The Department of Health and Human Services recently announced that health insurers and employers must provide more information to consumers shopping for health insurance. The ensuing coverage, shall we say, was a classic case of journalistic bungling. Reporters took what HHS officials fed them and crafted their pieces for public consumption. But the stories were confusing—in some cases flat-out wrong—and did not exactly offer the clearest of explanations about what’s supposed to be a clearer process for buying health coverage. I’d wager the public didn’t understand much of what the media dished out, and probably won’t until they actually start shopping for coverage again in the fall and find the government hasn’t made it easier after all.
Most media stories, like this AP dispatch, got the main point:
Private health plans will have to provide consumers with a user-friendly summary of what’s covered along with key cost details such as copays and deductibles. And because the summaries will use a single standard format, it will allow “apples-to-apples” comparisons among health plans that are not possible now.
The report that HHS released to the media discloses some important numbers: the amount of the deductible; what services don’t count toward satisfying it; what’s not included in the out-of-pocket limits, like premiums and charges from doctors who balance the bill; the copays; and, probably most important, the amount of coinsurance—the percentage of a bill patients must pay, which is increasing with each passing year.
But insurers and employers do not have to tell consumers how much a policy costs—in other words, no premium information has to be given. Yep, that’s right—the key piece of information needed to make a good decision is missing. When insurers design a policy, they consider the interplay of coinsurance, copays, deductibles, coverage, and, of course, the premium, which lets them know what price point will make a consumer say “yes.” Price is the bottom line for consumers, but it’s poison for sellers, who fear a shopper might choose a policy with a lower price, other things being equal. So much for that price competition that was to solve all the ills of U.S. health care.
Most stories downplayed the importance of the premium omission. Sarah Kliff on her WaPo wonkblog said the information “got slightly pared back.” A Detroit Free Press story did not mention premiums, nor did a short item in USA Today based on the AP story. The Los Angeles Times simply said the administration “dropped a requirement that health plans include premiums on the forms,” and noted that consumer groups applauded the regulations anyway. Ron Pollack, the head of Families USA and health reform’s biggest cheerleader, sent out a statement that didn’t mention the premium omission. The AP called the missing info “a shortcoming” and then gave the administration’s reason for omitting it. Offering premium information is too difficult because, the AP reported, “insurers can currently charge more for the exact coverage to people in poor health.” That’s true in the individual market, but not in most large group markets, where all employees—sick or well—in the group generally pay the same price for any given health plan. Furthermore, even a general premium for shoppers in the individual market would be helpful in comparing offerings, as long as they understand that until 2014 they might be surcharged if they are sick.
The stories missed a larger point. Jost told me “premium disclosure is not required by statute.” Chalk that up to clever bill drafting. The administration was trying to add it to the proposed regulations circulated months ago, but Jost said “plans and employers pushed back. It was one place to give.” HHS official Steve Larsen did his media walk-back. “People have premium information. They will have that. The goal of this provision was to focus on coverage, benefits and how they interact,” he said. In the disclosure pages I downloaded, premiums are mentioned almost as an afterthought, noted in the last section of the last page under the heading “Are there other costs I should consider when comparing plans?” The disclosure form says “it’s an important cost.” Duh!
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The fact is consumers will have to make some calls to learn the premium, may have to request paper copies (or investigate some website) if they want to lay the offerings side by side, and will still have to read the fine print, although the AP told readers there would be “no fine print.” This adds up to a complicated shopping experience, despite some improvement in clarifying and standardizing insurance terms.
This is the standard nonsensical stupidity propounded by those silly leftists who can no longer be called "commies" under Pravda's... er, I mean CJR's new comment censorship policy.
The lefties would have us believe (i) that the ignorant masses are far too stupid to evaluate a health insurance contract on their own, and way, way too stupid to buy their own used cars or houses without the Gubmint looking after them, but (ii) that these same incompetent multitudes should be given more say in running not only the government but also private businesses.
