“The healers have lost control”

Stacey Richter has interviewed hundreds of health care influencers on her podcast. She says employers and working Americans must be proactive and get educated.

Stacey Richter has had a unique vantage point to observe the catastrophe of the American health care system. 

She is the host of Relentless Health Value, a podcast that’s geared for senior health care executives – but really benefits anyone who wants to get smarter about health care. Stacey has been interviewing health care thinkers, leaders and entrepreneurs for a decade. Her most recent episode, number 425, features me. Check it out!

I am a big fan of Stacey and her podcast, so it was great fun for me to turn the tables here by interviewing her in this Q&A. I wanted to get her thoughts on the health care costs that are burdening working Americans and what we can do about them. She’s talked to health care insiders for 25 years as co-president of Aventria Health Group and QC-Health, and interviewed influencers on her podcast for a decade. I wanted to get her action steps for bringing about meaningful change. 

This interview has been edited for length and clarity.

How did you get started doing the podcast? 

I kept running into people who were trying to do the right thing and failing, because they didn’t have a broad understanding of how health care works. There are layers of complexity in our health care system and every layer has its own perverse incentives folded in the middle. If you’re trying to figure out how to solve a patient problem, and manage to get paid for it, or enough funding for your mission, you have to understand who gets paid by who and how and why. Otherwise you are going to fail and have no idea why. 

 It’s not the healers, sadly, who are making the business decisions. The healers have lost control. 

Who are your ideal guests? 

I try to get people who can explain what’s going on in the bowels of this complexity without the spin, and that's hard a lot of times. There’s a big difference in the marketing and what is actually going on and how decisions will actually be made. Look at any big company and the words on their annual report and how they’re actually making money it’s not the same. It’s not consistent. 

Who’s your target audience? 

Anybody that’s really trying to do right by patients, but in general, somebody deep enough in the health care industry. It’s not a 101 level, it’s probably a 301 or 401. Just because the health care industry is so complex. You have to have some background and deep interest. 

How do you describe the health care cost problems facing employers and working Americans?

I would wrap it all up into one phrase: the health care industry has become financialized. There’s a financial layer that is wrapping around health care or health benefits, and if people don’t understand that, sooner or later it’s going to cost them a lot of money. When I say there’s a financial layer wrapping around, there are entities with financial interests who have realized that health care or health benefits is an amazing way to make a lot of money, and they are doing so. Let’s say I own a company and want to make a lot of money. Normally I'd have to sell my product, at a price, convince you it was a fair price. With health care, I can charge whatever I want and you have to pay it. It’s an amazing business model, especially if you’re an insurance carrier or a broker. 

Are you making a value judgment? 

Yes, 48% of Americans are delaying or forgoing care due to cost. We have a situation in this country where there’s overwhelming financial toxicity. I go down that rabbit hole a lot. The cost of care is a comorbidity. A typical working American might see a spot on her arm and say to herself: Is it melanoma? It’ll cost me $600 to find out. So she avoids going to the doctor to get it checked and later ends up going to the emergency room. She can’t afford to pay at the ER either. So you just substituted a less expensive site of care with the most expensive.

What are some things you’ve learned about the health care system that you think employers and working Americans need to know? 

Health care is big business. And so is health insurance. It’s like an iceberg. There's the dollars that you see and then most of the dollars are under the water, what you don’t see.  About 50% of tax dollars are going to health care now. All of these underwater dollars are going to these entities. They’re very good at it and they’re happy to take advantage of the unaware. Ignorance is not bliss here. 

What should employers and working Americans do? 

Educate yourself. Take Allen Health Academy courses. Watch the videos. Listen to Relentless Health Value. Knowledge is definitely power here. 

You have to be proactive. If you don’t know this stuff ahead of time, now you’re sick and in an acute situation. Now you don't have time. A lot of this is like disaster preparedness. You have to have a baseline amount of knowledge so when the emergency hits you know what to do. 

These employers get overwhelmed. They get smacked from all directions from too much information. They think they’ll take action next quarter and then they do nothing. Analysis paralysis is such a thing. Whenever I talk to an employer I say: Be kind and gentle to yourself. There is urgency here but it’s easy to get overwhelmed. Read the stuff on Allen Health Academy. Watch Eric Bricker MD. Listen to Relentless Health Value. Try to follow the dollar. Be curious — be curious. Ask a lot of questions. Start there.

Employers - Let’s Work Together to Equip Your Employees

I love to see working Americans have their mindset flipped by effective health literacy education. Our health care system isn’t broken. It was designed this way. It’s no accident that employers and working Americans keep paying more than they should for health care. But employees are not powerless.

Does your organization sponsor health benefits for your employees? Want to see them get equipped to be savvy health care consumers? I’m looking for bold employers to equip their employees with my Never Pay Pathway health literacy videos. They’re based on my book, Never Pay the First Bill, and the knowledge will transform the way your employees engage the health care system.

The videos are an ENGAGING resource that will save money for your employees and their families - and your health plan. Let’s stop overpaying for our health care, shall we? Email me at neverpay@marshallallen.com for more information.

Email us at neverpay@marshallallen.com.