Way To Go (Part 2).

So, there we were in our last episode, musing about the Wall Street Journal’s heartwarming tale of caring and compassion in modern medicine: “Obamacare Insurers Seek Double-Digit Premium Hikes Next Year.”

Among the cited reasons: rising costs, shifting utilization, tariffs driving drug prices, and did we mention the expiration of federal Affordable Care Act subsidies?

All true, but maybe we get a bit more real:

If your health plan provides ACA coverage, you and your industry peers are facing a next-decade loss from federal cutbacks in the neighborhood of three-quarters of a trillion dollars. 

It’s the somber mirror of a million people being forced off Medicaid annually.

That, of course, will bring other collateral damage: more reliance on the ER as the “clinic of last resort,” an older, sicker, and more expensive Obamacare “risk pool,” and, of course, dramatically increased provider tensions.

What could possibly go right?

By the by, this is all happening in the face of health care inflation that’s run 7.5%-ish since the pandemic.

So, one more time with feeling: if you’re a health plan CEO or CMO, what do you do?

My argument: clarity not only shows you how to move forward; it tells you why you should.

Clarity illuminates a critical need to minimize the hit to brand trust and reputation since that will be key to everything.

Clarity underlines an indelible requirement to be honest and transparent — in public — since that will allow you to recover goodwill over time, embrace adaptation, and cast a positive halo over all your lines of business.

Clarity writes the simple math of member retention versus acquisition on the whiteboard.

Clarity demands the essential ability to execute, whether that means effective utilization management or more bargaining power in the ugly provider negotiations to come.

As it happens, clarity also provides the roadmap for the path ahead.

Launching a dialogue with members that doesn’t just virtue signal, but unarguably proves you’re listening, dialed in, and inviting them to become part of the solution.

Developing a health care “affordability agenda” that might feature lower-priced tiers of care (at a minimum, “better than nothing” options), concrete steps, and even self-help education.

Taking a stance on renewing federal tax credits for individuals who buy their own care (a 68% winner among all voters).

Afterward, taking the Wayback Machine to 2010, when health plans found the collective wisdom to band together on the ACA. 

The theory then, as now, rests on Ben Franklin’s famous point about hanging together, instead of separately.

If you don’t recall it, I can hum a few bars.

Or maybe we recall the line from Robert Frost's poem "A Servant to Servants" that precisely fits the moment. 

It's grounded in knowing that the only way to overcome tough times is to face them directly, instead of seeking an easy way out.

Especially one that doesn’t exist.

“Sometimes the best way out is through.”

This is one of those times.