Too stupid to buy a health insurance policy with "fine print", but nonetheless entitled to a larger voice in the government of a global superpower and also entitled to a greater say in the administration of private business in competitive markets.
THIS in essence is the self-contradictory foundation of the whole commie nonsensical philosophy.
Individually, the Marxists would have us believe that the average American requires Gubmint oversight... But somehow, these ignorant wards collectively can run things?
#1 Posted by padikiller, CJR on Sat 18 Feb 2012 at 11:05 AM
A "complicated shopping experience" is when insurers and banks make terms intentionally confusing, withhold basic services to improve their bottom line, and modify terms after the fact.
I guess "padikiller" doesn't remember the recissions, where people were kicked off their health insurance RETROACTIVELY, after they got sick?? That sort of immoral abuse led to the push for Health Care Reform
I think this version of HCR is terrible, for the same reasons right-wingers do: the mandate to buy private health insurance which only enriches insurers at the expense of citizens. We need Universal Health Care like every other developed nation. Costs less, provides more.
It's only the literal death-grip of the insurance lobby which won't allow for this, and which caused President Obama to throw away his only bargaining chip —single payer— before even coming to the negotiating table.
I can only imagine that "paidkiller" likes working to enrich insurers. I've seen report after report of healthy individuals paying tens of thousands of dollars/year for insurance: paying more for insurance alone than many people make in total wages.
This is going to have ever-diminishing returns, as fewer people will be able to afford insurance, even with this supposed reform. Insurers are set up to do one thing, and one thing only: make a profit, but not only—they are charged with making an infinitely-larger profit, expanding exponentially. This extortion racket will, of necessity, put itself out of business eventually, but not before it has made most of America destitute. The profit motive needs to be got out of medicine, not only because is it contraindicative to health, but because it is contraindicative to life itself.
#2 Posted by Lidia, CJR on Sun 19 Feb 2012 at 08:49 AM
@Lidia...
If your goal is saving money, putting the Gubmint into the equation is hardly the way to go.
Medicare loses many times more dollars to fraud, waste and abuse than the combined profits of all of the health insurance companies in the country.
Socialized medicine does not "cost less" and "provide more".
It costs less and provides less. Americans don't want crappy care like England and Canada have.
We don't want to see patients dying of thirst in hospitals after being neglected by lazy nurses in Gubmint hospitals.
Americans don't want to wait 94 days for an MRI like they do on average in Ontario.
#3 Posted by padikiller, CJR on Sun 19 Feb 2012 at 11:58 AM
Gubmint doesn't have any supporting facts for his claim that government or single payer health insurance costs more than private insurance. Everyone knows that medicare has a 2-3% overhead compared to 25-30% for private insurance.
Medicare however probably covers more procedures and doctor visits than your standard insurance contract for those under 65. And the deductible is certainly lower. But no one over 65 buys private insurance.
I request Gubmint to up his ante with some facts
#4 Posted by wvelick, CJR on Sun 19 Feb 2012 at 12:53 PM
According to the Obama administration, the Gubmint's "improper payment" rate (a euphemism for fraud, abuse and waste) is 5.5%
The profit margin for private health insurance companies is 3.4%.
#5 Posted by padikiller, CJR on Sun 19 Feb 2012 at 01:56 PM
We don't want to see people dying in emergency rooms as people step over them nor dozens of people dying of banal tooth infections either.
I live in Italy now, and my husband and I have gotten excellent care, although of course there is a wait for non-emergency procedures. I can see my PCP any day of the week without making an appointment. I have his cell phone number.
I don't think insurance company shills have ANY IDEA how it is in other countries. http://www.oecd.org/document/16/0,3746,en_2649_33929_2085200_1_1_1_1,00.html. The US is on a par with Cuba and Indonesia as far as child mortality is concerned, despite paying more than twice per capita of even more advanced European nations.
