Blue Cross offers a concession
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| Lack of choice is part of the current problem |
Recently,
I wrote about the impact insurance company pay rates have on our two South
County hospitals – Westerly and South
County – whose rates for providing the same services are generally much lower
than, for example, Rhode Island Hospital, even though patients rate the services of Westerly, and in particular, South County much higher.
In
response to adverse publicity, Blue Cross/Blue Shield said it would begin being more transparent about its
payment rates by no longer writing a clause into future contracts that forbids
health care providers from disclosing how much they get paid by Blue Cross.
This
change would take effect as new contracts are signed. State Insurance
Commissioner Christopher Koller had planned to require insurance contracts to
include price transparency. And our local state Senator Dennis Algiere, the
Senate Republican minority leader, had introduced legislation to require transparency.
It’s a baby step in the right direction, but there’s still a long way to go before the public can find fair deals in health care in the marketplace.
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| How's that socialized medicine thingy workin' out for ya, Sarah? |
In
the usual back-and-forth both in comments, conversations and e-mails, the overwhelming
power of insurance companies in the health care system became more and more
apparent. They control the purse strings, and by so doing, they can control
which health care providers thrive and which fail, as well as who lives and who
dies. And they often times do it with little justification.
Some
of you may remember that last year, Rep.
Donna Walsh took on one of the more
outrageous aspects of health insurance conduct through legislation that would have banned the common insurer
practice of charging women who buy individual insurance coverage more than men for no other reason than they are
women. Donna plans to reintroduce that bill.
The
insurance lobby actually testified that their reason for this was so they could keep rates
low for young men. They said they need to offer an enticement, since young men are notorious for being
uninsured unless they get coverage through their employment.
I
received one comment recently which was not the first one very sore spot in
Rhode Island’s medical system. Rhode Island has chosen what seems to me to be
the worst way to finance medical care. The
state severely limits the choices offered to Rhode Island employers and group buyers to a very small number of
insurers – Blue Cross, UnitedHealthCare and Tufts.
The
lack of choice hampers competition, which is the one saving grace the free
market approach to health care offers to consumers. By state mandate, just three private companies corner the market.
Personally,
I believe we can work around the edges and tweak the system a bit to reduce a
few of the worst aspects of the system, but will not catch up with the rest of
the industrialized world until we go to a single-care system, perhaps like a Medicare-for-all arrangement.
Let
the private insurers sell supplemental insurance, as they do now to Medicare
members, but let’s use the tried and true basic coverage system that Medicare
offers to provide basic universal coverage.
The US scores so poorly when compared to the rest of the First World nations because we do not have a universal health care system. That is, until Americans turn 65 and go on Medicare, whereupon their life expectancy is as good as or better than the other nations on the list.
