Why Haven’t You Done This Sooner? (No, Seriously…)

Let’s talk about healthcare. Specifically, let’s talk about why so many business owners—smart, capable, number-driven people—are still stuck in a bad deal they don’t even know they’re in.

I hear it all the time. The moment a company transitions from fully insured to self-funded, the CEO or HR director comes back and says:

“Why didn’t I do this sooner?”

Well, my friend, let’s break that down.

The Invisible Problem (A.K.A. “Why You Haven’t Noticed You’re Getting Screwed”)

You don’t notice a problem until it slaps you in the face—or, in this case, until your renewal rate hikes up 20% like it’s on steroids.

Most big companies don’t even blink at their health plan until they see double-digit inflation on a spreadsheet. And that’s exactly how the insurance companies want it.

Because here’s the secret:

Your insurer just raised your premiums by 10%, but behind the scenes? They’re making 20%–70% on underwriting gains inside the health plan.

That’s profit they keep. Money that never even touches your employees’ healthcare.

And you? You never see it. You never hear about it. You just keep cutting the check, thinking, “Well, that’s just how healthcare works.”

Spoiler alert: It doesn’t have to.

The Jedi Mind Tricks Of Big Insurance

You ever notice how big insurance loves using vague terms, three-letter acronyms, and enough legal jargon to make your head spin?

That’s not by accident. It’s a tactic—one designed to make you and your employees give up before you even start fighting.

Here’s how it goes down:

• Employee submits a claim.
• Insurance denies it. Sorry, that’s not covered under your plan.
• Employee calls for help. Let me transfer you to another department that will do absolutely nothing.
• HR shrugs. Well, that’s just how it is.
  

And BOOM! The game is over.

The employee is left with a $20,000 medical bill for something they thought was covered, and the insurance company? They pocket the difference.

Worse, HR doesn’t push back because—let’s be honest—they don’t want to ruin their buddy-buddy relationship with the rep who takes them out for golf once a year.

And Karen from accounting? She’s too busy arguing with IT about why her emails aren’t sending to go to war with an insurance giant.

So your employees suffer in silence while big insurance laughs all the way to the bank.

Here’s What We Do Instead

You reach out to me, and we run a three-step process that flips the script on this nonsense:

Investigate – We dig in. Where’s the waste? Where’s the bloat? Who’s making money off your plan while your employees get shafted?

Evaluate – We show you the real numbers (the ones insurers don’t want you to see).

Execute – We put a strategy in place that saves you money permanently and gives you full transparency into your costs.

And here’s the fun part:

When renewal time rolls around in 2025, you’re not walking in blind anymore.

You’ll have predictable, measurable, repeatable results. You’ll see where every single penny of your healthcare dollars is going. And best of all?

You’ll finally understand how this game is played—and you’ll be playing to win.

So yeah… why haven’t you done this sooner?

Let’s fix that.

Escape the system, or just continue feeding it… Your gateway is here >>

Offering healthcare benefits is not only essential to attracting and retaining top talent, but it’s also a fundamental aspect of caring for the people who keep your business running. But what if the system you’re paying into is rigged against you?

You may not realize it, but small companies like yours are often footing the bill for the healthcare of massive corporations.

The irony is that you might believe you’re protected when you sign up for a plan that’s used by big-name, country-wide corporations, thinking, “If this plan works for them, surely it’s good enough for us.”

Unfortunately, that’s where the story takes a turn.

There’s a harsh reality that few small business owners understand: you are not the favored client. For insurance companies, it’s the giants—the marquee clients with tens of thousands of employees—who get preferential treatment.

The system is designed in such a way that insurance companies are terrified of losing these massive accounts.

And to keep these top-tier clients happy, they’ll bend over backwards to retain them—even if that means shifting the costs of their healthcare down the line to smaller businesses like yours.

It’s a system that feels inherently unfair, yet it continues to persist. What happens is a cost shift from the big guys to the small guys. The Affordable Care Act (ACA) mandates that insurers in Fully Insured plans guarantee a profit margin of 15%-20% on claims. That’s been the case since 2010. This means the more money that’s spent on healthcare claims, the more profit the insurance companies rake in. There’s no real incentive to control costs because their margin is locked in.

