Healthcare Americana

TRANSCRIPT

[INTRODUCTION]

 

Announcer

At Freedom Healthworks, we are focused on putting medical professionals back in control of their practices, utilizing a structured, tailored approach to business startup and operations. It could make sense for you to work with our professional team to avoid expensive pitfalls, and more importantly, expedite your journey to success. As we all know, time is money. If you’re involved in the practice of medicine and desire to practice free of headaches and constraints, reach out for a no obligation, consultative conversation, call us today at 317-804-1203 or visit freedomhealthworks.com.

 

[EPISODE]

Christopher Habig

Welcome to another episode of Healthcare Americana. I am your host, Christopher Habig, CEO of Freedom Healthworks. Today we’re exploring the intricate world of healthcare laws and how they impact our growing direct primary care movement and others looking to move into the direct care world, utilizing a free market model. We are joined by Chris Deacon, a seasoned healthcare consultant from VerSan Consulting, who has extensive experience in healthcare policy legal consultation and is just fantastic anytime you get a chance to hear her and the work that she is doing. Chris, welcome to the show.

 

Chris Deacon

Thanks for having me.

 

Christopher Habig

Now, I mentioned a couple of times our paths have crossed a few times and I mentioned in our introduction, you are a very well traveled speaker getting out there educating the country on really what’s going on in the employer healthcare world, as I’m going to put it and feel free to step out of those bounds. I don’t want to try to shoehorn you in by any means, but I would consider you to be really the kind of end all be all as far as

what is happening in big legal cases around the country when employers and benefits and insurance companies start realizing that, hey, maybe we’re not doing our employees any favors by putting really oppressive benefits plans on top of them. Now, I mentioned a lot right there. So, in your own words, you’re on the speaking tour, what are people asking you to go up on stage and talk about?

 

Chris Deacon

Yeah, thanks for that very kind introduction. As you said, I’ve sort of been on the forefront of talking about the litigation aspect, or litigation world really, when it comes to employer-sponsored healthcare. And that can mean employers suing their carriers and vendors, or it can mean employees suing their employers, but all in this sort of breach of fiduciary duty space.

And I think one of the reasons I’ve been at the forefront of that is because of my time at the state of New Jersey where I purchased health benefits for all of our public sector lives. That was about 820,000 lives. Having a fiduciary obligation and duty was really at the forefront of how I handled my decision-making while at the state. And so I’ve sort of been out there talking about this for the last, you know,

almost 10 years, not just in the last three years, and have been saying for a long time that if employers don’t sort of get their act together and start making decisions that are in their plan and plan participants’ best interests and make better decisions, that they’re going to find themselves on the receiving end of lawsuits. And I think it’s finally starting to happen.

 

Christopher Habig

Now when you say fiduciary, again, I want to just break this down in very simple terms, because a lot of our audience is not going to be people who are familiar with kind of laws and things getting that vernacular, I would say. So when you say a fiduciary responsibility, what does that mean and how does somebody qualify as a fiduciary versus somebody who is not?

 

Chris Deacon

Yeah, that’s a great question. And thanks for asking it because so many people assume that they sort of know what it means. Right.

 

Christopher Habig

you get some nods and smiles in the audience. And then they just kind of focus in, like, do I actually know what that means? And then they miss the rest of the conversation. So I get it.

 

Chris Deacon

Right. Or you have people that have heard it sort of used out there in the industry in the last couple of years and think they have this really firm understanding, but at the end of the day, they don’t. So in its most simplest form, being a fiduciary essentially means that you’re being entrusted with somebody else’s money. And when you hold that money, that’s not yours,

duty and standard of care that you have to undertake when you manage that money, right? So if you’ve ever been an executor of somebody’s estate or you know how the bank has to handle your money when you deposit it, they have a heightened standard of care because they’re now responsible and they’re being trusted and entrusted with somebody else’s funds. And so in the health benefits space, what does that mean?

Every week or two weeks or month, right, when an employee gets paid and they have wages taken out of their salary or, you know, their paycheck for health benefits, that’s that employee’s money that is now being used with the employer’s money, but some of it’s the employee’s money being used to purchase their health benefits coverage. And so when the employer is responsible for

buying those health benefits or, you know, entering into these contracts for the provision of those health benefits, they have this heightened duty of trust and standard of care that they have to undertake to spend their employees’ money prudently.

