Over the past three years, New Hampshire employers and employees have had to absorb hefty increases in their health insurance premiums.
For a number of firms in the Lakes Region and North Country, the bearer of this unwanted news has been their independent insurance broker, Norman Sedgely.
As part of New Hampshire Public series, Profiles in Health Care, Dan Gorenstein spoke with Sedgely about his business and how the nature of insurance has changed.
Norm Sedgely’s white ranch house sits on a small hill in Tilton.
Sedgely, in his late 50’s, started his firm Managed Health Care Concepts out of this house about 11 years ago.
Sedgely’s home office is modest and so are his business goals.
Track 25
1:00 I like money, like everybody else, but it’s not my driving force anymore at this stage in my life. I just try to maintain an income level that keeps the house going, and enjoy life a little bit.
Sedgely has a stable list of clients, about 65 small businesses and individuals.
He’s an affable man; likes to see himself as a someone who helps his clients solve problems.
Until a few years ago, that’s how his clients saw him.
Track 10
2:58 they used to like to see me come. Now it’s like, uh, oh, here comes Norm again. It’s not a fun job anymore. No.
Sedgely says the first thing clients say is ‘I assume the rates aren’t going down this year.’
Over the past three years, Sedgely has been the bearer of bad news- double digit increases in premiums.
The broker says the 24% increase for one client in Conway pushed them to make a really hard choice.
Track 8
1:28 ...They couldn’t afford it anymore. We are talking about a plumbing outfit. With four folks working really hard.
Sedgely says it wasn’t like the plan the company offered last year was so special.
...Had any of their employees gone ot the hospital, their bill could have gone to $3000 dollars, on top of paying $900 premium you are paying per month.
With the price spike, the plumbing company was forced to choose a plan that gave its workers an even worse deal.
Their premiums go up, and if they get sick they will shoulder an even larger share of the bill..
This, says Sedgely, is happening all over.
Track 7
:27 right now it is just a matter of trying to stretch the budget as much as they can, and not reduce the benefits anymore than you have to. We are reaching the end of the rope now. It is starting to really affect folks in terms of the decreasing benefits that they have to pass on to themselves and their employees to be able to pay the premium.
Sedgely reports that his clients don’t seem to blame the doctors, the hospitals, the insurance companies, or the patients for the spiraling costs.
But he notes they are increasingly desperate.
Track 23
3:00 the thing you hear the most is ‘do you think a single payer system would work?’... So they ask me, do you think that will help. And I say I don’t see how it would. I just don’t see where that is a solution. b/c you are going to get the government involved, and for some reason when the government gets involved, costs seem to go right through the roof. And the quality fo the care will go down.
Of course the private sector has had its problems with cost control too.
In the latest national survey costs went up faster in private insurance programs, than in the government’s program for federal workers.
To Sedgely, the unraveling of health insurance happened in 1977.
Track 13
:07 prior to ’77, everybody was community rated. In other words, you threw your money into the big pot and then who ever got sick and needed the help drew the money out ot pay for the claims. That pretty much is how it worked for everyone. It didn’t matter if you worked for the state or you worked for this plumbing outfit with four employees. So everyone paid the same premium if you had the same coverage...it was a community rated pool for the entire state of NH.
But since then, for Sedgely, the whole business model of insurance has changed.
Companies with a healthier workforce pay less, and others pay more.
Sedgely understands why that might make sense, but it has spread the risk of sickness over smaller and smaller groups of people.
He thinks that’s a mistake, not just in economic terms, but in moral too.
Sedgely is set to become a lay minister and reads the Bible daily.
When asked if the good book spoke to the nation’s struggle with health insurance, Sedgely went to the book of Matthew.
1:38... And what Jesus is telling us there, is that if we concern ourselves with others, before we concern ourselves with us,...and this might be a bit of a stretch bringing this back to an insurance seminar, but when you really think about it, that is where the insurance industry has gone off the mark.
Sedgely says they have forgotten what the concept of insurance is all about.
Track 27 :00... We’ve decided that it’s not there to serve, it’s there to make some money, to make a profit. To take care of me, and not you.
At the same time, Sedgely is not ready to blame the profit motive.
Track 17
:26 ...You can’t be a good American and tell people they don’t have a right to make a profit, and I don’t even pretend to go there. But when you start to talk about passing the cost on to that little guy in Conway, who is spending $900 a month to cover his family, when 15 years ago it was costing him 70 dollars a month...i don’t know. It doesn’t seem right to me for some reason
Sedgely has always seen himself as someone who helps his clients solve problems.
This time though, he doesn’t have a solution.
For NHPR News, I’m DG.
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