Imagine running a business where you’re guaranteed 15%-20% profit on every dollar spent—who wouldn’t want to see more dollars flow through the system?

Large companies, like those employing 20,000 or more people, are marquee accounts for insurers. These are their crown jewels—the clients they’ll do anything to keep. From a business perspective, insurers want to flaunt these clients.

They want their logo on the insurance cards of federal employees, state employees, and the employees of Fortune 500 companies. It’s free marketing, and it reinforces their image as “the best in the business.”

What small employers don’t realize is that while these marquee accounts enjoy tailored deals that reduce their healthcare costs, smaller employers are left picking up the tab. This dynamic has been in place for decades, and unfortunately, it shows no signs of stopping. It’s a cycle where the insurance companies make more money, the big companies save on costs, and smaller businesses are left to absorb the difference.

Under the ACA, the guarantee of a 15%-20% profit on healthcare claims creates a perverse incentive for insurers. The more expensive the medical bills, the bigger the paycheck for the insurance companies.

And while the insurance giants make more money, small businesses see their premiums rise year after year. It’s a system where there’s no motivation to lower healthcare costs—because why would the insurance companies want to reduce their profits?

Small businesses, therefore, are not just paying for their own employees’ healthcare. They are, in essence, subsidizing the savings that insurance companies provide to their biggest clients. The more those marquee clients save, the more smaller employers end up paying.

—

Now you know… The current system is stacked against small employers, but with the right tools and insights, there’s a way to break free from being the donor in this unfair system.

The decision to move away from fully insured plans is not just a financial one—it’s emotional. It’s about breaking away from the frustration of feeling like a small player in a big game. It’s about knowing that, by choosing self-funding, you’re creating a healthier, more secure environment for your business and your employees, while securing your financial future.

As a small or medium-sized business owner, you already wear many hats, and the weight of rising healthcare costs can feel overwhelming. 

Imagine the relief of knowing that every dollar spent is going directly toward the healthcare of your team—your people—not funneled into some opaque pool that prioritizes others. The transparency of self-funded plans gives you the peace of mind that comes with knowing exactly where your hard-earned money is going. 

It also allows you to tailor your plan to meet the specific needs of your workforce, fostering a sense of personal investment in their physical and mental well-being.

No longer are you at the mercy of a large insurer making decisions about what’s best for your employees—you hold the reins, and that creates a deeper connection between you and the people you care about.

Escape the system, or just continue feeding it… Your gateway is here >> 

We’ve been sold a story. A story spun by big insurance companies and the healthcare industry, promising us a path to smarter, more cost-effective healthcare. They told us that high deductibles would make us better consumers, more careful with our healthcare dollars.

The idea sounded appealing on the surface: a little more responsibility, a little more “skin in the game,” and we’d all be savvy healthcare shoppers.

But here’s the thing: how can you be smart when you’re shopping blindfolded?

Imagine walking into a store. There are no price tags, no labels, just a shelf full of mystery boxes. “Don’t worry,” they tell you, “you’re covered after the first $5,000!” Would you feel empowered? Or trapped? That’s exactly what healthcare with high deductibles and no transparency looks like. And that’s what we’ve been sold—by both the healthcare system and the big insurance companies.

We wouldn’t accept this anywhere else. Not for buying a car, a house, or even a sandwich. But somehow, when it comes to our healthcare—the most important decisions affecting our well-being—we’re expected to navigate in the dark.

High deductibles were supposed to be the silver bullet to fix skyrocketing healthcare costs. They were supposed to make us all better, smarter consumers. Instead, they’ve just added another layer of confusion to an already baffling system.

Here’s the reality: they tell us to have “skin in the game,” but it’s a game where we don’t know the rules. We don’t know the score. We don’t even know which field we’re playing on. How can you be expected to make informed decisions when you have no idea what anything costs until after the fact?

The promise was that consumer-driven healthcare was the solution, but in practice, it’s turned into consumer confusion.

And here’s the kicker—real empowerment doesn’t come from high deductibles. It comes from transparency. It comes from knowing what you’re paying for before you buy it. We don’t need bigger deductibles; we need bigger flashlights to shine a light on the system. We need to see clearly what we’re paying for, what we’re getting, and whether it’s even worth it.

