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2009 © Digital Roam Inc.

Dan Roam                dan@danroam.com   www.thebackofthenapkin.com
Remember how all the reforms are
focused on the insurance side?




        All the big changes the White House is demanding are
             directed towards the private insurance companies.
                                                                 3
The White House should call it what it is:




 If the White House wins, it will be the private insurance
        companies sitting on the outside looking in.
                                                             4
Is that fair?




        The only value private insurers bring to the
       equation is to keep costs down for members.
   (And pay shareholders. Remember: this is a business.)
                                                           5
Is that fair? YES. Without a doubt.




Private insurers have failed miserably at keeping costs down.
   If they can’t manage member costs, why do they exist?
                                                                6
Private insurers had a remarkably
profitable 2008. (Yes, in the recession.)




  2008: Detroit dies.Wall Street tanks. 9.5% unemployed.
             Private insurance does just fine.
                                                           7
Is anybody else being asked to reform?
Yes, but not so much:




Me:                            Providers:
Take better care of myself.   Be more efficient.
Try not to get sick.          Do more with less.
Don’t get fired. (Ha!)        Order fewer procedures.
                               (Pharma is being asked to
                                 pay an $80 billion gift.)
                                                             8
In the end, who will pay for any reform?




                       Me.
     Assuming I’m presently employed and covered,
   I’m the only player putting money into the system.
                                                        9
And where will the money I pay go?
(There are 3 possibilities.)




1. Increase            2. Fund new            3. Fund a new
profits for            non-profit             government
Private Insurers.      insurance              insurance plan (no
                       exchanges.             profit allowed).

                    Yes, it is that simple.
                                                               10
Next napkin:



What plans are really
   on the table?

(And what is just hype.)
                           11

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Why private insurers may not survive healthcare reform

  • 1. 2009 © Digital Roam Inc. Dan Roam dan@danroam.com www.thebackofthenapkin.com
  • 2.
  • 3. Remember how all the reforms are focused on the insurance side? All the big changes the White House is demanding are directed towards the private insurance companies. 3
  • 4. The White House should call it what it is: If the White House wins, it will be the private insurance companies sitting on the outside looking in. 4
  • 5. Is that fair? The only value private insurers bring to the equation is to keep costs down for members. (And pay shareholders. Remember: this is a business.) 5
  • 6. Is that fair? YES. Without a doubt. Private insurers have failed miserably at keeping costs down. If they can’t manage member costs, why do they exist? 6
  • 7. Private insurers had a remarkably profitable 2008. (Yes, in the recession.) 2008: Detroit dies.Wall Street tanks. 9.5% unemployed. Private insurance does just fine. 7
  • 8. Is anybody else being asked to reform? Yes, but not so much: Me: Providers: Take better care of myself. Be more efficient. Try not to get sick. Do more with less. Don’t get fired. (Ha!) Order fewer procedures. (Pharma is being asked to pay an $80 billion gift.) 8
  • 9. In the end, who will pay for any reform? Me. Assuming I’m presently employed and covered, I’m the only player putting money into the system. 9
  • 10. And where will the money I pay go? (There are 3 possibilities.) 1. Increase 2. Fund new 3. Fund a new profits for non-profit government Private Insurers. insurance insurance plan (no exchanges. profit allowed). Yes, it is that simple. 10
  • 11. Next napkin: What plans are really on the table? (And what is just hype.) 11