So what does that mean in the health benefit space? It means that you have to act solely in the plan and the plan participants best interest. You have a duty of loyalty, meaning that you can’t have conflicts of interest. You can’t do business with your family and friends without disclosing it. You have to disclose conflicts of interest, pay reasonable plan expenses and those types of things. So at sort of at its core, that’s what it’s about.

 

Christopher Habig

In the in the real world again, you know, if we’re speaking to more of a medical profession here, so examples of other fiduciaries You know financial advisors accountants that kind of a thing where you’re giving them the cash and you want them to act on your In your best interests And so I think you know your explanation was spot on and it kind of brought it down to ground level And I think a lot of people, you know putting myself in their shoes are saying Well, wait a minute me

not something new. And you know, you mentioned you’ve been doing this for a decade or so, but it really caught fire in the last three years. Why? Because this is not a new financial arrangement by any means.

 

Chris Deacon

Right. Yeah, right. And I think going back to sort of that misconception, some people have been talking about fiduciary duties in the last couple of years and saying, there’s this new obligation that employers have to fulfill this fiduciary obligation. And I feel like sort of screaming and pulling my hair out because by no means is this new. You know, since the beginning of employer sponsored health benefits, the second you started handing over your money for your employer to purchase your healthcare.

that duty was triggered. We just haven’t really been doing a great job and fulfilling it for the most part. But what’s changed in the last couple of years is some lawsuits and some passage of laws that have really, let’s say given employers a greater obligation to access their plan data, sort of.

pulling their heads out of the sand, if you will, even if they sort of willingly kept it there, and they now can’t, they don’t have that excuse of, you know, saying, I didn’t know, because they have a duty to have access to that information. And then the third thing, and I think probably the most important catalyst here, is the fact that we’re paying $4.6 trillion as a country for healthcare, employees’ wages.

you know, if you get a 5% raise this year, which is, you know, pretty good, it’s probably getting eaten up by a 6% increase in healthcare costs. And we might have more Americans insured today than we did 10 years ago, quote unquote insured. But we have more Americans than ever that can’t actually access care because of the cost barriers that are put in front of them or because they can’t access or find.

primary care physicians or behavioral health physicians. So I think that third bucket is really the reason why people are fed up. We can no longer shift more costs to employees because Americans aren’t seeking care because they’re scared of the cost of healthcare. And that’s a really sad state.

 

Christopher Habig

Absolutely. You brought up about three points right there and I don’t want to just put those aside because there’s really so it sounds like there’s really no like one thing that was the catalyst of people looking at these laws and how they’re written and be like, oh wow, we’re not enforcing responsibilities here, which it always blows my mind, but I’m not technically I’m not really surprised by that. I’m sure there’s all types of codes and regulations on the books that people have no idea about and I can say that kind of tongue in cheek kind of knowing the answer is more rhetorical question than anything.

I want to go to your third point there. That we do see healthcare.gov and the ACA really more popular than ever from a covered lives standpoint, just from our standpoint. So we’re in the great state of Indiana and we’re talking to Legislator Brexas and we bring that up that, hey, ACA is going to thump their chest on this one and say, we’re ensuring more Americans through their public option than ever before. But you connected the other half of that story. It’s kind of like the old

you know, now you know the rest of the story type of a mindset, in Indiana for Hoosiers the average ACA deductible is pushing nine thousand dollars per person. That’s, why even have it in the first place?

 

Chris Deacon

Right, right. Yeah, it’s insane. It’s insane. It really is to think that we spend so much out of our paychecks, right? I mean, I’m not sure what the average family costs for a premium there is, but here in New Jersey, it’s around $24,000. And then you’re paying 9,000 on top of that just to get access to the coverage that you’ve bought. It’s not reasonable, it’s not.

