This is a question Leslie Michelson, CEO of Private Health Management, asked after spending nearly 30 years in the health-care business and noticing something was wrong that needed to be fixed.
His solution? A private health care network which he founded in 2007 that provides high value service – both in cost and quality – to ensure people receive the best care available to them regardless of their diagnosis.
Some Americans are pleased with the health coverage they’re receiving, according to a 2009 Kaiser Family Foundation study on American’s Satisfaction with Insurance Coverage. It found that most people were satisfied with their coverage and care. However, the full synopsis revealed this wasn’t necessarily the whole story.
“…Significant portions of those who rate their insurance positively still say they face problems paying their medical bills or are dissatisfied with certain aspects of their coverage. Additionally…substantial portions of insured people are concerned about the cost of their health care and insurance, the adequacy of their insurance to meet potential health care needs, and the stability of their insurance coverage.”
One area this survey did not gauge was the level of care for people facing serious health problems, such as a cancer diagnosis or lung or heart disease. These are the areas in which companies like Private Health perform best as they are able to quickly connect patients in extreme need with the best doctors available to them.
As some might expect, this service doesn’t come cheap. As reported by The Wall Street Journal, Private Health primarily caters to “high net worth individuals” and to businesses that use its services as a benefit to their executives. Michelson reports that Private Health currently serves between 12,000 and 15,000 clients, mainly in ‘private equity, hedge funds, professional and financial services firms.’
By establishing strategic patient-physician relationships that are difficult and often dizzying for a person to establish on his or her own, Michelson suggests that people can avoid the run around and find the best doctor to treat their condition when using Private Health – and that is worth the extra money.
Liz Neporent, health expert and ABC News writer, believes in this service firmly and chose Private Health after receiving a life-threatening diagnosis earlier this year. As with many others in her circumstance, Neporent felt that the odds were so stacked against her both from an insurance and medical point of view that professional help from someone who could better navigate the system was extremely valuable.
“This is a service that I’ve used and I strongly believe that it probably saved my life. I’m not a rich person,” she said, “but I scraped the money together to do this.”
Neporent points out that the problem with fighting a bad diagnosis yourself is that your doctor is busy and he’s buckled under the insurance system and can’t always spend the time to explain what’s going on, what the tests mean, what the diagnosis means, and make specialist referrals. So to have someone who can expedite your appointment on your behalf when time is crucial is priceless.
Neporent valued Private Health’s ability to explain how her insurance coverage was going to work, and even just the way they ensured her that everything was going to be OK. “It’s very good to have this voice of reason,” she said.
It can be challenging for anyone to know what to do and what doctor to visit when receiving a worrisome diagnosis. “Maybe you live in a small town in Kansas,” said Neporent. “Where do you go? Should you leave? Should you stay? Couple that with not being in your best frame of mind to make those decisions and the extra cost is all of the sudden worth it. Your money is one thing, but your life is another.”
Though most would agree that the medical system is a mess, it isn’t always clear what the root issue is. After living through a health nightmare of her own, Neporent doesn’t necessarily place the blame on doctors. Instead, she places it on insurance companies, which she explains as a “convoluted labyrinth of a system.”
She reported that Private Health is among a growing group of premium health care providers that’s rising up out of the medical care ashes to provide superior care. In her opinion, this is good news as President Obama’s Affordable Care Act may not fix the broken health care system like everyone is hoping. Instead, she believes it may make things even more complicated, especially with the “cat and mouse games” insurance companies will continue to make both patients and doctors play.
Although some insurance companies are now offering mock services, claiming to provide similar care as companies like Private Health, Neporent advises that we shouldn’t be fooled. “That would be like allowing the fox to run the hen house. Insurance is a big part of the problem – they don’t have your best interest at heart, so I would not trust them and not use them.”
Another benefit of companies like Private Health is their expertise in knowing the rights of consumers when it comes to insurance claims. Neporent points out that insurance companies can deny coverage for a lot of reasons, often thinking they’ll wear people down who will eventually just give in and pay up. In these instances, Private Health might be able to help some get insured who otherwise wouldn’t, especially in the case of pre-existing conditions simply by negotiating the legalities of such matters.
Though this service may cost a little more up front, Neporent contends the unparalleled care will be worth it in the long run. “It’s not ideal that it costs so much,” she said. “But it’s also not ideal that the medical system is so broken.”
Although Private Health is considerably more expensive than other health care services (a figure they don’t publish on their website and also wouldn’t share over the phone), Michelson hopes that premium health care will be something he and others can bring to the general public in the near future.
As with any other business, the more companies that are offering a specific service, the more competitive the pricing becomes and the more affordable it will be to consumers. If this happens and Private Health comes within the price range of the average American working family, we suspect the health care world will be a much better and less stressful place.
September 25th, 2012