Paul H. Flowers Jr. argues that health insurance renewals function like automatic raises for carriers and brokers, not for employees. He explains how concentrated carriers, premium-based broker incentives, and pharmacy middlemen drive costs up, and contrasts this with self-funded plans that many employers already use.
Chapters
I want you to get up right now, find your company's health insurance renewal letter, and actually read it. Cuz I don't think you have. I don't think anybody has. Every year it arrives. Every year the number is bigger. And every year somebody in a conference room sighs, signs it, and passes the cost down the line. To the budget, to the open enrollment speech, and finally to a parent's paycheck in January. And everybody knows it's wrong. That's the part that should stop you cold. Everybody knows. 4 companies control most of this market. And when you shop your renewal, the quotes don't compete, they climb together. In what other industry do all of the bids go up? Groceries compete, airlines compete, even oil companies pretend to compete. Health insurance carriers take turns. The broker advising you is often paid a percentage of the premium. The bigger the number, the bigger the bonus. Ask yourself who that advice really serves. The pharmacy middleman prices the pill, bills your plan more than the pharmacy ever receives, and keeps the spread. The The hospital bills your plan a sticker price almost no other buyer on Earth actually pays. And the carrier, the one who's supposed to fight all of this for you, earns its margin as a percentage of the very costs it's supposed to control. Nobody in that chain is paid to make the number smaller. Nobody. So, no, eh, you're not crazy. Your renewal didn't climb because your people got sicker. It climbed because the system is working exactly as designed. It's just not designed for you. And here's what they don't want you to sit with. Two-thirds of the covered workers in this country are already outside that system, in plans where the employer pays its own claims, sees its own math, and keeps its own good years. Same doctors, same coverage, a different owner of the money. The most dangerous sentence in American business is, "That's just what healthcare costs." It isn't. It's what silence costs. I'm Paul H. Flowers Jr., and I'm done pretending this is normal. You should be too.