 

Christopher Habig

Yeah, and we know we didn’t talk about the actual inflation numbers being closer to, you know, 6, 7, 8 percent too, with healthcare being another 6 percent on top of that. And I know there’s a happy little medium if somebody really wants to dive into it, but the fact is wage growth is far stagnant growth compared to the cost of actually raising a family or keeping up with your health bills. Chris, I think you’ve done a very good job of framing kind of why this is becoming a

relatively popular subject for you to discuss. You know, I’m curious because I’m an employer, right? Like I have started own company, we’ve approached the subject of employee benefits and we like to think we’re on the creative side of that. At what point do larger employers wake up and start demanding that, you know what, this whole thing of having employment tied to insurance, this doesn’t make sense anymore.

 

Chris Deacon

I don’t think we’re there yet. And the reason I say that is because if you go back 20 years, you’ll find thought leaders and folks asking that very same question. I have many quotes from, again, 20.

15 years ago of folks saying the cost of healthcare, employer-sponsored healthcare is unsustainable. 90% of, and I think this was right after the passage of the ACA, there were predictions that 90% of employer-sponsored healthcare would be gone and they would be on the exchanges because it was simply becoming unsustainable. So it’s hard for me to think that is, we’re at a moment where that will happen. But what I do think,

is that right now, and again, going back to that second bucket, and that’s the litigation being a catalyst for change, we have employers who’ve by and large, you know, sort of remained less than creative when it comes to the provision of their health benefits and very much sort of staying with the status quo and just accepting what’s handed to them and then passing it on to their employees. They’re being held to account.

And we’ve had the first lawsuit break, well, actually now two, with employees actually suing their employer for breach of fiduciary duty. And you know, another way to put that, the employees are telling the employers in these complaints, you’ve done a really…

I don’t know what the rating is on this, a really horrible job providing health benefits and purchasing on my behalf. And I’m filing a complaint demanding change. So we’ve had one employee from Johnson & Johnson.

 

Chris Deacon

file against that drug maker as an employer. And we’ve had several employees from the Mayo Clinic actually file a complaint against Mayo Clinic as an employer. And that’s particularly, you know, the irony shouldn’t be lost on us that they are filing suit against two of the largest players in the industry that are responsible for some of the exorbitant costs that we have in healthcare.

 

Christopher Habig

My first question, you know, comes to that because on the surface, I think, oh, hey, this sounds great. What is the goal of those lawsuits? What are they trying to achieve on the outcomes?

 

Chris Deacon

So I think the especially with the Johnson & Johnson case, which we more know a little more about at this point it’s being brought by a Group called the Fairmark Law Group and if you read the complaint it really reads like an expose a a powerful one on the PBM industry writ large So I do think that they are trying to achieve You know justice or whatever you

want to say for the actual class action plaintiffs. But I think more than that, they’re trying to change the industry. I think they’re trying to blow the lid off of an industry that is full of unnecessary middlemen, corruption, waste, fraud. And again, pointing the finger at the purchaser in this case.

who is the one that has the power and the responsibility and the legal obligation to do better by their employees. There have been predictions, well, will this force employers to stop providing benefits and just get out of that business and just sort of maybe hand over employees a boatload of cash and say, go buy your own insurance on the exchange. Will it lead employers to fully insure?

so that they can mentally check out and say, I’m going to shift this risk. Which, oh, by the way, doesn’t actually shift the risk because even fully insured employers actually still have a fiduciary obligation to purchase health benefits prudently. And I don’t happen to think, I do not predict that those will be the outcomes. I hope that the outcome will be a more constructive and productive one, and that is for employers to, you know, now both have the…

recognized obligation and opportunity to begin thinking about how they purchase health benefits more differently.

 

Christopher Habig

That’s kind of where I was going with that line of questioning and you got there without me, you know, having to walk to the door there.

Like specifically, because in my mind, we’re like, OK, if we want to rebuild the entire benefit side of it, you know, the employers still have to go through, you know, say these cases are just played out, right? Say they’re successful and we’re saying, great, we got to change the way we purchase things. I mean, how do they actually do that? You know, when you’re still talking with brokers and advisors who, by and large, are compensated by based on the percentage of, you know, how much the dollar amount that they sell.

sell as much insurance to as many people as they possibly can. I mean, this is yanking up the bush with STEM and roots and everything, which where do you start, I guess, is my point.

