It’s not that they can’t. It’s that they won’t. Because we can. And if we can, they can.

It does take a few critical ingredients: trust, transparency and common sense. And these are pretty rare in the current carrier world. Trust in them is at an all-time low; they fight transparency every step of the way and beyond; and not much of what they do seems to make any sense other than in a self-serving way.

Let’s break these down to better understand why they won’t make the changes in payment, benefits and experience that can drive lasting and sustainable value to the health care system:

Trust – in order for plan members to trust their carrier, the carriers would have to go out of their way to facilitate access to care and that runs somewhat counter to maximizing profits in their insured products.

Transparency – despite federal and state regulations, potential legal jeopardy of employers for not meeting their fiduciary obligations, and rising lawsuits, the carriers continue to block access to real prices. They also use various artifices to hide the way in which they transfer money to owned subsidiaries. All of which makes sense to them for their self-interest, but not for the interests of employers or their plan members.

Common sense – is there really anything to say about this one? Is it common sense to punish plan members seeking care to manage their chronic condition and instead pay for complications? Is it common sense to restrict access to gastric bypass surgery but allow access to more expensive therapies such as GLP 1s? Is it common sense to squeeze independent primary and specialty care physicians while opening the purse for ever-aggregating health systems? Does it make sense to have 90% of payments fee-for-service? Nope. QED.

What can you accomplish when you purposefully build trust with plan members and providers; are transparent in everything you do, including prices; and always use common sense when making policy decisions? You can upend the current system by rewiring all payments; the way in which benefits are designed; and the way in which providers, employers and employees experience health insurance.

Put plainly, you can produce excellence across the entire healthcare ecosystem.

That’s what we call healthcare to the power of XO. And that’s what we’re doing as of today for our plan members, the providers with which we contract, and the employers who have put their faith in something new, and better.