Tuesday, August 30, 2011

Insurers Deliberately Confuse Policyholders and Dump the Sick #p2 #tcot

A couple of years ago, when Sen. Jay Rockefeller of West Virginia asked me to testify about little-known health insurance industry practices at a hearing of his Senate Commerce Committee, I initially was reluctant. I knew that if I was completely honest, my life would change forever.

What he was asking me to do was to disclose practices that have contributed to the growing number of Americans without insurance, the even faster growing number of us who are underinsured, and the phenomenal increase in insurance industry profits over the years, even as the ranks of those without coverage swelled.

The purpose of the hearing was to determine what Congress could do to require insurance companies to provide more pertinent and comprehensible information to their enrollees and prospective enrollees to help them understand what they were buying. What could the government do, the senators wanted to know, to help consumers figure out their benefits, compare different policies, and truly understand what would be covered and what wouldn't, and what their total financial obligations would be, including out-of-pocket costs, in the event of sickness or injury?

I agreed to testify in hopes that, as an insider -- an insurance industry executive for two decades -- I might be helpful as members of Congress drafted this important part of larger legislation to reform the U.S. health care system, especially the health insurance industry. Without disclosure, it's hard to understand what you're paying for -- and what you can count on in return.

Two long-time advocates of greater transparency joined me on the panel: Karen Pollitz, then research professor at Georgetown University's Health Policy Institute, who would later join Health and Human Services (HHS) Secretary Kathleen Sebelius' consumer information and insurance oversight education team, and Nancy Metcalf, senior editor at Consumer Reports. Both of them encouraged the senators to require insurers to provide not only useful and understandable information but to do so in a standard format. Without that, they argued, consumers still would not be able to compare one health plan with another.

rest at 

http://www.prwatch.org/news/2011/08/10978/insurers-deliberately-confuse-policyholders-and-dump-sick

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