Why Not Health Insurance
By: Dr. Tom McCoy
As a member of the CrossFit community, you understand that we have this continuum, the sickness- wellness- fitness continuum. At any given point, you as a human are a spot on that continuum. The more you go towards sickness, the worse off you are. The more you strive for wellness and therefore fitness, the healthier and happier you are. What if I told you that traditional health insurance is constructed to thrive when people lean to the left, towards sickness; and the cost is not only your physical health, but also your financial health?
The CrossFit Medical Society has foundational pillars rooted in community and a belief that a person’s healthcare journey is their own. Straight from our homepage, “the CFMS aims to decentralize healthcare and return personal responsibility and choice to the individual. In other words, to help you take control of your health.”
So how do we do this? Well first, we do it together. Because our power lies in the strength of our community. We’ve partnered with an organization that aligns with our values and supports our mission. CrowdHealth is a crowdfunding platform with a proven track record demonstrating that operating outside the traditional insurance model is not only possible, it’s positively life changing in a number of ways. Our partner has successfully funded almost $10 million dollars in health care bills over the last 3 years, with a contributing community of over 9,000 people to date. Additionally, CrowdHealth has a 99.8% success rate in funding bills. This is why we are so proud to offer CFMS CommunityCare as the solution to the dysfunctional traditional healthcare system. And it’s specifically built for the CrossFit community!
It’s really important to note and understand that CommunityCare is not health insurance. If it were, we wouldn’t be offering it to our CFMS family. We don't want to be a part of a sick care system with high premiums and debilitating deductibles. We want a solution that allows autonomy for the individual and rewards them for choosing to live healthy lifestyles.
With that comes full transparency, we won’t make the same "guarantees" insurers do. But here’s the thing, if health insurance really served everyone with the best interest of the person at the center, then there wouldn’t be a need for a solution. Yet, here we are.
We should all be given the opportunity to make informed decisions on how we want to take care of ourselves and our families. So it’s important to us to share why we don’t want to be in the same category as health insurance.
Ask yourself this: why are you better off with CommunityCare?
Well, insurance companies have backwards incentives and structures that will actually increase your prices which negatively affects consumers. For example:
Did you know that the United States government limits the amount of profit health insurance plans can receive from your premiums? That sounds great in theory, but think about it this way: if a health plan can only make profits on up to 15% of your premium, and you have a $1000 premium per month, their profits are limited to $150 per month on that price. So then, what’s a major way health plans can grow their profits? By increasing your monthly premiums! If they boost your premium by 10% to $1100, they can now profit $165 per month. This means health plans are now incentivized to make your prices go up, not go down.
To function and stay in business, health plans rely on extensive contracts with doctors and hospital systems in your city. If health plans don’t have networks, then they are unlikely to sign up big companies in your city for their plans, because no company wants a health insurance plan that has super limited options on doctors and hospitals. Therefore, these networks are extremely valuable to health plans. Once they get a hospital system under contract, they don’t want to lose it from their network; to keep the network size, they must keep their providers happy, so they forfeit their ability to negotiate well with the hospital systems. This gives the hospital systems the power, so they can continue to increase their prices to insurers, which leads to an increase in health insurance customers’ prices, which then increases the health plan profits (see point #1).
Traditional health insurance is devaluing the hard work of the providers. Our providers are working too much to try and cut it with the breakdown they get from being in-network. They are suffering to get by on jam-packed schedules and getting undercut from insurance companies. What if you could offer your favorite provider a cash payment on the day of service? CommunityCare benefits everyone.
We encourage you to read through all the FAQs as there is a lot of information on how this will work for you, but the long and short of it: CommunityCare doesn’t make revenue on you being sick. Our job is to leverage our collective power to negotiate with hospitals and doctors, this dramatically reduces YOUR costs. We simply generate revenue on the marginal fee you pay each month for access to this service (amongst some other really cool offerings-like a yearly Biomarker panel which is included, and a $250 referral bonus when someone you know joins).
Coming back to the question about why we think it’s a good thing that we candidly state we can’t guarantee your bills will be paid… For starters, if we did, we’d be health insurance. We don’t want any part of that. But how many times have insurance companies “denied claims?” Regulators give insurance companies a green light to say they guarantee payment even though, according to the Kaiser Family Foundation, 40 million claims were denied in 2019. That’s 17% of in-network claims from plans that are sold through healthcare.gov! That means if you have a health plan through healthcare.gov, you have a nearly 1-in-5 chance of your claim being denied. Do we need to recall the 99.8% success rate of submitted bills that CrowdHealth funded for their founding community?
“We’re ok with being different and doing the hard things. We’re also really good at leveraging community. We support each other inside and outside the affiliate. CommunityCare is the solution to healthcare’s most vexing problem. ”
The plain and simple of it is that health insurance companies get away with guaranteeing coverage, but time and time again they don’t live up to their word. Our community comes from a CrossFit methodology where we pride ourselves on telling it like it is. We’re ok with being different and doing the hard things. We’re also really good at leveraging community. We support each other inside and outside the affiliate. CommunityCare is the solution to healthcare’s most vexing problem.
