The Foundation’s president, Ankeny Minoux, said that about 67 percent of the people who call are eligible for public programs. The rest are undoubtedly searching for private coverage, and the Foundation seems to be a lead-generating operation for insurance agents. Its tool for helping employers and individuals seeking private coverage tells them to contact the help line for assistance in finding a broker. The matrix of public and private programs for New York, for example, refers people to the New York Association of Health Underwriters. The Web site also says that if callers don’t qualify for public programs, they are referred to brokers within the “Uninsured Help Line database.”
What kind of advice does the help line give? I called and asked for help getting a policy in New York. After disclosing that I take an eye medication, the customer service rep told me “New York doesn’t offer very much,” adding “Your state doesn’t offer anything for people with pre-existing conditions or high risk. Most insurance companies will deny you.” She missed the mark big time. New York is one of the few states that requires all carriers to offer a policy to everyone, regardless of their health status. That means that people with pre-existing conditions can always buy a policy, although there may be a waiting period before expenses associated with the condition are covered. The operator apparently hadn’t checked the Foundation’s matrix for New York, where the correct rules are explained.
There’s a cautionary tale here for all journalists swimming in the health care swamp. The words “nonprofit” as well as “nonpartisan” don’t always legitimize an organization whose officials are eager to be quoted. Too often, some groups that carry those labels are disguised marketing and public relations operations for their funders. It’s always best to check who’s funding the group, what their goals are, and disclose that information to audiences. That’s the step the Times left out.
your second link doesn't work
#1 Posted by twitter.com/COBRArules, CJR on Wed 4 Mar 2009 at 07:45 AM
Wow, Trudy. That's quite a screed. Whatever happened to the journalistic prinicple of giving the target of the attack a chance to comment?
Someone just alerted me to this post of yours. I'm on deadline right now, or I'd pursue it immediately. But sheesh.
Tim Race
Business Health Care Editor
(and "Patient Money" editor)
The New York Times
#2 Posted by Tim Race, CJR on Wed 4 Mar 2009 at 04:05 PM
Tim, I don't think most readers will see this as a screed. It's a moderately worded piece of journalism criticism, and like other kinds of criticism—theater criticism, book criticism, for two examples—we didn't need to call for comment, in my view.
The piece makes the simple point that if the Times is going to refer people to a Web site like the Foundation for Health Coverage Education, it probably needs a better ID of the foundation than "nonprofit." Trudy points out that the the foundation is funded by the insurance industry, as The Wall Street Journal did report when it mentioned the site. She further notes that the site seems to serve in part as a lead-generation service for insurance brokers. And that, when she herself called, the operator gave her bad information. Shouldn't readers know a little more about these kinds of outfits when you recommend them?
#3 Posted by mike hoyt, CJR on Thu 5 Mar 2009 at 02:34 PM
I admit, "screed" was an overstatement.
Actually, I'm glad to have an expert on health policy like Trudy
Lieberman vetting our work. And she's right: Our Feb. 28 Patient Money
column should have indicated that the Foundation for Health Coverage
Education is largely financed by insurers. Consumers deserve to know that,
and we appreciate the reminder.
It’s too bad that Trudy apparently reached a dimwit when she called the
FHCE's toll-free number. It might be worth her replicating that experiment to
see if someone more knowledgeable answers next time.
But as we also noted in our column, a consumer can visit the foundation's
Web site. And there, by entering your state of residence and answering a few
basic questions about the household, income and health status, you can find
out what programs or private insurance options might be available. It’s true,
if you need to purchase private insurance, those insurers will be only too
happy to sell it to you. But in this country, unless you're eligible for
Medicare or government assistance, you pretty much have to buy your
insurance from an insurance company.
My main issue with Trudy's critique is that it was misleadingly narrow. To read Trudy is to assume our main source was the FHCE. It wasn't. Nor was it the only information resource the column "steered" consumers to. We provided a list of seven, with brief descriptions and Web addresses, including the consumer advocacy group Families USA, the Department of Labor and the Department of Veterans Affairs.
And Trudy seems to see a link between our reference to FHCE and our discussion of health savings accounts. If you read our column you realize that the expert commenting on such accounts is actually Ron Pollack, the executive director of Families USA.
Finally, I'm not sure what to make of Trudy's tart dismissal of our
discussion of COBRA and the possibility that some families might be able to
combine it with CHIP. She writes: "Maybe these strategies will work for some
people, if they can afford private policies in the individual market and can
meet the insurers' health requirements. Many can do neither."