That’s the change we need to demand. That’s what we should be fighting for —a healthcare system that actually works for us, not against us. A system that doesn’t hide behind layers of bureaucracy and complexity but instead gives us real visibility, real options, and real choice.

And that’s exactly what I’ve ensured with Better Source Benefits plans—no more smoke and mirrors, no more guessing games. Just clear, transparent, and fair healthcare coverage.

The choice is ours, but only if we can see it. It’s time to break through the status quo and demand a system that actually serves us—not the insurance companies. We deserve better. And it’s time we got it.

Escape the system, or just continue feeding it… Your gateway is here >> 

If you’ve ever turned on the TV, scrolled through social media, or flipped through a magazine, you’ve likely seen a steady stream of advertisements for medications like Restasis, Ozempic, Vraylar, Eliquis, Farxiga, Linzess, Jardiance, and Taltz. These medications promise relief from chronic conditions, improved quality of life, and better health outcomes. But they come with a hefty price tag, and for many companies providing healthcare benefits, these high-cost medications are wreaking havoc on their bottom lines.

The problem is simple: corporate healthcare plans—often fully insured, cookie-cutter packages—are struggling to absorb the escalating costs of prescription drugs. Employers are shouldering more of the financial burden, passing rising premiums down to employees, while employees face increasingly steep out-of-pocket costs just to maintain their prescribed treatments. 

The result? Less access, lower adherence, and worse outcomes. It’s a vicious cycle.

And if you’re a member of a corporate sector – whether an employer or an employee – there’s only one way of escaping it. 

You make your own plan, with your own rules.

That’s what Better Source Benefits designs for the clients. These solutions don’t just shift the cost of healthcare—they change how it’s managed, creating opportunities for both employers and employees to save significantly, especially when it comes to high-cost medications.

Through carefully structured, deeply discounted arrangements, our custom self-funded healthcare plans allow employers to secure medications like the ones you see advertised for far less. And when we say “far less,” we don’t just mean a small percentage difference—we mean significant cost reductions that can take a meaningful chunk out of an employer’s healthcare expenses.

Let me give you just a couple of examples from our list: 

• Glatopa: $0 instead of $750
• Relistor: $0.00 instead of $2,314.97
• Traltz: $0.00 instead of $6,482.52
• Trulance: $0.00 instead of $549.31
• Envarsus: $0.00 instead of $374.04
• Restasis: $854 instead of $1,956.90
• Ozempi: $1,485.00 instead of $2,719.62
• Tradjenta: $314 instead of $1,550.70
• Vraylar: $1,309.99 instead of $4,413.60
• Flowent: $226.98 instead of $1,253.25

…. And that’s only the tip of the iceberg.  

I know that every employer reading this, is impressed already. But what’s truly revolutionary is how these plans can benefit employees.

We’re not just talking about lower co-pays or reduced premiums. With our solution, employees can often access these expensive medications at no cost to them. That’s right—free

Imagine getting a 90-day supply of your prescribed medication without having to worry about how much it’s going to cut into your paycheck or impact your monthly budget. Our plans make that a reality by eliminating the cost to employees while still maintaining high-quality coverage.

Access to medications for chronic conditions without financial barriers can improve patient adherence, which is crucial in managing long-term health conditions like diabetes, heart disease, mental health disorders, and autoimmune diseases. When employees can stick to their treatments without interruptions, they see better results.

That means fewer hospital visits, fewer complications, and less time spent navigating the healthcare system.

If you’ve ever turned on the TV, scrolled through social media, or flipped through a magazine, you’ve likely seen a steady stream of advertisements for medications like Restasis, Ozempic, Vraylar, Eliquis, Farxiga, Linzess, Jardiance, and Taltz. These medications promise relief from chronic conditions, improved quality of life, and better health outcomes. But they come with a hefty price tag, and for many companies providing healthcare benefits, these high-cost medications are wreaking havoc on their bottom lines.

The problem is simple: corporate healthcare plans—often fully insured, cookie-cutter packages—are struggling to absorb the escalating costs of prescription drugs. Employers are shouldering more of the financial burden, passing rising premiums down to employees, while employees face increasingly steep out-of-pocket costs just to maintain their prescribed treatments. 

