This article describes the health insurance policy used by one, small,
fully insured company. The most important benefits for reducing the h
uman and financial cost of cancer are benefits that improve the decisi
on processes of the healthy person, and a benefit that promotes involv
ement of a primary care physician at the time of death. These benefits
in our health insurance plan are designed to: 1) assure easy access t
o a primary care physician; 2) provide incentives to teach the benefic
iary to use the knowledge of the primary care physician as he/she make
s decisions regarding care; 3) provide claims monitoring to identify s
mall problems before they become serious; and 4) eliminate factors suc
h as capitation and physician profiling, which provide strong financia
l incentives for the primary care physician to disengage from the care
of seriously ill patients. Once serious illness is identified, it is
important to pay generously for the person's struggle to regain health
. The strategy described in this article does not rely on networks or
negotiations with providers, and therefore can operate uniformly throu
ghout the U.S. All large companies using this strategy to date have ex
perienced a permanent drop in health care costs, largely due to a redu
ction in the incidence of expensive cases. (C) 1998 American Cancer So
ciety.