There are many tools that can be used to educate your employees. For example, if you are using an online enrollment system, encourage your employees to utilize the site and review the information available to them. Many employers want to make the enrollment process “easy” for their employees and tell them that they don’t need to worry about anything if they don’t want to make any changes. I think this is a disservice, because those employers are encouraging them not to be interested in this subject. 

The subject of “insurance” awareness is similar to “tax code” or “investment” awareness. Most people throw up their hands at the mere mention of these subjects, feeling that they are too complicated to understand and they will deal with it when and if they have to. I say to be forewarned is to be fore-armed. The time to know the best place to take your child for emergency treatment of a broken arm is not when it happens. You should know which facilities are in your network and whether it is best to go the Emergency Room of a hospital (probably not), an Urgent Care Facility, or your doctor’s office.

We need to have more informed consumers of health care. They need to be educated in fraud and abuse tactics so that they can be instrumental in containing health care costs. If they have had a recent array of testing done by a doctor, they should know that sometimes these test results can be shared with a second doctor and not have them repeated. We have all heard the term “second opinion,” but how often do people actually get one? Do employees realize that sometimes the best place for treatment may not be in their own community? There are facilities that have been designated as “Centers of Care” for specific conditions or procedures. 

The attitude of “I don’t have to worry, the insurance will pay for it” needs to stop. People need to be educated to assume responsibility and participate in managing their health care. There is no such thing as a “free lunch.” You will pay for it now or later in the form of increased premiums or other costs.

The bottom line is: encourage your employees to be educated in their entire employee benefit package. Don’t offer short cuts; keep them involved. Knowledge is power. In the long run, they can help contain your costs by becoming responsible, knowledgeable consumers of health care.

Mr. Jones touched on the first issue in his blog post titled “Mexican consulates enter healthcare business… leaves California holding $1.1 Billion bill“.  The three countries that Moore shows as having ‘free’ healthcare, do not have the rest of the world clamoring to enter their countries by whatever means necessary to take advantage of all our free services.  It has been known for years, that when blocks of immigrants enter this country they are schooled on how to obtain all these free services.  This occurrence seems to be directed at Mexican immigration, however, the same thing happened when we opened our doors to immigrants from Southeast Asia.  They were directed to big employers with great benefits, how to get low interest rates to buy homes and start business and how to get their children educated on the government’s dollar.

The second issue is the amount of healthcare fraud that is committed in this country.  Not one word was said about those that take advantage of our system for their own personal gain.  If you were to investigate the most grievant offenses of healthcare fraud, you will find that a large portion is committed by ‘foreign born’ professionals.  These professionals then recruit others to perpetuate their schemes and agendas.  I wonder if Michael Moore would ever do a “movie” on the Rolling Lab scams that have plagued our system for years.  At the root of this operation were Russian doctors that took years to investigate, ferret out and prosecute.  Before all was said and done, millions of dollars left our system and ended up in the pockets of these doctors.

Fraud is a multi-billion dollar a year issue in this country!  Until we can get a handle on the fraud issue, there will continue to be those unfortunate people that will pay the high price for those undeserving people that are reaping the benefits.

In his tribute to Hilary Clinton, Mr.. Moore drives the point that we, as a people, rejected her National Healthcare reform because the AMA and pharmaceutical companies convinces us that she was proposing socialized medicine and that it was a bad thing.  Once again, no mention of cleaning up fraud to allow for more dollars available for healthcare.  Nor did he mention the quagmire known as HIPAA, that duplicates regulations and processes that were already in place and has cost our country countless millions of dollars to administer.  Another example of government intervention when they had no clear picture on how the rest of the country was going to comply with these new regulations.

All the examples that were used in this film were extreme.  He alluded to the fact that we have a high infant mortality rate and that Americans are not as healthy as other countries.  I wonder how those statistics would play out if they were to eliminate counting illegal immigrants and those that are faking illnesses and injuries to help line another’s pocket.  I wonder how many dollars will flow into Michael Moore’s pockets by exercising his American right that is guaranteed by the First Amendment of the Constitution, freedom of the press and freedom of speech?    There is no such thing as a free lunch!  Maybe Mr.. Moore still has that lesson to learn.   My family has a saying, “Figures don’t lie, but liars figure”.  Numbers and statistics can be manipulated to serve those that are trying to make a point.

So the question remains, if America has such a lousy healthcare and political system, why are the rest of the world’s people so anxious to get here?

Until politicians step up to the plate and take a stand employers, small and large, can institute programs to help curtail rising healthcare costs. Here are some points to consider:

1. Inform employees of the cost of perpetuating healthcare fraud and that the costs are eventually shifted back to employers and employees by way of higher premiums and costs. 
2. Share the actual cost of healthcare and other benefits with your employees. Dissuade the thoughts that ‘Insurance will pay for it" by explaining how unnecessary utilization of benefits will increase costs.
3. Inform employees when an advertisement is received indicating that there are ‘no out-of-pocket’ costs, there may be fraud involved. Be aware of the costs that are actually incurred for individual healthcare. Was that x-ray or lab test being charged really performed? Did you receive all the medications for which you are being charged? Did you really see that provider on the dates indicated?
4. Encourage employees to report billing discrepancies promptly.
5. Follow through with all the pre-authorizations required for hospitalization, surgery and high cost procedures.
6. Encourage case management for employees and dependents that might be incurring catastrophic medical expenses.
7. Advise employees to choose their healthcare providers carefully.
8. Institute wellness programs
9. Report suspected healthcare fraud to the carrier involved and the proper authorities and follow through until resolved.
10. Be diligent in reviewing your company’s healthcare costs on a regular basis.