The result? Less access, lower adherence, and worse outcomes. It’s a vicious cycle.

And if you’re a member of a corporate sector – whether an employer or an employee – there’s only one way of escaping it. 

You make your own plan, with your own rules.

That’s what Better Source Benefits designs for the clients. These solutions don’t just shift the cost of healthcare—they change how it’s managed, creating opportunities for both employers and employees to save significantly, especially when it comes to high-cost medications.

Through carefully structured, deeply discounted arrangements, our custom self-funded healthcare plans allow employers to secure medications like the ones you see advertised for far less. And when we say “far less,” we don’t just mean a small percentage difference—we mean significant cost reductions that can take a meaningful chunk out of an employer’s healthcare expenses.

Let me give you just a couple of examples from our list: 

• Glatopa: $0 instead of $750
• Relistor: $0.00 instead of $2,314.97
• Traltz: $0.00 instead of $6,482.52
• Trulance: $0.00 instead of $549.31
• Envarsus: $0.00 instead of $374.04
• Restasis: $854 instead of $1,956.90
• Ozempi: $1,485.00 instead of $2,719.62
• Tradjenta: $314 instead of $1,550.70
• Vraylar: $1,309.99 instead of $4,413.60
• Flowent: $226.98 instead of $1,253.25

…. And that’s only the tip of the iceberg.  

I know that every employer reading this, is impressed already. But what’s truly revolutionary is how these plans can benefit employees.

We’re not just talking about lower co-pays or reduced premiums. With our solution, employees can often access these expensive medications at no cost to them. That’s right—free

Imagine getting a 90-day supply of your prescribed medication without having to worry about how much it’s going to cut into your paycheck or impact your monthly budget. Our plans make that a reality by eliminating the cost to employees while still maintaining high-quality coverage.

Access to medications for chronic conditions without financial barriers can improve patient adherence, which is crucial in managing long-term health conditions like diabetes, heart disease, mental health disorders, and autoimmune diseases. When employees can stick to their treatments without interruptions, they see better results.

That means fewer hospital visits, fewer complications, and less time spent navigating the healthcare system.

So let’s talk about the Trump health plan, which they say doesn’t exist right now. And the reason for that is very simple.

The Affordable Care Act was in the can for years and it was torturously written so as not to look like a tax, which is exactly what it was ruled to be from the US Supreme Court. So the wordsmiths that are in the Swamp as we have been known to hear it called, had already cooked up the Affordable Care Act long before it was ever launched under President Obama.

So the Affordable Care Act was a carefully crafted policy that was setting our country on the rails to a single payer system. So when you have comments or questions coming to the Trump, campaign about what his plan is to replace the Affordable Care Act.

There is no replacing it. There’s a patch, there’s a workaround, or there’s a full on repeal. However, there are too many popular components of that law. The safety net is in place and I don’t foresee anything going forward that’s gonna replace the whole thing.

Now, will there be amendments? Yes.

Will there be adjustments? Yes.

Will there continue to be a public and a private offering? The magic eight ball says yes, because anywhere there’s been a publicly funded medical plan, whether it’s the US or Australia, you always see an overlay or a secondary or private healthcare plan to supplement what the government does, because guess what?

The government does not have enough money. They cannot print enough money to cover the costs of everyone’s whim and folly, which we are currently seeing with the use of this GLP -1 business. Weight loss is sweeping across the nation. Everybody’s cutting weight, even though the facts are in on the dramatic weight loss being 70 % of muscle mass as opposed to regular fat.

So the long -term effects aren’t even in place yet we have the federal drug administration, the FDA approving prescription drugs to have weight loss at a breakneck pace without the true long -term effects being studied. So I will say to you that summary for the Trump campaign versus the Harris campaign is you can expect both of them to look at the Affordable Care Act as their go -to. And for Harris, they could certainly rest on their laurels because it is working towards a single payer option. And for Trump, you can look at their campaign and if they’re elected presidency to patch and amend what is currently in place. You’ve already seen Trump try to manage the cost of prescription drugs and which…

did take effect during his administration. So that’s going, yet the drug market continues to proliferate with high cost medications because as we know, there ain’t no money in the cure, the money’s in the medicine. I’m John Clay and this is your Healthcare Minute.