Our healthcare system is broken in many ways, but there’s an ugly truth that is less talked about. Private health insurance is failing American workers. The prevalence of high-deductible health plans and ever-increasing out-of-pocket costs means that three-quarters of workers are worried about being able to afford the care they need. It’s making the “valued employees” of thousands of American businesses sicker. And when their health issues can’t be put off any longer, it costs the employee and employer more in the long run. If that doesn’t scream for disruption and a new approach, what does? Solving what’s wrong with private health insurance may seem impossible, but that’s precisely why it’s ripe for bold innovation, for those of us willing to push the boundaries for something better.

Challenging Conventional Wisdom

Disruptors and entrepreneurs in multiple industries have shared that true innovation comes from challenging conventional wisdom and pursuing ideas that others deem impossible or too risky. You can’t simply copy or modify existing models to make meaningful changes. A groundbreaking idea must challenge the status quo to create something better. As a result, innovation often arises when daring to tackle what is considered unachievable.

Cost-Incentive Alignment: A Critical Need

Private health insurance is not meeting employee or employer needs due to rising costs and misaligned incentives. It’s become a vicious cycle. Employees cannot fully access these healthcare benefits if they can’t afford them, and that means employers are not getting the intended value of this insurance. Employees get sicker when they can’t get needed healthcare, which ultimately is more expensive for the employer with higher absences and costs, while employees are incurring medical debt at greater rates.

Tackling this challenge is not for the faint at heart. Those trying to improve private health insurance can only do so by understanding these foundational issues. To start, incentives across all players—employers, employees, providers, and payers—are misaligned. In general, employers and payers want to control costs and clamp down on utilization of care. Employees want affordable access when they need it, and providers are often encouraged to increase revenue by providing care that may or may not be necessary. These incentives can be in direct conflict, and patients get caught in the middle just trying to stay healthy.

Rising Costs and Employee Health

Costs are, rightfully, a huge concern and continue to rise faster than inflation year after year, squeezing employers and consumers alike. To remedy this problem, most businesses have simply increased employee cost-sharing through higher deductibles and out-of-pocket maximums. We’re now seeing the highest percentage of people putting off medical care due to cost in 22 years.

A Call for Innovation

This transformation is not a pipe dream. The possibility is real, and innovation is happening, but we need more courageous individuals and companies to take on these healthcare challenges. For employers seeking to be innovative, it is crucial to extend that innovation to the health benefits offered to their employees.

Conclusion

Innovation in America’s healthcare system is not only possible but necessary. By challenging the status quo, aligning incentives, and addressing rising costs, we can create a healthcare system that truly serves the needs of American workers. Let’s dare to dream big and build a future where healthcare is accessible, affordable, and effective.