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Partnering with health plans to identify and deploy technology solutions to highest priority pain points

POV: trying to explain the US healthcare system to people of other nations... Revised script, for #SNL's consideration: Washington: In our new nation, everyone shall choose the right health coverage for their needs!  Soldier: Who will pay for it, sir? W: Employers! S: They will pay for it? W: Some of them S: What of those who do not work? W: Some of those shall be covered by the government S: Only some..? W: And we shall call that Medicare S: Okay, that makes sense W: Or Medicare Advantage. Or Part D. Or Medicaid. Or ACA. Or VA. Or FEHB. Or IHS.  S: Why so many names, sir? W: Liberty, son S: That sounds complicated, sir W: It is, soldier, it is S: At least they won't have to pay W: Oh they will have to pay, soldier. There shall be deductibles, and copays, and out of network providers S: Why, sir? W: And vision and dental, and behavioral health. And prescription drugs, which shall be covered through special companies whom nobody shall ever understand, called PBMs S: What are those sir? W: Nobody knows... But they shall work in mysterious ways to lower the price of drugs, and sometimes to increase them S: But why, sir? W: Nobody knows.... Except for Eric Bricker, MD, or maybe Eric Topol, MD, or some other Eric, we can hope S: At least the doctors will know and tell the people? W: The doctors will neither know nor care. All costs shall be shrouded in mystery. And there shall be tens of thousands of codes S: Codes sir..? W: And we shall have great books of codes, and armies of coders to code them into long documents that shall be sent to and fro at great speeds S: Are you sure all of that is necessary, sir? W: And we shall give the health plans stars, and HEDIS measures S: Hedis what, sir? W: HEDIS measures. And they shall determine a great many things but nobody shall understand them. And just when they begin to understand we shall add SDOH scores, and change the rules on Prior Auth S: Prior what, sir? W: Prior auth, the rules by which a doctor can determine what procedure he may prescribed to what patient at what time S: The rules of the government, sir? W: No, each health plan shall set its own rules. And to determine if the rules are followed the doctor shall send a fax S: A fax, sir? What's a fax? W: Nobody knows... S: At least, all diseases shall be conquered and none shall be sick? W: No. We shall be ranked 32nd out of 38 nations on life expectancy, and 61st in the world on maternal health outcomes S: That doesn't sound so good sir W: it is not S: But why sir? Why? W: Nobody knows... [stares into the distance]

Washington's Dream - SNL

https://www.youtube.com/

Elya Tagar

Partnering with health plans to identify and deploy technology solutions to highest priority pain points

4mo

Eric Pfleger, Erik Josephson, Erik Pupo, Erika Satterwhite, and Thomas Erikson - I would have added you but ran out of characters...

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John Blevins

Vice President, Corporate Alliances

4mo

Ha! Well done! “Yes, we’ll have a system where we require a fourth party (employers) to make all coverage decisions and eliminate choice for individuals…and we will make the tax-exempt treatment of that fourth party sponsored coverage—but not individually purchased coverage—our country’s largest tax-expenditure…and we will call it market-based.” (Hard to be as pithy as George Washington on this one)

Janet Hohmann

Communications leader: marketing, public relations, social media, and executive, internal, and crisis communications.

4mo

I love this sketch - it KILLS me every time. And your analogy is spot on!!!!!

Laura Turner, CPdM

Product Strategy Owner @ Arkansas Blue Cross and Blue Shield | Certified Product Manager

4mo

This is wonderful! Perfect explanation 🤣

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