Once they realize how much they can save on these Carve Outs, they can go to their employees and tell them if they use these new hospitals or centers , the company saves so much money, there will be no out of pocket cost to the employee.
See where I’m going with this ?
The path to universal HC starts when big companies , who in aggregate cover more than 60 pct of insured employees, start getting smart about eliminating the middlemen, by first using Carve Outs and then expanding them to all elements of care. Then, hiring claim administrators that are not affiliated with the big conglomerates, and only paying a fee per claim, they can offer to cover all care, with no patient OOP.
If 60 pct of insured employees are moved from the big conglomerates to direct contracts , the cost of care would go down, because those companies are actually directly negotiating and working with providers.
The revenues of those providers will go up , because the middlemen are out
And of course employees will spend less on care.
Effectively smart companies can offer Universal Health Benefits with no out of pocket beyond basic copays for all their employees.
If companies can negotiate and offer Universal Care , so could a city , or state and then potentially the federal government, using the corporate template and approach