In his weekly “Stories I’d like to see” column, journalist and entrepreneur Steven Brill spotlights topics that, in his opinion, have received insufficient media attention. This article was originally published on Reuters.com.
Just because President Obama and his team have been pathetic when it comes to letting Americans know what’s in his healthcare reform law doesn’t mean the press shouldn’t be zeroing in on this huge, multifaceted story. The law is packed with changes - some of which have already taken effect but have barely been written about - whose ramifications range from likely upheavals in the advertising and marketing industries to an apparent lifeline for all Americans who are mystified or even tormented when dealing with their health insurers.
A marketing explosion
Let’s start with the business angles. As this article from Advertising Age points out, once various provisions of Obamacare take effect, key sectors of the healthcare industry, particularly hospitals and insurance companies, are going to have to become heavily engaged in consumer marketing and communications. In the last few years we’ve seen some hospitals use advertising to establish their brand, and, as I mentioned in this column in February, United HealthCare has been aggressively advertising to consumers.
All of these early efforts are about to be taken to a whole new level because of Obamacare - which requires that by 2014 everyone must buy health insurance and every state must have an exchange where consumers can go online and compare insurers’ offerings. This means not only that the market for health insurance is going to expand but also that much of it is likely to be sold directly to individual consumers rather than through an employer. Meantime, hospitals and doctors’ networks will want to advertise to have more leverage in negotiating with insurers to include them in the insurers’ networks.
That there is already a robust community of public relations, marketing, advertising, and market research professionals who specialize in the multitrillion-dollar healthcare industry is itself an interesting story. But getting inside the dynamics of how that business is now going to explode - and which big players, such as the largest ad agencies, are likely to start buying up the specialists - is a much bigger deal.
Healthcare is the largest industry in the world’s largest economy, and, with the exception of the drugmakers, those who provide it have never really had to communicate directly with consumers, let alone compete for them.
However, there’s an even bigger story related to the coming competition in healthcare: How, if at all, is this explosion of new marketing and advertising going to be regulated? What will hospitals be allowed to say about their safety and survival rates? What records, if any, might regulators force them to disclose? And who would those regulators be? The Federal Trade Commission? The Food and Drug Administration? How will the turf be divided and what authority does either agency have?
Insurance in plain English
In that prior column I wondered why health insurance companies aren’t compelled to provide data on claims paid versus claims rejected. I now realize I missed a much more basic issue: Why aren’t insurers required to write and present their policies in plain English? Put simply, there is little chance that you have any idea of exactly what your health insurance policy covers or doesn’t cover, even if the policy is sitting in front of you.
This, it turns out, is one of the key aspects of Obama care that the President and his staff have done such a lousy job of touting. The new law doesn’t appear to require insurers to report their rejection rates, but it does require something far more important: All health insurance companies and group health plans must provide all customers with a plain English summary of benefits, including a glossary that explains any key terms - “network,” or “habilitation services,” for example — in simple English. And this isn’t one of those provisions in the law that doesn’t happen until 2014; it goes into effect this Sept. 23, or about 10 weeks from now.
This provision, calling for a “Summary of Benefits and Coverage and Uniform Glossary,” [PDF] is hardly buried in the 2,407-page bill; it’s on page 23. But I haven’t seen or read anything about it.
Here are excerpts from its requirements, which I’m including here because they describe, or prescribe, a document that is worlds away from anything any American with health insurance has ever seen:
“(1) APPEARANCE.—The standards shall ensure that the summary of benefits and coverage is presented in a uniform format that does not exceed 4 pages in length and does not include print smaller than 12-point font.