Recently, our blog has been focused on health care reform and issues raised for both employers and the health care industry. But, with August being “National Immunization Awareness Month,” it seems a good time to take a short break from reform laws and focus on our own health.

Sponsored by the CDC and the National Center for Immunization and Respiratory Diseases, this annual reminder is well timed. August ushers in the new school year and is also when we start to get coverage of predictions for the new flu season. Seal flu, anyone?

As a general guideline, the recommendation is that everyone age six months and older needs a seasonal flu shot every year. Other shots work best when they’re given at certain ages. Public and private schools also require certain vaccinations for incoming students.

Shots can prevent infectious diseases like measles, diphtheria and rubella. But people in the U.S. still die from these and other vaccine-preventable diseases. It’s important to know which shots you need and when to get them.

Not convinced? Consider this … in 2000, the CDC declared “measles elimination” in the United States, meaning that year-round transmission had ended. During the following decade a median of 60 cases per year were reported. In 2011, however, the number climbed to over 220. Other diseases are also making a comeback. The CDC predicts that 2012 will see the highest number of cases of whooping cough in over 50 years. Over 18,000 cases have been reported already this year, more than twice the total number of cases reported in 2011.

Do you know if your vaccinations are up to date? This may be a good month to find out.

[Posted by Sue Skindzier-Todd, benefits advisor at Digital Benefit Advisors, a division of Digital Insurance]

For the past several years, much of the health care debate has been framed by a very open battle between President Obama and several of the nation’s largest health insurers. Most notable among these corporate giants is WellPoint (WLP.N) and UnitedHealth Group (UNH.N). Give the president credit for understanding how to sell health care reform to a skeptical public in part by demonizing insurers. Give the insurance companies credit for being as politically tone deaf as a major sector of our economy could possibly be during the months leading up to March 2010. We can debate at another time whether Goldman Sachs (GS) proved more politically inept during the financial reform debate.

Remember back for a moment to early 2010. The administration appeared ready to abandon any hope for a major legislative win on health care reform. As if on cue, WellPoint via their Anthem Blue Cross property in California delivers a massive rate increase to the individual market based upon faulty assumptions. Headlines around the country pit Speaker Pelosi and the White House as the forces of good battling corrupt insurers blinded by their thirst for profit. Shortly thereafter we have the Affordable Care Act HR 3962 and health care reform becomes part of the social, political and economic fabric of America.

At its very core, the current debate in our country is about whether health insurers can control costs downstream and should profit from their participation in the health care sector — or whether the government could and should more efficiently finance and manage this marketplace like most other nations around the globe. This is a tremendously complex issue, one in which more established thinkers than I can debate. However, what I do think is necessary is to add balance to the rhetoric and additional perspective on the issue as a whole.  It is overly simplistic and completely inaccurate to position carriers as the culprits in this economic crisis. Anthem and United don’t generate the claims. They pay them or say no.

Although there are certainly outliers relative to profit, the managed care business is around a 4% margin business. Let me make a simple and straightforward commentary. Getting paid for paying the claims and baring risk is nowhere near as lucrative as other components of the health care sector. Take a look at pharmaceutical firms and medical device suppliers versus managed care companies in the Fortune 500 listing for return on revenues in 2009. Is there a completely logical reason why certain industries should escape the moral hazard of profiting from the health care arena and others should not? It could be argued a number of different ways. The easy distinction is that if you bare risk and say no on claim payments and/or raise premiums versus develop and market drugs… at the very least you are a much bigger target. Where is the political outrage over physicians being in the pocket of big pharma or huge physician schemes to defraud Medicare?

In my opinion, it is difficult to look at profits by any component part of the health care industry without looking at the end game and how best to deal with this tremendously complex and vexing problem. Is the government or is the profit generating private sector more capable and better equipped to deliver the following?

• Insured populations properly educated to take responsibility for their health and directly impacting future claim costs
• Innovative technology that helps to integrate care in a way that dramatically impacts quality  outcomes
• Innovative wellness firms and concepts that impact health and by extension chronic illnesses
• Hospitals and doctors focused on not just treating sick patients but Accountable Care Organizations (ACOs) keeping populations healthier

This is at its core the end game and the issue at hand for Americans to decide over the next decade. It is not whether insurers are making obscene profits. Any reasonable review of the financial results previously discussed confirms this fact. Perhaps if Democrats and Republicans alike dial back the rhetoric and view health care reform more objectively, there is still a reasonable chance of fixing our current system. HR 3962 can be a starting point to address many of the structural imbalances in our current health care and health insurance marketplace. Ultimately, Americans taking control of their health is the only way we will solve this problem irrespective of who is driving the claim payment bus.

We believe that over the next several years, health insurance distribution will begin to look much more like the P&C space. Most notably, not all brokers will have access to all carriers and all products… not even through General Agents. Small agents have a very difficult time in the P&C world being competitive locally. Conversely, access has never been a material issue for agents of any size among benefits firms.

In the past two weeks alone, I have been in direct discussions with carriers who have sent out notices to smaller agents that they will no longer be licensed and appointed to sell product… even through General Agents. The numbers are in the thousands. This is just the beginning. Once this horse leaves the barn, there is no turning back. Size will soon matter in the benefits business as well.