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Book Review: The New Health Insurance Solution By Paul Zane Pilzer

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I wanted to actually try Mr. Pilzer’s suggestions before writing this but I just haven’t been able to get to it. I will post my results later when I have.

The biggest challenge this book presents is that you actually have to pay attention to your health insurance. This is something that I, and I’d say most Americans, have never really done. I have insurance through my employer. There’s something about a deductible and that’s about all I usually know.

Until something happens, that is. I really woke up to this when two things happened. I broke my thumb over the summer. This required surgery and follow up appointments which racked up quite a bill. In the end, the whole ordeal cost well over $5K! And, miraculously and somewhat mysteriously, my insurance paid all but $109. That’s all I had to pay.

Amazing.

Then in October I decided that I wanted to strike out on my own. I quit my job, set up a consulting business, and immediately started worrying about health insurance. For me, this detail is even more worrisome than taxes.

For the time being, we are on my wife’s insurance but frankly it’s not a very good plan and it’s quite expensive. I planned to find individual insurance as soon as I could anyway and now I feel a lot more confident about this process thanks to Pilzer’s book.

In the first place, this guy is excited about health insurance. I really have never encountered anyone with so much enthusiasm for this, to me, mind numbingly boring topic. His excitement really comes through in the book. Under most writers I wouldn’t make it two paragraphs into this subject before falling asleep. But Pilzer keeps the reader’s attention with his enthusiasm.

It also helps that the text is often interrupted with charts, text boxes, subheading, etc. All of this drags you along as he explains his rather simple solution to rising employer health care costs.

His solution, and I’m not spilling the beans on him here because it’s right there in the title, is to leave your traditional employer provided healthcare plan. He argues that things are such now that obtaining individual insurance is actually cheaper and can provide better coverage for healthy individuals than under the old system of employer provided insurance.

“Yeah, right,” you’re probably thinking. Conventional wisdom says that purchasing individual health insurance is cripplingly expensive. That’s what I believed when I saw the synopsis of this book. But Pilzer demonstrates how one can combine high deductible individual insurance with a new financial tool that Congress recently put into place called an HAS to make it work.

Like I said, I haven’t tried it yet myself but I will.

I sat down with this book and read it cover to cover but only because I planned to write this review. I wouldn’t recommend this to anyone else nor would I do it myself if I were reading it for the first time. Even with the enthusiasm and attention grabbing format I mentioned above I found my mind wandering while I read it. This IS a book about health insurance, after all, and there’s only so much you can do with this subject.

And Pilzer apparently realizes this. Mercifully, the first section of the book, directly after the table of contents, is called “Executive Summary.” In it he presents almost every realistic health insurance scenario followed by a summarized solution and where you can find the specific details of his solution in the book. So in some ways this can be called a reference manual to Pilzer’s new health insurance solution.

And he doesn’t just cover individuals. There is quite a lot written for businesses about how they can take advantages of the new health insurance laws to cut their costs for health insurance. The most innovative approach was to educate employees about the cheaper solutions available to them for finding individual insurance then compensating them, before taxes, for their costs at a fraction of the overall costs associated with the traditional arrangement. Everybody wins.

So, if you have health insurance, need insurance or handle the insurance for your company, I recommend this book.

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About Bryce Eddings

  • http://www.efsbenefits.com Lynne Erickson

    I like this book and the general concept behind it. There is one huge flaw though. Even though the IRS allows employers to deduct premiums funded to employees through an HRA, it is still NOT a good idea for employers to completely drop group health benefits in favor of a defined contribution plan. Here is why:

    Even though the IRS says it’s legal to setup HRAs whereby employers can reimburse employees tax-free for amounts spent on individual and family health insurance premiums the DEPT OF LABOR does not condone employer funding of individual and family health insurance premiums. Here is why:

    1.) Just as the author says, 20% of employees will not be able to qualify for their own individual policy due to pre-existing conditions, thus, in order for those employees to get insurance they would have to go onto a State HIPAA (guaranteed issue) plan. It is not ethical for employers to encourage employees to get state-guaranteed coverage.

    2.) And this is even a bigger problem….The Department of Labor states that anytime an employer (and this pertains particularly to small employers who would be most at risk) pays either directly or indirectly for one or more employees individual or family health insurance premiums, the employer is, in essence, creating a group benefit plan. By definition, group benefits must be “guaranteed-issue” and they also must cover maternity. What if an employee or one of their dependents gets pregnant and decides that they need maternity coverage, even though they didn’t purchase it on their individual policy? A crafty ERISA attorney might decide that the employer is liable for the maternity claims for that employe or his/her dependents! That is a risky situation for the employer to be putting itself into! What if one of the employees is unable to obtain individual coverage, and while in the process of trying to obtain state-guaranteed coverage, he/she ends up having a very large medical claim? I see the employer just asking for a discrimination lawsuit and possibly becoming liable for huge medical bills for that employee.
    Well, that is just my opionion. I just think it is a bad idea.

    However, the rest of the concepts in the book made a lot of good common sense!

    My husband and I are Colorado brokers, http://www.efsbenefits.com

  • Sammy McMorris

    Very well… I love how you describe the book even though I haven’t got the chance to read it yet, I am encouraged to get one… thanks