 

Chris Deacon

Well, I think you have to recognize, number one, that it’s going to be really uncomfortable, and you’re going to disrupt and ruffle some feathers, right? And I’ll just, you know, I’m not tooting my own horn here or trying to seem immodest, but when I started with the State of New Jersey, I remember very, very distinctly, one of my first projects was running our TPA RFP and being told that

This is the way we buy benefits. We look at this as A on telling me disruption and discount. That’s how we evaluate our bidders. And I very quickly realized that to do things differently, we’d have to think not just outside of the box, but throw the box away. And we weren’t going to buy off of a discount. We were going to look at unit cost and guarantee unit costs year over year wouldn’t go up x%.

Was it difficult? Yes. Did it require multiple conversations of people looking at me like I had two heads because I wanted to do something different? Absolutely. But we accomplished it and we did accomplish it in a state and environment that was very hostile to change, which New Jersey is not unique in that sense. Because when you save…

For as an example, we save, we have one tweak, we were able to save $100 million in the way that we were reimbursing out of network. And really overnight. And when you save $100 million, and that’s coming out of somebody else’s bottom line, right? And so being disruptive can be very difficult and there can be a lot of pushback. But if you lean into the discomfort, it’s absolutely possible.

It is not easy. There are no silver bullets. There is not one digital technology that is going to save us. There is not one model, right? I also think that a lot of times we think, well, that worked for you, but it’s not scalable, right? What’s scalable across the U S to help these large employers or to help the larger system. And the question shouldn’t be, is it scalable? The question should be, can we replicate it? Right.

Can we replicate the intelligent purchasing that is happening across the country in different geographies and locations? And I think the answer is absolutely yes.

 

Christopher Habig

Is it too simple to say, you know, if you’re an employer and you’re listening to this one, I advise you to go out there and if you’re having that benefit discussion, make sure you know how that other person across the table from you is compensated. I mean, can we start there, just boil it down? And I tell that to patients all the day, or I should say, you know, just regular people. They’re like, you know, Chris, how do I help change healthcare? Because it seems daunting. And I think that’s kind of like the point, like how do you shift?

20% of our US economy into this type of feeling and I’m like well next time you go see a doctor just ask the price If a business owner just asked their broker advisor How are you paid and what is it if I take this deal? Does that move the ball any on a? Micro level that we can then build upon

 

Chris Deacon

I think yes, but the more important point there is the ball will not move at all until we begin asking that question. So it’s absolutely foundational that be one of the first questions we ask. And you could take that and say, you know, as a patient going, you know, what is, what does this thing cost? Or why are you prescribing me that particular medication? Is there, is there a generic or is there, you know, smart questions from an employer

Yeah, where are you getting your revenue from? I want to know all the streams. If they’re trying to sell you a point solution, are you receiving anything on this deal? That doesn’t mean that the broker’s a bad person or the consultant’s a bad person or company, or that that’s not how business is done. But you have to ask the question so that you can then evaluate the decision you’re about to make with eyes wide open. And that’s what.

I think is again, it’s just so important is understanding. It doesn’t even mean that we might, you know, we might still make the same decision to go with that vendor or to go with that point solution or to go with that broker. But if we are keeping our eyes closed to the answers to those questions, we will find ourselves on the receiving end of a lawsuit. And we should, and we should, in my opinion.

 

Christopher Habig

I tend to agree with you now framing it from the other side of that table. I feel like right now we’re just pointing fingers at insurance companies, the brokers, that kind of thing. You know, from their standpoint, do they recognize what’s coming down the pike for them? Do they see that their business models and that double digit increases year after year? Do they recognize that this just can’t be sustainable? And I know you said we’ve been saying that for about 15 years now, but.

Do they get it or they just think, hey, this is great, we’re going to keep it going as long as possible and we dare you guys to do something about it?

 

Chris Deacon

I think they absolutely get it. And I think that’s one of the reasons why you’ve seen some changes in the model. So for example, United Healthcare, Optum, or even Blue Cross Blue Shield at Ness CVS, they’ve seen that their revenue,

the ability to gain market share, gain revenue, was somewhat limited when they’re only providing, let’s say, an ASO service, and they’re getting a PMPM to administer. So maybe let’s get on the provider game, right? And so now we have Optum being, how they…

employ more physicians than Kaiser Permanente. And we just saw further expansion of Elevante’s anthem buying urgent care centers and primary care centers, right? So I think there’s absolutely hedging going on, expanding into the digital health space. Now the question is, are we as a society and as consumers of healthcare,

and purchasers of healthcare going to stand for that piece of the pie continuing to grow? Is it gonna be 4.6 trillion? Is it gonna be 5.6 trillion in 10 years? Is it gonna be 25% of our GDP in 10 years? Those are all open questions. And until we start asking the hard questions and looking under the hood and really understanding what we are spending our money on.

And really, if you look at our health outcomes as a country, not getting our money’s worth for what we’re spending, I absolutely think that will continue to creep up. But they’re sophisticated, they’re smart. They know, I think they have a game plan for 10 years out. But I also think that enough folks are waking up and even politicians, the tone in DC is very different than it was five years ago with respect to healthcare.

So I do think that there is an opportunity for change. We just have to demand it.

 

Christopher Habig

get the pitchforks and torches ready and go marching. And I say that kind of out of jest and kind of lighthearted, but I think we’re already seeing that in a lot of rural areas. Of Indiana’s 92 counties, I think over half of them do not have any type of medical center within a 30 or 45 minute drive. It’s really crazy to think about that. And folks are pointing fingers at the big hospitals. And so when you were talking about how insurance companies are buying up physicians offices

my mind. I mean, that is a massive conflict of interest right there. But I haven’t seen any litigation or any court opinion saying, you know what, these two business models from insurance in what should be, I guess, is the way I should put this, a risk management strategy and company, getting into business with physicians and that kind of stuff where more volume and faster churn creates more dollars. I just don’t see how those two things are squared underneath one roof.

 

Chris Deacon

Yeah, no. And they shouldn’t be. I mean, it’s mind blowing that the FTC and Department of Justice haven’t played a more critical role here in saying, this doesn’t make sense. And no other business or industry would this be sort of permitted. But they’ve cloaked it in terms of greater efficiency and coordination of care and limiting barriers. But to your point, right?

We’ve seen massive consolidation, let’s, you know, on the hospital side as well. And I was just speaking with somebody earlier, I had a family event in rural Tennessee this weekend. I was in Bristol, Tennessee, small town in Northeast Tennessee. And Ballot Health is the only provider that anybody can, they have a monopoly. And when…

they were sort of permitted to become this massive monopoly in this area. It was because they professed to, you know, be able to coordinate care and provide a holistic care experience for the members of this rural community that had huge health struggles, whether it’s diabetes or the opioid epidemic.

But I became sort of, you know, served as sort of a confessional for my family members this weekend who just came to me and telling me story after story of driving two and a half hours to find a labor and delivery department, having to drive two and a half hours to go see their grandchild in a NICU. Or, you know, again, I mean, I could tell you stories for days that I heard. So yeah, when you, you know, we kind of joke about the anger and the pitchforks, but you know.

When you take away the ability of somebody to get access for their loved one’s care, and whether that’s a child or a loved spouse or a grandparent or whatever, there is anger and there’s frustration both on sort of a health side and then the finance, not to mention the financial side that can be ruinous for people. They’re upset and I do think that will be part of the, huge part of the catalyst for change.

 

Christopher Habig

Now where in your mind do physicians play a role in that? Because we talk about, and the reason why I ask, it seems like hospitals, insurance companies are basically pointing fingers at private equity bogeymen over here. And I’m saying, okay, three of you can sit there and point fingers at each other all you want to. Fact is, there’s real people on the ground hurting like you just talked about. There’s business owners that are hurting who are starting to wisen up to it. A lot of those times, those conversations don’t include the physicians who are going ahead

to sell to a hospital or to sell to the private equity group, vacate their practice, and then consolidate operations in urban areas, excuse me, population centers, like you were just talking to. So, you know, in your mind, I guess in my mind, obviously, this is not going to be a surprise, but I think the whole physician world is culpable in this and that they have to take some

your thoughts on it.

 

Chris Deacon

Yeah, I think there’s some blame to be shared for sure. I think if we were to look at allocation of blame here, the only sort of party that is hurting more than anybody and lost in this is really the patient, right? We’ve been purchasing healthcare poorly for them.

whether it’s the hospitals, the carriers, or even in some cases, the physicians. That being said, if you were to look to the future and say, what sort of healthcare system do I want to see in my grandchildren’s future? There are a few parties that are going to have to be a part of that, that we want to be around. And in the middle of that picture of the future is going to be the physician and the physician-patient relationship in restoring that.