Americans pay and pay and pay so that private insurers can charge their 30% overhead as opposed to Medicare's 3% overhead. If paid killer is claiming there's a 3% profit, that might be what the shareholders get after the CEO of Untied Health skims off his $1.6 BILLION DOLLARS.
A billion and a half dollars for a single human being.
paid killer, "Mankind will not consent to be lied to indefinitely." =Upton Sinclair.
#6 Posted by Lidia, CJR on Sun 19 Feb 2012 at 05:01 PM
If there were a gov't-run health entity, there would be fewer means and less incentive to defraud anybody. The basis for fraud is the money aspect.
No sane person goes to the doctor to get extra colonoscopies jsut because they are "free"; there's no earthly incentive to do so. Most people want to consume the least amount of acute care possible, obviously. OTOH for-profit testing facilities like those owned by Rick Scott are based on doing exponentially more testing (which is why—after defrauding Medicare to the tune of over a billion dollars— he turned his hand to running a state government, in order to mandate testing sent to his for-profit labs). The problem in this equation isn't Medicare, it's Rick Scott and his for-profit concerns.
A gov. lab has no incentive to run medically-useless tests.
#7 Posted by Lidia, CJR on Sun 19 Feb 2012 at 05:09 PM
@Lidia
Thanks for the example of the woman dying in the emergency room of a Gubmint hospital as Gubmint employees stepped over her.
Nothing could make my point better.
Your other two links are broken.
As for Italy...
Sure, you can have great health care for everybody if you put it on a credit card as Italy has done. Italy in fact has the highest debt (as a percentage of its GDP) of any of the euros.
#8 Posted by padikiller, CJR on Sun 19 Feb 2012 at 06:40 PM
"Medicare loses many times more dollars to fraud, waste and abuse than the combined profits of all of the health insurance companies in the country."
Why do you keep saying dishonest things?
#9 Posted by Thimbles, CJR on Sun 19 Feb 2012 at 06:44 PM
"We don't want to see patients dying of thirst in hospitals after being neglected by lazy nurses in Gubmint hospitals."
Which is a situation unique to government hospitals.
http://www.youtube.com/watch?v=UJjpayGvdqE
Whatever padi.
#10 Posted by Thimbles, CJR on Sun 19 Feb 2012 at 06:54 PM
Americans don't want to wait 94 days for an MRI like they do on average in Ontario.
Why do you have to lie.
"Provincial Wait Time (9 out of 10 patients complete their procedures in this time)"
Definition? "Wait time: The point at which 9 out of 10 patients have completed surgery or have had their exam."
Completing a procedure 'by' the 94th day is not the same as completing a procedure 'on average in' 94 days.
#11 Posted by Thimbles, CJR on Sun 19 Feb 2012 at 06:58 PM
Time to toll the Reality Bell, Thimbo.
Kings County Hospital is a GUBMINT HOSPITAL.
"Kings County Hospital Center is a hospital located at 451 Clarkson Avenue in East Flatbush, Brooklyn, New York City. It is under the umbrella of the New York City Health and Hospitals Corporation (HHC), the municipal agency which runs New York City's public hospitals.
Thank you for making my point, dude.
#12 Posted by padikiller, CJR on Sun 19 Feb 2012 at 07:08 PM
LOL!
So instead of it taking 94 days for 50% of people to get an MRI it takes 94 days for 90% of people to get an MRI.
Not exactly helping your cause, Thimbles.
#13 Posted by padikiller, CJR on Sun 19 Feb 2012 at 07:13 PM
"Thank you for making my point, dude."
First off, we're talking about private insurance systems vs public insurance systems. That was what Lidia was talking about. This neglect took place in a private insurance system environment.
There is no excusing patient neglect, but to claim that neglect and medical error is a public only phenomenon is dumb, isn't borne out by the statistics, and doesn't seem to be in short supply in the US considering the amount of malpractice lawyers with healthy practices.
