HEALTH PLANS: Who said this….?

In one of the many newsletters I diligently peruse so that you don’t have to be contaminated directly I read this. Astonishing, even considering the source.

I had a terrific opportunity to speak to 700 health insurance agents and brokers on Tuesday morning, here for the Capitol Conference of the National Association of Health Underwriters, most ably led by CEO Janet Trautwein. These people are entrepreneurs who are on the front lines of saving the private market for health insurance in this country, and they are my heroes.

So who is it who thinks that this country’s health care heroes are the insurance brokers and underwriters who are in fact just waste motion making money off our dysfunctional insurance system? Answers/guesses in the comments please…..

CODA: I was actually speaking at a PRI event last year and met an insurance broker who explained to me that he was giving wonderful service to his clients. I with a hint of cynicism asked him what he meant and he said that he was helping them navigate the health care system, finding them the right doctors and negotiating with hospitals for them. I pointed out that those were the functions of a health advocate not a traditional insurance broker. He agreed. Hmmm…I said so you want to move your business from commission based insurance sales to fee-based consumer advocacy, and he told me that he had even been discussing this with Sheila Kheul (the main proponent of single payer in California) as a potential role for brokers in a single payer world.  How many health advocates like you do you think we need in California, I said. About 2-3,00 he said. How many health insurance brokers and underwriters are there in California I asked. About 50,000 he said.

That leads to me thinking that this bunch isn’t going quietly into the night….but then again they’re "heroes"

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8 replies »

  1. Nope, I’m sorry Ken. Your worst fears have been realized. My diligent research also returned Grace-Marie Turner of the Galen Institute. I can’t believe it!!!!! This is just absolutely crazy!!!! What next?
    I’ve never heard of the Galen Institute, but it looks as if they pride themselves on their support for the free market health care system. I’m shocked that you were able to dig up an over inflated compliment their president made to people working in the free market health care system. Are you really sure it was her that said it? This is HUGE!!

  2. Who wrote this post? Am I missing that somewhere?
    If you’ve read any of our blog, you’ll see that we are very strong single payer advocates. It’s just a better system.
    As for the current system, what we do as brokers is help the client understand the difference between all of their policy options, what is covered, how it is covered, etc. We help them understand all of the risks associated with each plan and each company.
    The complicated part is the underwriting. All of the companies have different underwriting standards. So a person with a certain condition might get declined with some companies, riders or rate increases with others, and accepted standard with others. And some will accept them standard only if they have a certain plan type, like a deductible over $2,500. Consumer Reports interviewed me about that topic extensively for the article that Steve Beller, PhD mentioned above… I’m “Jay Norris, an insurance broker from Broomfield, Colo mentioned in the article.”
    After we help them apply and get through underwriting, which are also not simple processes but I’ll spare the details, we help them with any problems with billing or claims they have with the insurance company. Billing issues are pretty straightforward, but we’ve helped a lot of our clients fix or negotiate claims problems that would have taken a lot more time and money if it were a lawyer getting paid to represent the client against the insurance company.
    So, whoever wrote this article… When you were talking with that insurance broker and he simply stated “navigate the healthcare system”, he was probably saving his breath because of the cynical tone you projected even though it was obvious you had no clue what you were talking about.
    This complicated mess of a system we have right now is much different than a simple single payer system could be. And (good) brokers are the simplest, most efficient way for every consumer to have their own “health advocate” without paying an extra fee. Rich or poor, they all have access and it’s included in the insurance premium.
    While the current system as a whole is inefficient, (good) brokers play a valuable role helping consumers to not get screwed by the insurance companies. So, I disagree with your statement that they’re “just waste motion.”

  3. My diligent internet search (three minutes with The Google) indicates that the likely voice is Grace-Marie Turner of the Galen Institute.
    Please tell me I’m wrong.

  4. Okay, enough suspense, who was it? A politician I hope? For the sake of the post, I hope it was somebody unexpected, like Hillary Clinton or Ed Schultz. If it was just some CEO of a health insurance company, republican legislator, or health insurance industry think tank pandering to the industry – what a let down this post will be…..

