Like millions of Americans, I am a fan of the show “Lost.” For years, this show has delivered a high level of drama driven by engaging story lines, adversarial characters and very entertaining, yet confusing, sub plots. After each season writers promise answers to the numerous confusing questions that viewers were left with at the end of each episode.  Critics and pundits comment, fans discuss the characters over water coolers and bloggers speculate about the next season. Of course, as with all good dramas, they keep us continually on the hook. Sound familiar???

After my last visit to Washington, during the NAHU Capital Conference, I am beginning to feel as though a new season of “Lost” is playing out our industry. As with the television show, we constantly tune in to changes in Washington, the drama that plays out and the promises of answers to come. Unfortunately, those answers frequently elude us and many times are not what you would expect.

There does however seem to be an end in sight! “Lost” is wrapping up its final episodes (promising yet again to reveal all of its answers) and this season of healthcare reform is drawing to a close. Before the season finale, questions remain; Who are the heroes, who are the villains? Have we done enough to rescue our clients? What will happen once the final curtain drops?

To illustrate this idea, consider all of the stakeholders in this chapter of healthcare reform as the characters in the “Lost” series. Characters have a different agenda, are prone to changing allegiances and continually pull in opposite directions. As much as the characters in “Lost” couldn’t agree on how to get off the island, our stakeholders in healthcare reform can’t agree on how to move our industry forward. What we now have in common, however, is that we know that this year, something is coming to an end.

Fortunately, as members of the GPAHU, we have a chance to direct the final season of healthcare reform. In my first message as President of the GPAHU, I wrote that agents and brokers are the only profession that interacts with each part of healthcare system. We direct employers, subscribers, doctors, hospitals, insurance companies, lawyers and now government officials to achieve positive outcomes. Getting this expanded cast to work in-sync has been our challenge. After previewing the Patient Protection and Affordable Care Act and the accompanying Reconciliation Act of 2010, here is a preview of what our characters could experience during the next season of reform without our direction:

• Employer’s rate increases will outpace medical inflation for the next few years due to new insurance taxes and over-utilization.
• Subscribers will see more out-of-pocket costs from their employer plan.  This may incent them to look at individual policies, higher out-of-pocket alternatives or dropping coverage all together.
• Doctors will continue to be forced to do more with less while we as a society’s demand increases. Proposed Medicare reimbursement changes along with reduced fee schedules will decrease their ability to service their patients at the levels expected.
• Hospitals will be in a similar position to doctors while being held to new contracts based on results instead of quality of services.
• Insurance Companies will be revealed as the new villain and will have to reconcile increased premiums with riding profit margins.
• Lawyers, once the villains, will strive to play both sides of the fence. They will need to find a balance between the increases caused by windfall medical malpractice lawsuits and the practice of defensive medicine.
• Government Officials in certain agencies such as HHS and CMS will assume the great responsibility to increase services while reducing cost. At the state level, you will see tremendous pressure to pay for new programs and establish state level regulations required by the federal decisions.

While directing this cast of characters may seem daunting, it can be accomplished with your help. GPAHU, along with NAHU and PAHU, are committed to supplying our members with the manuscripts necessary for their employers, employees and subscribers. As we look forward to the final episodes, we hope that with proper direction, we won’t be disappointed or disenchanted with the outcome.  Like any television show, however, it takes your attention, input and participation to succeed. The GPAHU looks forward to the upcoming challenges and have prepared a variety of events this year to provide you with the valuable information needed to survive these times. We hope you will join us for the education sessions as well as our trip to Harrisburg planned for April 20th. We will continue to help you help shape the script so that our profession remains in the center of the healthcare system and live to see syndication!

Larry Turnbull
President GPAHU,
Executive Vice President,
David M. Banet & Associates