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Health insurers have come up with the idea of the century

Stewart Segal, MD
Policy
August 29, 2011
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I have come up with the idea of the century.  My idea will make your company the richest in the world while attracting millions of new patrons to your credit and debit card services.  I don’t know why no one has done it in the past.  It has made the insurers of America countless billions of dollars and now you can profit as well.  My only request is that you pay me 1% in royalties for bringing this opportunity to you.

Ready?  It’s so simple it will knock your socks off.  Under your current company guidelines, your cardholder charges a purchase and takes his merchandise home.  You charge your cardholder interest and charge the merchant a processing fee.  Once the transaction is processed, you pay the merchant the money owed to him.  You make a profit off of interest and fees.

Under my plan, the cardholders still charge their purchases, pays you interest at a greatly reduced rate, the merchant still pays you a processing fee, and you still process the transaction.  Ready to be amazed?  Under the new plan, you no longer pay the merchant, you “reimburse” him at a rate you set.

Yes, you take a lesson from the insurers of America.  You strong arm (“negotiate with”) the merchants by threatening to take their patrons away.  By reducing the interest rate your cardholders pay, you buy their undying loyalty.  No longer do you have to pay a merchant $100 for a $100 dollar purchase.  Now, using your newfound power, you can pay the merchant $60 and pocket the other $40.  Your profits will skyrocket.  Your cardholder loyalty will grow exponentially.  When the merchants protest, you tell them they will have to get rid of waste and tighten their belts.

As your profits and power grow, you will be able to “negotiate” better contracts.  In years to come, you will drop reimbursements to 50%.  You will establish the concept of “reasonable and customary charges.”  Under “reasonable and customary,” you will arbitrarily decide what merchandise and services are worth and then reimburse their costs at your new, lower rate.  Merchants will complain but customers will love you.

Eventually, you will learn about product substitution.  Instead of sending your cardholder a $400 Coach purse, you will send them a Goach (generic substitution costing you $10).  Your profits will continue to grow.  You’ll offer to replace the Goach if it breaks (limit of two replacements).  After the second failure, you offer to send a Coach for just $100 more.

Your profits will exceed those of the insurance industry.  Patients can avoid seeing the docs for their colds but no one can afford to pass on that new dress at Macy’s.  Wall Street will love you.  Yes, the cost of items sold will rise as merchants strive to keep their doors open.  Eventually, you will “negotiate” the cost of items for your cardholders.  Owning your VISA card will become a necessity.  Paying cash will be unaffordable.  Those who do not have a VISA card will either go without merchandise and services or mortgage their house to buy what their family needs.

Your company will have transitioned to a near God-like monster, much like today’s insurers.  You won’t care; you’ll be rich and powerful beyond your wildest dreams.  You’ll fund Congressmen and Senators and presidential elections, owning the White House.  You’ll even be able to control the insurers!  All of this can be yours for 1% of your profits.  Call me, we’ll talk.

Stewart Segal is a family physician who blogs at Livewellthy.org.

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Health insurers have come up with the idea of the century
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