The healthcare insurance business model today stands in the crosswinds of market and non-market forces. On the market side, there is a now daunting challenge to remain competitive to sustain, much less increase, market share and margin. The constantly escalating costs of healthcare, increasingly passed on to consumers by their employers and health insurers, have pushed consumers to the brink. They now have to select insurance based mostly on what they can afford, rendering meaningless almost overnight the traditional approaches insurers have taken to differentiating their products to earn and retain customers.

On the non-market side there is a new Administration that is focused on taking on the cause of those who have seemingly fallen through the cracks of America’s private healthcare insurance system. From a beachhead of Medicare and Medicaid some in our government now are threatening to become a new competitor for the insurance needs of all Americans … and without the constraint of having to remain financially viable at the end of the day.

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