Do you want to admit that having heightened liability for malpractice and neglect is good for preventing systemic problems in patient treatment?
"So instead of it taking 94 days for 50% of people to get an MRI it takes 94 days for 90% of people to get an MRI.
Not exactly helping your cause, Thimbles."
You are math challenged.
Say 100 people need an mri. 60 people go to one of the 3 hospitals in toronto that does it in 21 days. 25 people go to a different hospital that does it in 45 days. 5 people can't make it to one of those hospitals so they go to one that has a wait time of 94 days.
That means only 5 out of 100 waited 94 days and 10 out of 100 waited longer than that.
85% of the people would have waited a month and a half and the statement "9 out of 10 patients complete their procedures in this time" is true.
But hey, in japan the mri's were a casual appointment and they had public insurance and hospitals.
And thus concludes another stupid conversation with paddywhack.
#14 Posted by Thimbles, CJR on Sun 19 Feb 2012 at 08:11 PM
I can respect the idea that socialized medicine is a necessary thing for the sake of social justice. I don't agree with this collectivist belief, but I can respect it.
What I can't respect is newfangled commie notion that the Gubmint can do things better, cheaper or more efficiently than private enterprise. This notion, prevalent amongst the modern leftists, is just absurd.
Marx didn't believe this stupidity. Neither did Lenin, Mao, Castro, or anyone else who has ever tried it.
Putting the Gubmint into the system always, always, always costs more money, produces crappier services and products, and creates inefficiencies. It always, always, always COSTS money to let the government run things.
The sooner the daft lefties figure this truism out, the better off the world will be. Socialized medicine results in equal helpings of crappy medical care and exploding deficits.
When the Premier of Quebec needed chemo, he hightailed it to the U.S. faster than an Occupier fleeing a job fair. For a reason.
I also can't stand the silly leftist position regarding regulation. The leftists would have us believe that the average slobs are too stupid to be permitted to contract to buy cars, houses or insurance policies without the Gubmint looking after them to keep them from being duped.... But that collectively, these same dupes should be given more power to run things.
This is an absurd, hypocritical and self-contradictory claim.
#15 Posted by padikiller, CJR on Sun 19 Feb 2012 at 09:06 PM
Lidia wrote: "A gov. lab has no incentive to run medically-useless tests."
padikiller responds: You're missing the point, Lidia.
A Gubmint lab has no incentive to run medically NECESSARY test. A Gubmint employee has no incentive to do anything.
This is how people get dead in Gubmint hospitals, as in your example.
Nonetheless... The Gubmint manages to waste more than 5% of its budget.
And WHO in the Gubmint is held accountable for these billions in waste?
HUH? WHO gets canned?
Nobody.
In fact, a recent study has shown that Gubmint employees are more likely to die on the job than get fired.
But careful now... Don't call the hearse too soon. They might just be taking a nap.
#16 Posted by padikiller, CJR on Sun 19 Feb 2012 at 09:43 PM
I love hearing from those like PADIkiller....
Despite all evidence to the contrary , everything is apparently the fault of the "lefties". He'd probably even blame corporate America moving all the manufacturing jobs to China for higher profits on the lefties.
Perhaps he thinks the lefties caused the global financial crisis & the death of capitalism. As for the American healthcare system , I am sure it is the best in the world for a small proportion of them but I'll take our Australian health system with gubmint workers who are not morons like he seems to generalise. Like American elections & the US congress , the American healthcare system is laughed at by most of the world. Keep up the delusions.....or perhaps get round to paying off the American debt....you can't blame Europe for ever.
#17 Posted by Cracklier Newman, CJR on Mon 20 Feb 2012 at 12:32 AM
"Sure, you can have great health care for everybody if you put it on a credit card as Italy has done. Italy in fact has the highest debt (as a percentage of its GDP) of any of the euros."
Ok, so what about Germany then?
