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2009 © Digital Roam Inc.
Dan Roam                   dan@danroam.com   www.thebackofthenapkin.com
Napkin #1
Health care in America is a business
governed by a simple equation:




   I get sick.   My Doc fixes me.   My Doc gets pa...
In the last several years there’s been a shift
in the equation:




     Insurance jumped in between me and my doctor.
  I...
That happened because health care is
really two different businesses:




There’s the business      … and then there’s
of ...
I’m in the middle.




             Me, my health, and my money
         sit in between these two businesses.
            ...
When I’m healthy, insurance loves me:




          I pay premiums that insurance collects, and
          they don’t have ...
When I’m sick, providers love me:




 Through my insurance, I pay Doctors, hospitals,
 and pharma for their products and ...
These two businesses hate each other.




   (Ultimately, I’m the only source of money for both.)

                       ...
They have conflicting interests and fight
over my money. (It’s a zero-sum game.)




Providers like to prescribe   Insurer...
As the providers and insurers fight, my
costs keep going up. (Bankrupting me and my employer.*)




         I’m the only ...
Now government steps into the picture:




                                Government is
                           worrie...
Government thinks most of the changes
are on the insurance side:




                  Almost all legislation being debate...
Next napkin:



  What health care
reform is really about.

(It isn’t health care.)
                          14
2009 © Digital Roam Inc.

Dan Roam                dan@danroam.com   www.thebackofthenapkin.com
Remember how all the reforms are
focused on the insurance side?




        All the big changes the White House is demandi...
The White House should call it what it is:




 If the White House wins, it will be the private insurance
        companie...
Is that fair?




        The only value private insurers bring to the
       equation is to keep costs down for members.
...
Is that fair? YES. Without a doubt.




Private insurers have failed miserably at keeping costs down.
   If they can’t man...
Private insurers had a remarkably
profitable 2008. (Yes, in the recession.)




  2008: Detroit dies.Wall Street tanks. 9....
Is anybody else being asked to reform?
Yes, but not so much:




Me:                            Providers:
Take better ca...
In the end, who will pay for any reform?




                       Me.
     Assuming I’m presently employed and covered,
...
And where will the money I pay go?
(There are 3 possibilities.)




1. Increase            2. Fund new            3. Fund ...
Next napkin:



 What plans are really
    on the table?

(And what is just hype?)
                           25
2009 © Digital Roam Inc.

Dan Roam                dan@danroam.com   www.thebackofthenapkin.com
Today, we have a purely business-driven
insurance model.




Today, health care in America is a profit-
oriented business ...
There are 3 options on the table:
#1 is a less restrictive private model.




   The first option is less restrictive priv...
#2 is private insurance (like today) in
         competition with “co-ops”.




                  Restrictive private insu...
#3 is private insurance competing with
         government-managed insurance.




           Restrictive private insurance...
Who is behind each?




The conservatives didn’t    The White House
want any change, but they   wanted this, but now
know ...
Which bills promote which?




                             33
The private insurance industry doesn’t like
         any of these options (for good reason).




       Insuring everyone ...
Insurance sees the first option as the least bad*, so
they’ve poured money into sinking the others.




* Then again, if
t...
Coming on the 4th napkin:




 Business and politics aside,
what do the options mean to

         me?
2009 © Digital Roam Inc.

Dan Roam                dan@danroam.com   www.thebackofthenapkin.com
Quick review: 3 insurance options are on
the table:




All 3 require universal coverage for all citizens.
The difference ...
Note: when the debate started, there was
a 4th, all-government option.




                  Reps. Conyers (D-MI) and
    ...
This “single-payer” option has been
removed from the debate.




               The White House has pulled support.
      ...
At the end of the day, what
do the 3 options mean to me?




                               42
1) If I’m presently employed and insured,
all options will cost me more.




Higher premiums        Indirect taxes       D...
So why reform? Because if we do nothing,
it’s going to cost even more.




People concerned that reforms will bankrupt the...
The additional costs are unknown. All I can
choose is how my money will be taken
from my pocket.




I’ll pay higher     I...
2) A key issue to debate is whether I will
pay directly or through my employer.




Switching the tax benefit to a tax cre...
3) In all cases, my actual health will at least
not get worse.




All plans let me   All plans let me   All plans will he...
Although today’s debate is really insurance
reform, there are issues on the other side:




Although they’re not core to t...
In the end, how we each decide to support
reform will be guided by 3 questions:




Should health be   Change is coming;  ...
Dan Roam   dan@danroam.com   www.thebackofthenapkin.com
Dan Roam is author of the
                 international bestseller
                 "The Back of the Napkin:
            ...
In the end, who will
In the end, who will
In the end, who will
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In the end, who will Healthcare Napkins All

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In the end, who will pay for any reform?




Me.
Assuming I’m presently employed and covered,
I’m the only player putting money into the system.
23

Published in: Health & Medicine, Business
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