcare options can save you money. They were discussing David's sensitive skin and allergies, which had caused him to develop hives. Emma noticed a small black speck on her leg near her ankle that looked like a dried circle of blood. Emma tried to brush and take off the speck, but it wouldn't come off. David, who had grown up in tick country, knew that the speck was likely a tick and that it should not be removed with fingers. They tried to use their US travel insurance to find medical care, but the virtual care service did not recognize them. The insurance representative was unable to provide any help and eventually hung up on them. Everyone they asked suggested going to the hospital, but Emma refused. Emma and David used Google Maps to find a primary care doctor in Piazza San Marco and walked there. There was a security guard at the doctor's office. The janitor they asked for help spoke a little English and directed them to a generic door with no sign. The doctor had gone out for lunch and came back to open the door for them. The doctor's office was clean and had a reception area, but no receptionist. Emma had a tick and the doctor was surprised as they are not common in Venice. The doctor charged €25 for the initial consultation. The doctor performed minor surgery to remove the tick and used a magnifying scope to make sure it was all out. The procedure took about 10-15 minutes and the doctor charged €25 for the whole visit. In the US, the same procedure would have cost between $300-$400. At the end of the day, it's important to remember that insurance companies pay for the majority of the cost, but the premiums are paid by the employee. That's why it's so important for patients to take responsibility and research their healthcare options as much as they would research a car purchase. By taking the time to research and understand the system, you can save yourself a lot of money and headaches.Episode LinksConnect with Emma FoxWebsiteEmma's WebsiteConnect with David ContornoLinkedInWebsiteOther MaterialsThese materials help you promote your podcast. Quotes can be used for audio & video grams or quote cards. Blog and social posts will help your website and social media presence.

The healthcare system is designed to make money rather than promote health, and Emma Fox and David Contorno discuss how to be a more informed and empowered consumer of healthcare. They provide advice on how to access financial assistance programs and discuss the high salaries of hospital executives, who are not necessarily making decisions based on clinical outcomes. Emma and David share their story of how they were quoted $6,500 for a medical bill, but received a bill for $22,000, and how they were able to get the bill adjusted to $6,900 by exercising a legal term called accord and satisfaction. They also discuss the importance of understanding the financial assistance programs available, even for those who make into the six figures as a household, and how the top executives of Novant were paid $458.7 million from 2010 to 2021.Episode Outline:(00:04:10) IV Infusion Treatment(00:00:00) IVIG Infusion Cost(00:12:53) Financial Assistance Programs(00:08:28) Financial Assistance Programs(00:17:10) Health Care SystemQuotes:(00:17:33) I can't wait to get into more of these. I feel like we could chat forever, but let's give someone a little break from the mind blown that is finding this stuff out because it's heavy and I hope people get as angry as we got, which kind of led us to this path.(00:03:00) Where else in the world does both the customer and the provider of services not know the cost or the price until after services are rendered, except in the US. Healthcare system?(00:07:23) Why do we not start with that? But we took the oral steroids and they actually had a longer lasting and more positive effect.(00:11:33) I almost think the first thing is the clinical. I don't think anyone should be afraid anymore to ask questions and I didn't ask enough questions. What other treatment options are available? Why did you choose this one? Maybe get a second opinion even.(00:15:49) There's absolutely no reason to feel bad. The whole reason that they get the tax breaks that they get for being nonprofit is because they're required to give away what's called charitable care. They're required to do it.Blog Post:It's no secret that the healthcare system is designed to make money rather than promote health. Emma Fox and David Contorno recently discussed how to be a more informed and empowered consumer of healthcare. They shared their story of how they were quoted $6,500 for a medical bill, but received a bill for $22,000. Through exercising a legal term called accord and satisfaction, they were able to get the bill adjusted to $6,900. Emma and David's story is a powerful reminder of the importance of understanding the financial assistance programs available for medical care. Even those who make into the six figures as a household can benefit from these programs. It is also important to remember that the top executives of Novant were paid $458.7 million from 2010 to 2021. Most of these executives have business degrees and make decisions based on financial outcomes, not necessarily clinical outcomes.It is also important to note that drug companies make less money when people are healthy, and insurance companies make more money when people are healthy. This means that there are little things done to ensure people don't get healthy. Emma and David got angry and this led them to this path of exploring how to be an informed and empowered consumer of healthcare. To be a more informed and empowered consumer of healthcare, there are a few tips and tricks to keep in mind. Firstly, healthcare estimates are now legally required to be a good faith estimate and cannot vary by more than $400 from what was quoted pre-service. Patients should not be afraid to ask questions and seek a second opinion when receiving medical treatment.Nonprofit hospitals are required to offer financial assistance programs based on income alone, which can reduce or eliminate a patient's bill. Patients can present themselves as cash pay to get more effective assistance. Financial assistance counselors are often bonded money by the hospital if they get a patient to agree to any payment plan. The true 501 R required financial assistance policy is often hidden on the hospital's website.Finally, people should not feel bad about using hacks and tricks to get financial assistance. Tax breaks are given to nonprofit hospitals, and the taxes they don't pay are made up for by the local community. Nonprofit hospitals are also required to give away what's called charitable care. It's important to be an informed and empowered consumer of healthcare. With the right knowledge and understanding of the system, you can save yourself a lot of money and heartache.Episode LinksConnect with Emma FoxWebsiteEmma's WebsiteConnect with David ContornoLinkedInWebsiteOther MaterialsThese materials help you promote your podcast. Quotes can be used for audio & video grams or quote cards. Blog and social posts will help your website and social media presence.

Do you feel like you're getting the short end of the stick when it comes to the US healthcare system? Are you tired of paying more for worse outcomes? If so, you're not alone.As healthcare consultants who build health plans for employers outside of the traditional channels, David Contorno and Emma Fox understand the perverse incentives within the US healthcare system and how those incentives guide the outcomes that we are getting. And they are here to help you make the system work for you.In the upcoming episode of their podcast, David and Emma will provide tips and tricks to help you navigate the system. They'll discuss how to build a comprehensive health plan that cost employers substantially less, cost employees substantially less, and even minimize or eliminate out of pockets. They'll also discuss the perverse incentives that lead to worse outcomes for more money and how to combat them.The episode is coming soon, so be sure to subscribe and get the latest updates. With the help of David and Emma, you'll be able to make the US healthcare system work for you. Don't miss out!