Well, yes. But so what? The column was meant to help people in a bad situation weigh all their options. If those options aren’t ideal, that’s why we can only hope that the health care reformers in Washington can find a better way.
I hope Trudy continues to read our weekly Patient Money column, and will
hold us accountable. We need her knowledge, and maybe even her tough love.
But I also hope that if she does write about Patient Money again, her
critiques will more fully and accurately convey the column's content.
Tim Race
Business Health Care Editor
(and Patient Money editor)
The New York Times
#4 Posted by Tim Race, CJR on Thu 5 Mar 2009 at 10:24 PM
Tim,
Thanks. We will continue to read Patient Money and hope you will continue to read Trudy's critiques. We're glad the Times pointed to other options, which it did.
We think that one of our jobs here is to suggest a wider array of sources to you and others, including some that are often left out of the health reform discussions, as Trudy did yesterday in a piece on how the press explains (or fails to explain) COBRA:
http://www.cjr.org/campaign_desk/explaining_cobra.php
Trudy also does an irregular series here called Excluded Voices, interviews with experts who could bring something to the table in the health care reform debate. Her latest was with Timothy Jost, law professor at Washington and Lee University and author of Health Care at Risk: A Critique of the Consumer-Driven Movement.
http://www.cjr.org/campaign_desk/excluded_voices_1.php
We hope you and others find these useful.
Mike
Mike Hoyt, CJR executive editor
#5 Posted by mike hoyt, CJR on Fri 6 Mar 2009 at 09:33 AM
In 2004, two national studies showed that fully one-third of America’s then 46 million uninsured -15 million people - were eligible for government sponsored health insurance but were either unaware of the programs or just not signed up.
Unlike the impression that Ms. Lieberman has created in her March 3 critique, the Foundation for Health Coverage Education was founded on the thought-provoking premise that something had to be done to educate this population to the government’s available programs and make it easier for them to sign up.
I started the Foundation initially to help an estimated 2 million uninsured Californians. The first step was to create – apparently for the first time ever –a single sheet of paper with a grid showing all of the public programs that were available in the state. The demand for the resulting California Health Care Options Matrix was so great from not only insurance brokers – the primary entity for people when they seek health insurance – but also from doctors, hospitals, clinics, social workers, educators, HR professionals and politicians, that I decided to create a non profit organization to disseminate the information. Almost immediately two outreach tools were added – an “800” help line with live 24/7 operators and a website that would walk visitors through 5 eligibility questions and to identify for them programs for which they qualified.
As more and more requests for this kind of assistance came from out of state, it became obvious that the public had a great appetite for this type of information. Using California as our prototype, we organized the entire U.S. health care system both public and private into an online environment.
The FHCE was the first non-profit I have ever created. Soon I learned the necessity of raising capital in order to expand our reach. It is true that the WellPoint Foundation has been our largest contributor over the past 5 years but it has never put conditions measured or marketed for private business insurance through our site. And while I appreciate that Leonard Schaeffer has been a force in the insurance industry, Mr. Schaeffer was also Administrator of the Federal Health Care Finance Administration and Assistant Secretary for Management of the Federal Department of Health, Education and Welfare under the Carter Administration. Another of our other distinguished advisory members is Alain Enthoven, A Stanford professor who helped create the national health care policy think tank known as the Jackson Hole Group which promotes centralized government distribution of health insurance.
We see the work we are doing as humanitarian, as an effort to improve the public health by lowering the ranks of the uninsured. The FHCE works within the current infrastructure in order to help Americans navigate the incredibly fragmented and complicated health care system. The 10% of the people who have called our help line to find they are not eligible for public programs but could be eligible for individual or family health insurance through an insurance company is minimal. The amount of this type of insurance that happens through our system is immaterial and the 20,400 brokers we work with in order to get the word out to the public say they find themselves in a pro bono effort when they get involved. We also work with hospital chains, including Catholic Health Care West (the 8th largest hospital system in the nation), the American Cancer Society (which receives 1.2 million phone calls per year with a significant percentage of the people in need of health insurance) and the Departments of Insurance of California and Ohio, as well as major insurance companies who refer their individual declines to the FHCE. These are all front line entities that find our services tremendously helpful when they are trying to help those in need.
We have received donations from Google, Inc., Kaiser Foundation and a number of other non-profit foundations,
#6 Posted by Phil Lebherz, CJR on Tue 10 Mar 2009 at 04:14 PM