Demand Openness from Health Insurance Industry

One of the things I liked about Obama’s campaign was his seemingly relentless pursuit of opening government up to the people. It wasn’t hard to sell that point. It’s clear that under Bush, the people were kept in the dark so some light was more than needed with a new president.

Obama has made strides in his efforts to bring “transparency” to government by bringing in smart tech people and creating sites like data.gov. Though not perfect, it is a step in the right direction. People have more access to raw government data than before, which helps educate the public. We should count our blessings we not only elected a leader who believes in an educated public, but also takes such visible steps to help educate the public.

As health care continues to dominate headlines and debates both in Congress, at local hang outs and even around the dinner table, one thing is missing: health care transparency.

Open standards for electronic medical records: OK. Coverage for more Americans: on the table. Eliminating “pre-existing” conditions as grounds for denial: on the table. Giving Americans more choice/control over their health care: on the table.

Except how can we make informed choices without access to the data that determines those choices? How can we make informed decisions on anything related to health care if the data remains obscured by government and health insurance bureaucracy?

Simple answer: we can’t. But, as we’ve all come to realize, any issue around health care is anything but simple.

A start would be to provide standard definitions for “pre-existing” conditions and for what constitutes a “history,” and make those definitions universal. If one incident, even if not repeated, constitutes a “history,” then say so. If the “pre-existing” condition list is so expansive as to include any trip to the doctor that resulted in “recommended treatment,” even for the common cold, then say so.

By leaving such things undefined, or rather leaving it up to insurance companies to define, creates wide-spread confusion and denial of coverage in one state but approval in another. People will be more likely to gravitate towards the states where they are more likely to get coverage, sucking states dominated by money-hungry insurance companies dry. Loss of population leads to loss of tax revenue. Loss of population means companies have a smaller pool to help shore up their work force, so they will look to move where there are people. Small businesses will gravitate towards states that are more kind to them. An imbalance will be created that will only exacerbate existing budget falls.

Requiring health care companies to show where exactly premium dollars are spent is another starting point. How much goes towards claims? How much goes towards advertising? Payroll? They are run like companies, so all the money goes somewhere. It comes out of our pocket and goes into someone else’s, and we should be allowed to know who.

So if the government is truly set on health care reform, and truly wants Americans to be able to make their own health care decisions, then demand insurance companies become more transparent than the government. Clearly no one can rely on studies conducted by groups, even if the groups claim to be “neutral.” Americans must be given access to the very information used to decided whether or not they can receive coverage, whether or not a particular procedure or visit is covered and whether or not their health is really that important.

Health care reform may force insurance companies to cover more people than they’d like (despite their claims that they will have access to a broader base, which they already do but choose to deny), but until Americans are given more than a cursory view of how the system works, health care reform won’t do much good in the long run.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: