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Aetna CEO's advice on health care
Ronald Williams, Aetna CEO
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TEXT OF INTERVIEW
TESS VIGELAND: One of the players at the health care reform table is Ronald Williams, the CEO of Aetna Insurance. Williams has been among the most outspoken insurance executives in supporting significant changes to the health care system.
He spoke with my colleague Kai Ryssdal about some of the issues they'll need to consider during this two-day meeting in Washington.
KAI RYSSDAL: You have said, as have many, many others, that it is time for change in the American health care system, that it's time for a transformation. What do we do? What are the first steps?
RONALD WILLIAMS: I think it really starts with this recognition that we have an excess of 45 million people in the country who are uninsured. And the question is what types of solutions and ideas can we undertake to help bring them into the system.
Ryssdal: Well, the president has said he wants some kind of mandatory universal coverage. Are you buying that?
WILLIAMS: I have been a strong proponent of getting everyone in the system and keeping everyone covered.
Ryssdal: So the government should have the power to make us all go out and buy some kind of insurance. Is that what you are saying?
WILLIAMS: Well, I think if we're going to have a requirement that everyone have equal access to insurance, you really have to have a way to make certain that everyone is expected to participate. There are lots of different mechanisms, and we would leave it to the legislative bodies to figure out the right answers.
Ryssdal: Who is going to pay, though, sir?
WILLIAMS: One I would say that the employer-sponsored system is a huge part. So employers will pay a big part as they do today. I think individuals would pay. And I think there are opportunities to look at the individual households and figure out what the right way to induce funding. We have tax credits we can provide. There are other things we can do.
RYSSDAL: Where does the role of the private corporation such as yours come in? Are you willing to take slightly less profit to make sure everybody gets covered?
WILLIAMS: We think we make a fair and reasonable profit. I think people dramatically overestimate the amount of profit that we make. We make about 6 percent after tax, which we think is a fair and reasonable number. And we believe we can bring more people in -- that we can be more efficient -- and really offer them a product at a lower price.
Ryssdal: Why is it that this time around in health care reform, 15 years after we tried it with the Clintons, the health insurance industry, companies such as yours, seem to be taking it a lot more seriously, understanding the need for some kind of change.
WILLIAMS: Well, I think what we're looking at is a recognition that health care costs are increasing dramatically. And I think one of the things important for everyone to understand is that health care premiums are a direct reflection of health care costs. And I like to use the example that it's as if we have a temperature of 104, we take the thermometer and it gives us a reading of 104 ,and we blame the thermometer for our temperature. The reality is our premiums are reflective. And I think we in the industry understand that unless we collaborate with physicians, with hospitals, with plan sponsors, and with the government and develop private-public partnerships that can slow down the rate of increase, we're looking at health care costs doubling between now and 2017.
Ryssdal: To continue with your thermometer analogy there, nobody actually hates their thermometer, I'd venture to say a lot of people aren't really thrilled with their health care companies.
WILLIAMS: It's fair to say that we sit in a very difficult intersection. We have the employer who often purchases the health plan, and we go to the employer, and we say, "Yyou can buy good, you can better, or you can buy the absolute best where your employers will not pay a nickel for anything." And the employer says, "You know, I wish I could buy that." So there really are purchase decisions going on there. And then you have the member who when they select the plan thinks about their household budget and affordability and perhaps selects a plan that isn't as comprehensive as they would if they knew they were going to be an extensive user of the system.
Ryssdal: Ron Williams the chairman and CEO of Aetna. Mr. Williams thanks a lot for your time.
WILLIAMS: Thank you.
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My husband and I moved from Ohio to SC 5 years ago. We have a major challenge trying to find a physician and Medical Facility that will work with Aetna and visa versa. It has been a terrible & upsetting experience! We feel totally insecure about being rejected by Physicians & Hospitals when it comes to finding health care, When I call around in several attempts to make appointments as a new patient, They all say the same thing. "No we do not accept Aetna covered Patients." When I have asked why I am told, "due to Our past problems filing claims with Aetna, and slow pays and refusal to pay the amount billed." Aetna has ruined their reputation with too many Physicians and Medical Facilities. This fact has drastically lowered the quality of Me and my husbands life & posed a problem to our state of health and health care options. EVEN IF AN INSURANCE COMPANY USES THE EXCUSE OR REASON NOT TO APPROVE OR PAY X AMT. OF CHARGES TO ANY CIRTAIN DOCTOR'S SERVICES, OR HOSPITAL ETC,DUE TO Physicians and Hospitals OVERCHARGING FOR THEIR SERVICES, WHERE DOES THAT LEAVE US?! This is so wrong!