#18 Posted by ggm1, CJR on Mon 20 Feb 2012 at 01:24 AM
@Crackier
Health care in Oz is great... As long as you're not an aborigine, that is...
If you get sick, an American helicopter takes you to the hospital to be treated with the very best American drugs...
And thanks to the U.S., you're not speaking Japanese when you get there.
But seriously... Australia has a two-tier system. Everybody is entitled to crappy care and the rich can (and are encouraged to) pay for private care. The utterly predictable and inevitable result of such a system? A 17-year gap in life expectancy between paler Australians and aborigines.
And lets not forget that Australia's Medicare program is running in the red... A deficit of nearly 7% just this past year.
It's easy for the Aussie Gubmint Money Fairy to dole out Band Aids and Vegemite on somebody else's dime. But eventually, the crap's going to hit the fan.
It's like Margaret Thatcher duly noted - the problem with socialism is that eventually you run out of other people's money to spend.
#19 Posted by padikiller, CJR on Mon 20 Feb 2012 at 01:50 PM
@ggm1
It looks like the German Gubmint Money Fairy is running a little short on funds too...
Time to pay the piper.
#20 Posted by padikiller, CJR on Mon 20 Feb 2012 at 02:05 PM
Am I the only person who noticed that the article quotes somebody named "Jost," but doesn't say who he is? Either I'm way off (in which case I apologize), or this is a rookie mistake for a journalism review.
For what it's worth, I'm guessing it's this guy: "Bio for Timothy Jost
Timothy Stoltzfus Jost, J.D., holds the Robert L. Willett Family Professorship of Law at the Washington and Lee University School of Law. Jost is a member of the Institute of Medicine. He is coauthor of a casebook, Health Law, used widely throughout the United States in teaching health law, and of a treatise and hornbook by the same name. He is also the author of Health Care at Risk: A Critique of the Consumer-Driven Movement; Health Care Coverage Determinations: An International Comparative Study; Disentitlement? The Threats Facing our Public Health Care Programs and a Rights-Based Response, and Readings in Comparative Health Law and Bioethics. He has also written numerous articles and book chapters on health care regulation and comparative health law, including monographs on legal issues in health care reform for Georgetown’s O’Neill Center, the Fresh Thinking Project, the National Academy of Social Insurance and National Academy of Public Administration, and the New America Foundation and Urban Institute. "
#21 Posted by Ernie Bornheimer, CJR on Tue 21 Feb 2012 at 07:01 PM
Whoever "Jost" is, I will bet a hundred dollars to a thousand that he's a card-carrying Democrat and a dyed-in-the-wool Obamamaniac.
No freaking doubt about it. And I'm not kidding.
This kind of crap is a standard Lieberman trick... Namely run off to a liberal think tank guru for reaffirmation of the foregone conclusion. (The other one being the "man on the street" interview).
All designed to create an air credibility from purported authority. Such is what passes for "professional journalism" here at CJR.
#22 Posted by padikiller, CJR on Tue 21 Feb 2012 at 07:38 PM
Well SURPRISE, SURPRISE!
It looks like my money is safe, if this "Jost" is indeed Prof. Timothy Jost.
Since 2007, Professor Jost has donated more than $3300 to guess which current Democratic President? Oh, and $1700 to Moveon.org and the DNC. And a couple of grand to the Dem Sen. Campaign Committee. And couple of hundred bucks to a Dem congressional candidate.
Looking back and we see that Prof. Jost donated thousands upon thousands of dollars between 2004 and 2006 on Kerry, Sen. Jim Webb, Moveon.org, the Dem Sen. Campaign Committee and the DNC.
For Pete's sake! It seems that Trudy thought she could slip this one by.
When will CJR either put a leash on these biased "watchdogs" or at least hire some non-Marxist who is actually committed to the principles of honest journalism to balance out the leftist nonsense that passes for "journalism" here?
#23 Posted by padikiller, CJR on Tue 21 Feb 2012 at 11:15 PM