Oscar takes over Atlantic Avenue subway station to expose what's screwed up about our health care system.
NewsOur Culture
5 min read
MSMario Schlosser
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For the next month, this station will expose what’s screwed up about our healthcare system. Today’s system charges more than any other in the world, but it doesn’t deliver better results. It keeps patients in the dark about their own health. It’s unnecessarily and sometimes intentionally confusing. It is incentivized to give you more treatment rather than better care. And it’s not held accountable for what should be its ultimate goal — protecting and improving people’s health.
But we aren’t here just to throw stones at the healthcare system. We also want to tell you what we plan to do about it.
We founded Oscar four years ago because the current system sucks, and we want to replace it with one that works with you and for you. When you’re sick, you shouldn’t have to go it alone. We don't just want to enroll you and disappear, only to show up when it's time to pay a claim. We want to be a call or a click away whenever you need us, using data and the latest technology to provide you with the best tools, guidance, and care. And we will work like hell to earn your trust every single day, because that's what it means to be a real partner.
We’ve come a long way towards achieving that goal, but we still have so much to do. This is a complicated problem and we’re not perfect—we may not always get it right. But unless we keep working on fixing this system and how we operate within it, these issues will only get worse. As we continue tackling this problem, we want to share the core principles that have guided us from the start. They are the standards we’ve set for ourselves and to which we hope our members hold us accountable:
Your health is not a line-item on a spreadsheet, a series of numbers on an insurance card, or a list of CPT codes. You should be treated like a person, and you should be able to get a real person on the phone to help you.
2. Healthcare should be simple, convenient, and easy to understand.
The U.S. healthcare system is incredibly complicated. It is highly fragmented, heavily regulated, jargon-ridden, and ridiculously confusing. But health is such a fundamental part of our daily lives. We believe something so important should be understandable, easily accessible, and under your control.
3. Healthcare should cost less. Way less.
The U.S. spends twice as much on healthcare per person than any other country on Earth (1). Not surprisingly, 1 in 3 adults has trouble with medical bills (2). Oscar is also not immune to this issue; it has forced us to raise our rates by an average of 16% due to the rising cost of care. We changed our network to combat these trends in partnership with the hospitals in our network. By working together and sharing some of the financial risk, we’re slowing—but have not yet reversed—these market trends.
4. Healthcare costs should be transparent and tied to quality.
Having your appendix removed in the US can cost from $1,500 to $180,000 (3). Why? Hospitals set their own billing rates, so the cost for the exact same procedure vary greatly depending on where you get it done. And unlike most industries, there’s no tie between cost and quality in our healthcare system—value for your money is a concept that simply doesn’t exist. The hospital systems in our network have committed to work with us to ensure high quality care at sustainable costs. We don’t work with systems that force arbitrary rate increases over time for the same level of care.
5. Doctors and hospitals should be paid for improving your health, not for every test they perform.
Today’s healthcare system rewards doctors and hospitals for doing more, rather than for doing better. This “fee-for-service” system pays providers for every single visit, test, procedure, blood-draw, needle-prick, or x-ray you endure. And since many doctors’ offices don’t talk to each other or share data, you keep getting repetitive tests and treatments you don’t need—which leads to more and more bills you have to pay. We are developing unique partnerships with our doctors that reward them for improving your health, not for every individual interaction. By bringing all the fragmented pieces of the health system into an integrated experience, you avoid unnecessary or redundant procedures and subsequent costs.
6. When it comes to doctors, quality always beats quantity.
You’re not going to settle for subpar doctors and hospitals when you need care—and neither will we. And we understand and encourage close relationships between patients and their doctors. That being said, the simple truth is that we can’t keep high-priced hospital systems in network and fulfill our mission of providing quality care at affordable prices. Instead, we partner with high quality providers who will integrate with us to provide our members with a seamless care experience. So while we’re not the plan with the most doctors, we’re constantly working to ensure we’re the plan that provides the best care.
7. True care is as much about keeping you healthy as it is about getting you better when you’re sick.
Sickness happens, but it shouldn’t always have to. Oscar invests in keeping you healthy. Our plans include free preventive care and wellness rewards: your annual checkup is free, you can talk to a doctor over the phone for free, and we’ll pay you $1 when you hit your daily step goals. If you’re not feeling well, our plans offer low copays for the most common services (like visits, labs, or x-rays) from day one, so you don’t have to worry about how much you’ll pay. We did this because we care about you, and because it’s smarter and more cost-efficient; small actions made today can preclude severe and costly interventions to treat major health concerns down the line. So we think investing in you now will pay off—for both of us.
8. You live in the 21st century. Your health insurer should, too.
The way things work today, doctors and insurers use paper files, process claims with fax machines, and make you chase your own medical records as you navigate through the system. And if things fall through the cracks, you’re the one left to deal with it. Our healthcare system is in dire need of an upgrade. Applying the power of technology, analytics, and beautiful design to this system can modernize, simplify, and improve your entire healthcare experience.
