This document discusses the competing interests that are driving up healthcare costs in the United States. It notes that healthcare spending totals $3.4 trillion annually and is negatively impacting companies' earnings and employees' wages. The main competing interests that are highlighted include brokers, PPO networks, insurance carriers, and pharmacy benefit managers. The document advocates for putting healthcare as the top priority and enacting common sense solutions and a willingness to change in order to help control costs.

1. RESTORING THE AMERICAN
DREAM
DAVID CONTORNO

3. YOU RUN A HEALTHCARE
BUSINESS WHETHER YOU
KNOW IT OR NOT

4. “GM IS A HEALTH
& BENEFITS
COMPANY WITH
AN AUTO
COMPANY
ATTACHED.”
Warren Buffett

5. THE UNITED STATES
CURRENTLY SPENDS $3.4
TRILLION ON HEALTHCARE

6. HEALTH
CARE
COSTS
ATE
YOUR
EBIDTA

7. HEALTH
CARE
COSTS
ATE
YOUR
PAY
RAISE

8. “THE WORLD AS WE HAVE
CREATED IT IS A PROCESS
OF OUR THINKING. IT
CANNOT BE CHANGED
WITHOUT CHANGING OUR
THINKING.”
Albert Einstein

9. TOO MANY
COMPETING INTERESTS

10. YOUR BROKER
COMPETING INTEREST 1

11. MY ETHICAL DILEMMA
“Here’s the odd thing, though, as plans got worse, rates still went up…and my revenue kept going up” -David
Contorno, My Ethical Dilemma, BenefitsPro Magazine, November 1, 2017

12. YOUR PPO NETWORK
COMPETING INTEREST 2

13. YOUR PPO IS RIPPING YOU OFF, BIG TIME.

14. PUTTING HEALTHCARE FIRST

15. YOUR INSURANCE CARRIER
COMPETING INTEREST 3

16. THE ONLY WAY TO INCREASE REVENUE IS TO REDUCE SERVICE
STAFF, RAISE PREMIUMS, AND/OR PROCESS MORE CLAIMS
$1M
80%
20%
$10M
80%
20%
THE 80/20 RULE (MEDICAL LOSS RATIO)

17. 80/20 RULE IN ACTION
CARRIER STOCK PRICE GROWTH SINCE ACA PASSAGE

18. YOUR PHARMACY BENEFIT
MANAGER
COMPETING INTEREST 4

19. WHAT HAPPENED WITH CVS HEALTH THIS QUARTER?
“THERE WAS GOOD NEWS AND BAD NEWS FOR CVS HEALTH'S TOP LINE. THE GOOD NEWS WAS THAT REVENUE FOR ITS
PHARMACY-SERVICES SEGMENT, WHICH PROVIDES PHARMACY BENEFITS-MANAGEMENT (PBM) SERVICES TO
CUSTOMERS, INCREASED 9.5% YEAR OVER YEAR, TO $32.3 BILLION. THIS GROWTH STEMMED FROM HIGHER
PHARMACY-CLAIM VOLUME, HIGHER BRAND-DRUG PRICES, AND INCREASED SPECIALTY DRUG VOLUME.
WHAT WAS THE BAD NEWS? REVENUE FOR THE RETAIL/LONG-TERM CARE (LTC) SEGMENT SLIPPED 2.8% YEAR OVER
YEAR, TO $19.6 BILLION. THREE KEY FACTORS CONTRIBUTED TO THIS DECLINE: A 2.6% DECREASE IN SAME-STORE
SALES, A HIGHER GENERIC DISPENSING RATE, AND CONTINUED REIMBURSEMENT PRESSURE. “
-THE MOTLEY FOOL, AUGUST 17TH, 2017
STATES ARE STARTING TO STAND UP TO ‘THE NEW BIG TOBACCO’ BECAUSE WASHINGTON WON’T
“…STATES SUCH AS CA, NV, TX AND ND HAVE TAKEN IT UPON THEMSELVES. THEY’RE CRAFTING LEGISLATION TO SHINE
A LIGHT ON THE COMPLICATED SYSTEM WE USE TO PRICE DRUGS. NATURALLY, THE COMPANIES THAT HAVE ACTED AS
GATEKEEPERS AND MIDDLEMAN ARE FUMING. “ITS ALMOST COMICAL HOW HARD THEY ARE PUSHING BACK” CA
ASSEMBLYMAN JAMES WOOD.
-BUSINESS INSIDER, JUNE 13TH 2017

20. SOLUTIONS
COMMON SENSE & WILLINGNESS TO
CHANGE:

22. FOUNDATIONAL COMPONENTS OF HIGH-PERFORMING PLANS

23. IN ACTION

24. QUESTIONS?
“THE GREATEST
DANGER IN TIMES OF
TURBULENCE IS NOT
THE TURBULENCE –
IT IS TO ACT WITH
YESTERDAY’S LOGIC.”
- PETER DRUCKER
DAVID@LAKENORMANBENEFITS.COM
704.663.4236