Is it going to have a massive carrier in the middle or a PBM or a private equity owned hospital system? You know, probably not in all of our ideal futures. So I think that they, you know, again, there’s some culpability to be shared, but I also think that they have been victims of a system, and a system that we’ve allowed to perpetuate from sort of a policy perspective.

a physician that is sort of going up against a ballot health and, you know, has been left out of the network because of the terms that were offered. You know, what choice do they have? They have a mortgage. They have a family, right? Just like we do. And so while yes, there’s some blame to go around. I also think that there is also a lot of, there is a lot that they’ve been victims of as an industry, you know, and that goes for physicians and nurses.

But more importantly, the role that they can play in helping build that future that we all would like to see is critical. And I think that no matter where they are in their career, whether they are working as an employed physician for a hospital or an independent physician or a private equity owned physician, they need to use their voice and whether that voice comes in the form of a vote.

or a stronger voice in terms of advocacy at the local community level, state level, or federal level. They absolutely have a role to play and I hope that they step up and play it.

 

Christopher Habig

When you talk to what in my mind are three stakeholders of healthcare, you’ve got the employers who foot a lot of the bills other than, you know, direct pass, indirect pass, that kind of stuff. But patients and physicians, those are in my mind, the three stakeholders there. I mean, this conversation just to me, like the overarching theme is that.

If I’m one of those three stakeholders, there are choices out there. I just need to dig a little bit because they’re a little hard to find right now. But there’s options.

 

Chris Deacon

Mm-hmm. Oh, absolutely. Yeah. And I think that of those three stakeholders, the employers and the physicians probably should bear the most responsibility in adopting those bright light solutions that could be the future and what we want to see in the future.

And the reason I say that and sort of hesitate at pointing too many fingers at the patient, although there is obviously a role for a patient being more consumed, I’m sorry, informed as a consumer, what we’ve done as an industry, and this goes for employers too because we’ve absolutely been part of the trust.

issue, having shifted more costs to employees over the last 10 years and putting them on consumer driven health plans without providing them with any information to be good consumers. There is a trust deficiency in the system. And that trust deficiency has sort of led to patients and consumers that don’t trust the system. They don’t trust when employers often are trying to bring them.

solutions that are good for them and good for their pocketbook and good for their health. But that’s on us to rebuild that trust. And it’s a difficult challenge, but it’s a task worth with sort of tackling and putting our might into. Because that trust is only going to be rebuilt with full transparency, honesty, and hard work.

 

Christopher Habig

It’s the only industry in my mind that the demand is actually going up. The demand doesn’t actually go anywhere. And yet so many hospitals and offices and healthcare companies fail. I’m like, the demand is always there, guys. How can you not put a business model in the economics together where you’re actually profitable in this one and helping out people in your community? You know, what I always I almost started laughing there when you were talking, too, because we’ve always had this mindset. And I think my generation might have been the last of it, where we see people who are younger.

that’s coming into the workforce where it’s not drilled into them anymore that, hey, you got to go get a new go get a job out of college and I get a job that has benefits. I think that notion is starting to dissipate. And people see this veneer like, oh, wow, once I crack it, it realized that this health plan is really constructed to keep me in poverty or to bankrupt me more so than being a smart consumer or actually taking care of myself. So that was my only that was my only comment when you know, because I agree with you.

with everything else you’re saying from an employer and a physician side of it that, you know, we have to make a market that is receptive to.

good quality medicine and I don’t use the Q word lightly, right? Like better health outcomes is usually what I say, not just a matrix of meaningful use and profit maximization. We have to make a market that respects the patient and respects that relationship like you were saying. So Chris, as our talk winds down here, just curious, when you’re off traveling, you’re given these talks, what kind of groups are you in front of speaking? Which ones are reaching out and saying,

what you’re doing and what’s going on.