Ron Williams reformation should really start from within. I have Aetna, and not only have they denied every claim a doctor has filed on my behalf (that's for an amount over $20.00) but then when I call customer service I get the run around everytime. They talk over your head and make you jump through hoops to file a claim correctly,and even more so to get them to hold up their end without threatening to file a breech of contract. It's ridiculous. They send out so many EOB denial forms that they would probably make up the difference in their paper bill to just do what they are paid to do. I hope they cover therapy because having them for an insurance company has got me more stressed than I've ever been in my life. If that's the type of nonsense this CEO condones, then we may as well throw him in the f.o.b.s. pile,too.
For once I wish that we could concentrate on the major reason why our health care system is in a crisis mode even though we spend more money than anywhere in the world. We need to start talking about obesity, alcohol and drug abuse, and lifestyle changes. Look at the number of children that are going to grow up with diabetes,etc. We need to wake up.
Just read the interview and everyone's comments - great to read everyone's opinions. I am an insurance agent selling individual & group health insurance. I see what goes on with monthly premiums, claims, etc. but not the interworkings of the entire process. Monthly premiums for health insurance are excessive. Government should offer a VERY BASIC health plan including prescriptions to all AMERICANS - non-citizens not included. Employers should be able to build on these basic plans if they choose to as well as individuals choosing to build on them. Let's get started.
Kai didn't ask Mr. Williams about the 800-pound gorilla: the cause of rapidly escalating US health care costs. Here are two candidates:
Technology: Hospitals and clinics buy ever more expensive devices, then upgrade computer hardware and software to keep up with the new data. Are these expenses leading to efficiencies and are the savings being passed on to policy holders?
* Pharmaceuticals: Americans consume greater quantities and pay a lot more for drugs than other nationalities. Somebody has to pay, and increasingly it is our elders.
CEO Williams leads Aetna, with whom I've had the displeasure of painfully negotiating outrageous bills. All he is interested in is expanding the pie of policies; he hardly seems to care about the reasons for mounting costs of health care or wants to do anything about it other than to shift the burden onto his policy holders and governments.
Marketplace should pay more attention to WHY health care costs so much. Kai dropped the ball on this one.
"Ron Williams is right, at least under the current system your employer is in control in regards to what is covered, under a government run system this wont be the case.." Why do I want my employer to control my health insurance? I happen to love my job, but I don't think my employer should pull the strings regarding my health. Just because the current rules are in place doesn't mean it's the best policy.
Mr. Williams skirts some painful truths. And it makes me mad even more because these so-called interviewers never ask the difficult questions. Americans, hospital, and doctor staffs are fed up with health insurance because it has everyone so tangled up with idiotic, inefficient rules and requirements. The billing services of all of the health care providers are also part of the entire mess. Covering 42 million uninsured people is one of the least of our problems with these companies, and by the way, one of the easier problems to fix. On this point, I agree with Williams that everyone has to pay. The left loves Europe, and everyone there pays into their health system. You can't have your cake and eat too with this stuff. Now let's talk about what really makes people mad at insurance companies. Pre-existing letters that DELAY claim payments. Student Status letters that DELAY claim payments. Precert, and Referral rules, that DELAY, CONFUSE, and can DENY claim payments. Add to this every insurance company has their own dopey website, their own dopey "policy" about what is experimental or investigational, and it all adds up to one big cluster F#%! Sorry, but you people gotta know. And, lastly, the beloved "employer based" system. It SUCKS. There are so many things that go on that regular people are unaware of. Employer get their employees the tiny benefit package, and these insurers sell the "executives" a separate policy. One that covers them for everything in the world. Some of these employers are the ones that decide whether to deny an employees appeal. The employee is not even aware of this. All of this goes on behind the employees back. Then when the insurance company writes the denial letter, the employee thinks the insurance company denied them, when in fact it was their own employer!! And, why should any employer have to know my medical history in the first place? I'm telling you there is so much wrong with what we have now it will never get fixed. It's a laughingstock.
It's frustrating at how many people dislike health insurance companies. They actually get upset because they make a profit. But what company today, doesn't try and make a profit, and a profit less than 6%?
The doctor is making a profit. The hospital is making a profit. The drug companies are making a profit. But because the healthcare companies have to pay the profits to these providers their not entitled to make a small profit? They are providing networks of certified physicians, programs to promote wellness and prevention, paying claims, and servicing its members. Why the double standard? Why is it Ok for other non-health insurance companies to make a profit, but not them?
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