  5. Actually, if the insurance agent understands his job, it begins when the client goes to the doctor. If the agent understands how the modern market works, his rep will be all over the blogosphere. Help the client get the claims paid, help back to normal, and he’ll have all the business he needs. So here’s a thought: Have the agent who sold the plan be responsible for the bills getting paid. Maybe incent him with a chunk of the cost savings, or reward him on renewals. (I’d also like to see advanced commissions abolished, so that you actually have to build a working, cash-flowing practice.) This will 1. Ensure that agents are not selling crap plans, and 2. Remove the quickie-close agents.

  6. Your newsletter quote from the NAHU conference is incredible. And revealing. I take it as good news as it reveals that the profit-driven medical industrial complex folks are on the defensive.
    Thank heavens we’ve got our own group of “Health Care Heroes” here in Massachusetts (the real kind, not to be confused with “Health Insurance Heroes” impostors). Something tells me that the ranks of this “HC Heroes” group is about to swell magnificently and that it might even include many who are urgently needed but sadly have been led astray, tempted by the endless flow of insurance company “foundation” money in our state….
    You see, despite the fact that ordinary people like me – nurses, docs, health center staff and our patients – have been railing against the industry-backed MA Health law going back long before the law was even passed, it seems that now the public, including its “opinion makers”, is seeing what the real deal is. And it’s a raw deal.
    There’s a growing awareness that the MA Health law is largely an exercise in rearranging the deck chairs on the Titanic while throwing many uninsured and underinsured overboard to the sharks.
    A public backlash is sure to come and already our efforts to reach out to other states to warn them has aided the real “HC Heroes” in CA and NM who have successfully blocked an individual mandate law that would force people to buy private insurance policies. (to get a sense of the coming storm, see this one line excerpt and more from the recent Daily News editorial):
    “To risk oversimplifying a most complicated area of public policy: That’s what you get when you let the health insurance industry write the reforms.”
    Cost Control and Health Care Reform
    Waltham MA Daily News Tribune, Editorial, 2/10/08
    “The cost of health care continues its inexorable rise, bringing with it a host of problems: more people uninsured or underinsured, more spending diverted from other purposes, employers’ profit margins shrunk, state and municipal budgets stressed. Presidential candidates from both parties have looked to Massachusetts’ health reform law for answers, but they won’t find effective cost controls here…
    Think of it this way: An industry has a product to sell, in this case health insurance. It’s a profitable business because most people feel they must have the product, but not everybody. Some people, mostly young and healthy, feel they can get away without the product. Others simply can’t afford it. Since the product keeps getting more expensive, the number of people who aren’t buying it grows.
    But there’s one way the industry can get everyone to buy its product: Have a law passed requiring it…”
    HealthCareBlog readers should know that the above is all true but it doesn’t stop there. Many additional negative aspects of the law exist that the above editorial doesn’t touch on. These include the state residents who’ll be paying double (through their state taxes and Dept of Revenue penalties) and getting nothing, and the “crowd out” provisions written in to the law to advance the cause of the “entrepreneurs who are on the front lines of saving the private market for health insurance in this country”.
    There’s likely to be over 200,000+ these individuals who can’t afford the mandated insurance and aren’t eligible for state subsidies nor for a “waiver” (the required state permission to remain uninsured – how perverse is that?). Under this law they are facing tax penalties of up to $920.00 annually, all for the pleasure of remaining uninsured.
    To read more on this as well as the “crowd out” provision of the MA law, visit http://bluemassgroup.com/showDiary.do?diaryId=10524

  7. The quote above about the “heroes” reminds me of a recent conversation I had on another blog with health insurance brokers about the cost of insurance. I made the point that one group struggling under the burden of high health insurance costs are people purchasing policies on their own, i.e., they do not work for an employer who offers them coverage. I mentioned a January 08 Consumer Reports investigative report “On Their Own: Far from a remedy, insurance for individuals is a world of pain.”
    The responses I received gave insight into the minds of health insurers, specifically, how they deal with the tension of cognitive dissonance when, on the one hand, they believe they are offering a service that benefits millions and, at the same time, they are faced with complaints about health insurance cost. Unfortunately, there is a tendency for humans to respond to the tension cognitive dissonance causes in ways that are neither rational nor productive, as evidenced by the conversation we had.
    The quote above seems to reflect the same psychological phenomena of cognitive dissonance.
    I discuss this at this link to the Curing Healthcare blog.