 

Chris Deacon

Yeah, well, I think as you mentioned, we met a couple of weeks ago at the FMMA, the Free Market Medical Association, which I’m really, I love the work they do, and I love the approach that they take with respect to the, you know, the market, right? Meeting the buy side and the sell side and making sure that we’re meeting at the right point in the middle there because we have such a dysfunctional…

it’s so difficult to even call it a market in many ways. So groups like the FMMA, and I think I’ve spoken at now two or three of their events, some of the purchasing coalitions I speak to, there are groups that sometimes I give a sort of a warning at the beginning. I might not be invited back. Last week, I actually spoke right after the Blue Cross Blue Shield rep, which was fun for me.

I don’t know about for him. But and then I also spent a lot of time educating, you know, behind closed doors with policy leaders and those who influence policy leaders on this stuff. And, you know, I started as an attorney and now I very much, I think I’m sort of an educator and I don’t necessarily think that I’m.

I know I’m not the smartest person in the room, but I am willing to speak uncomfortable truths and sort of tell it like it is. And I have the benefit and the privilege of being very independent. So I can do that because I don’t have to sort of, I don’t depend on the income stream of a lot of these organizations that have to be taken down a peg and really sort of spoken about honestly, if we’re gonna make change.

So I’m having fun doing that and that’s what I’ll be doing for the foreseeable future.

 

Christopher Habig

So I know I said last question there, but one more just kind of popped in my head here as we get ready to end our time together. Which one of the cases and which one of these kind of objects in motion, which one are you most optimistic about that will drive lasting change in a dysfunctional market, as you very eloquently put it?

 

Chris Deacon

So I think the line of cases along sort of the Johnson and Johnson case and the Mayo case, I’m not necessarily going to put all my eggs in the basket of those particular cases success, because each case is going to have its challenges with respect to, you know, showing standing or enough injury to actually survive the next steps. But that line of cases, and when I say line, I mean

employee versus employer, I think are going to be the most meaningful because nothing, and this goes sort of in every sector and every industry, including healthcare, nothing moves people like money, right? And when you have the threat of litigation personally as a fiduciary and then as a company,

You got the long term impact of that potential class action. It absolutely transformed the financial services industry and the 401k industry. In a decade, it completely transformed it. I mean, to go back and look at how that industry functioned and under the shroud of secrecy and the fees that were charged and all the rest of it and how it was transformed as a result of billions of dollars of litigation because there was real money at risk for these companies.

So I think that’s where real change from an employer purchaser perspective, because it’s not just going to motivate employers, it doesn’t stop there. Employers are the ones that purchased healthcare on behalf of 160 million Americans, and they have big voices in DC if they’re willing to use them. And so motivating them through that litigation, I think is gonna potentially be very transformative.

 

Christopher Habig

I want to thank you for not including in your solutions any type of act of Congress or at this point in time a miracle or act of God is equally more likely to happen. So it just bugs me a lot. You know, I’ll be in I’ll be in meetings and roundtables and in everybody’s pointing at Medicare or pointing at, you know, some fix in Washington to come save the day. And I’m like you, I’m kind of beating my head against the wall. Like guys, we could either vote with our dollars like you just said, or, you know, put 50 little different experiments out there.

that are called the United States of America and see what works out there. But I love that conclusion. I appreciate you just going out there and saying, the basic fundamentals of economics does work. Let’s make sure that we’re dealing business with people and having dealings with people who understand that.

 

Chris Deacon

Right, absolutely. And, you know, that is not to say that DC doesn’t have a role to play, but to sort of continue on your point, so much of the dysfunction that we have today is not as a result of inaction in DC or state capitals. It is as a direct result of some of the decisions that were made in DC. So, yeah, I think, you know, market forces can work if we have a market.

And some of that might take some leadership and some state capitals in D.C. But absolutely we could begin to reform the system just voting with our dollars.

 

Christopher Habig

Chris, I appreciate you. Thanks for taking the time to join us here on Healthcare Americana.

 

Chris Deacon

Thanks for having me, it was fun.

 

Christopher Habig

That’s Chris Deacon with VerSan Consulting. And to all of our listeners, thank you for listening today. Don’t be afraid to share this podcast, reach out to us in any way, because without you, we’re not gonna have a chance to talk about or really enact any of the solutions that we just hit there. So remember, staying informed is the key to changing everything for the better. Once again, I’m your host Christopher Habig. Until next time.

 

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