I wrote a recent LinkedIn post expressing concern about the tone of conversations taking place online and how the bashing and attacking of carriers and providers continues to escalate. I pointed out the obvious, the BUCAHs are paying attention and will react. It's happening. 

Overt and cloaked reactions 

I recently heard my first story of a carrier rescinding an appointment directly as a result of online commentary and perceived ties to other, even more inflammatory, individuals. That story was quickly followed by others who have also lost appointments. 

The carriers are paying attention to what you say online and are cutting those off who, in THEIR opinion, cross a line. But, it’s not only about what you say directly yourself, it’s about others with whom you associate and support online. I’m not saying this is fair or reasonable, I’m just telling you it’s happening. 

I have to also assume there are less obvious ways in which BUCAHs are retaliating. I’m pretty certain, before they rescind an appointment, they are already handing the client list of the soon to be ex-appointee off to a more BUCAH-friendly appointee. You know it happens.  

Benevolent or malevolent intent 

Don't get me wrong for a moment, I'm not suggesting anyone involved in contributing to a broken system gets a pass, AT ALL. What I am saying is there is a professional way to challenge and push boundaries and then there is simply stupid angry.  

There is a lot of stupid angry going on. 

The question should be, "What is the end-game?" Are we are trying to fix a problem or simply take someone down? I hope the former. But I believe, for some of the most vocal, it’s become the latter. 

Did he/she really just say that? 

There are many confusing the battle with the war. The collateral damage from those battles is going to hurt a lot of the same people you should be working to protect. 

The posturing and chest beating way too often crosses the lines of professionalism. I am often embarrassed for the individual and even more often for our industry. Conversations that have great potential to be productive and pull an industry together quickly become rants that cross over into maniacal diatribe. 

I have heard directly from otherwise reasonable advisors that their new mission is to take down the BUCAHs. But shouldn’t your mission be to serve the best interest of your clients?! 

Closely related are those who stand on a bully pulpit and state publicly, “I’ll never write another BUCAH policy.” Based on the rescinded appointments taking place, they likely won’t have that as an option much longer. OR, maybe they already have had that option taken away and are now playing spin doctor?  

If you can live with that outcome, you may choose to fight more aggressively. Just remember, the “you” in this equation extends to the rest of your team, as well as your prospects and clients.  

Most agencies still derive a majority of their revenue from commissions. And, right or wrong, many employers may still find the carrier plans (with all their shortcomings) to be the best option, even if only as an interim step to a more efficient plan. 

The price to pay for your rhetoric is shared by many. 

Don’t be a naked emperor 

Most of the same advisors who are so vocal in attacking the BUCAHs have been the financial benefactor of the same system they now attack. In fact, most continue to receive that same financial reward on a majority of their accounts. 

I get that you may have had an awakening and see the world in a new light, but you will best serve your clients by constructively helping others do the same. 

I had a conversation with a newly converted and overly passionately advisor recently. He told me that carriers cutting/removing commission used to be his greatest fear, but now he revels in working only on fees as he has set his sights on bringing on new VBID clients.  

He said the transparency is refreshing. Of course it is! But, when I asked him how the transparent compensation discussions with his current clients were going and how they were receiving the information, he admitted, “Well, I’m not having those conversations with my current clients. But, as soon as I write enough new business and don’t have to worry about those smaller accounts any more, I’ll start having those conversations.” 

I’m not even joking, you can’t make this stuff up. 

I’ve heard others relay the exciting conversations they have been having with prospects and how much more successful they have been in getting C-suite attention. There's a consistent message of how employers should be abandoning their BUCAH plans, expecting 30%-40% savings through creative self-funded plans, using DPC, securing bundled services, engaging transparent PBMs, direct contracting with providers, you know the drill. 

And, of course, all of those may be great solutions; I am a huge proponent of all of them. In fact, we’re working on a daily basis to better prepare the agencies in our network to have these very conversations. The problem is, in many cases, the advisor likely can’t deliver. When I asked one such advisor which solution provider they had vetted and partnered with in each category I was told, wait for it, “I’m not sure, but I’ll figure it out when the time comes.” WTF?!  

Not only is this advisor putting himself at risk, think of the potential damage he will bring to an employer and their employees. I know some of these advisors have never even written a traditionally structured self-funded plan before. 

As excited as I am about the re-emergence of VBID and as strongly as I believe its various components will help fix a significant amount of what is broken in our healthcare system, the careless and reckless approach being taken by many scares the hell out of me.  

Who are you? 

And, more importantly, whose attention are you trying to get online? Too many advisors seem to be showing off for other advisors rather than using their message to educate their prospects/clients.  

I get the impression that to gain credibility and garner recognition, advisors feel they have to take a shock jock approach. It’s important to remember how far removed the industry needle is from that of your client audience. That BUCAH attack that gets you “hell yeahs” from your bro-crew is at the very least scaring the hell out of your target audience and, quite likely, coming across as outright offensive 

Regardless of who you think you are talking to, your prospects and clients are watching. Do you think they want someone representing them who can advocate for them professionally or who seems to be out-of-control angry?  

I have no problem with extreme positions or pointing out examples of abuse, but some of the conversations I see are more appropriate to  be taken offline or, at the very least, to more private discussion groups. 

Why you so angry? 

I ask that question tongue-in-cheek. I’m as angry as anyone. The greed, fraud, waste, and outright dysfunction of our system should piss us all off. But it’s going to take cooler heads to scale the solutions we are already seeing. 

It has taken the concerted efforts of many and the passive acceptance of many others to bring us the sad state of our healthcare system. Similarly, it is going to take a concerted and active effort of most of the same parties to fix it. As well intentioned as I THINK most are, not everyone talking the talk is really ready to take their first step. 

So many of these brokers just don’t understand the big picture of VBID well enough to approach it from a position of reason and instead go over-the-top-aggressive to fill in their confidence gaps.  

The deeper your understanding of the solutions becomes, the more reasonable approach you will be comfortable taking. Very few of your clients will be able or willing to take a quantum leap from traditional, fully-insured BUCAH plans to the extreme ends of a VBID plan. It is very likely you will need to create a multi-year plan to move them down that path. If you put yourself in the position of being cut off by the BUCAHs, you are going to find yourself unable to get your prospects/clients from here to there.  

Challenge, with caution 

As long as your business depends on selling someone else's product, I would advise being careful in how you push them to get better. There is too much riding on your professionalism - for you, your family, your team, and your clients. 

As I said before, I believe anyone contributing to a broken system (including brokers making the wrong recommendations for financial reasons) needs to be called out. However, if the tone is professionally assertive it will be all but impossible to ignore. But out-of-control, stupid angry rants are easily ignored. No matter how right the message, the tone will keep it from being heard. 

And, the message of how to fix the healthcare system is too important to not be heard. 

Photo Credit: bowie15

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