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After Stanford professor Jeffrey Pfeffer underwent surgery years ago, he kept a folder labeled “Blue Shield Troubles”.
When pepper When he received an offer to work with polling firm Gallup, he proposed a study of how much time Americans spend on the phone with their health insurers. Gallup agreed.
Your result: We call our health insurance company around 12 million hours a week. (They found too that as employees, when we call our health insurers, we are more likely to miss work and are more checked out and burned out at work.)
And with all of that … it’s important to know as much as you can about who we’re talking to when making those calls. How do you make money? What are the incentives?
What few of us know: In many cases, companies don’t get paid for insurance. If you insure yourself through work, your employer is likely to insure yourself (about two-thirds of all employees and more than 90% of people who work for companies with more than 1,000 employees).
But it’s not obvious if your job is self-insuring. You have an insurance card that says Cigna or United or Aetna, etc. But you are operating in a different universe. For example, self-financed plans are subject to federal law, so your state insurance board cannot step in and help. And that’s just a start.
In this episode we begin to orientate ourselves in this other universe. We talk to pepper, one of our favorite insurance brains, Karen Pollitz from KFF and to the journalist Leslie Walker, their reporting for the podcast “Compromise“Indicates that companies playing their role in” self-insured “setups can engage in some shady practices. And the employers they work for – even large, powerful companies – often don’t have a lot of oversight or even a lot of influence.
Here is a Transcript for this episode.
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