Letter: Bill supports biomarker testing
This letter originally ran in the Lincoln Journal Star.
News
Something New
May 11, 2009
Much of the current health care reform debate is a rehash of issues that have been argued for many years -- government vs. private insurance, insurance market rules, mandated benefits, etc -- all important but not "new". Last week, however, there was something new from a policy perspective.
Karen Pollitz, a professor at Georgetown University, released an innovative study that looks at the benefits in actual health plans sold in Massachusetts and how they would affect people who have breast cancer, stroke, or serious diabetes. Pollitz developed a model of a typical case for each condition and looked at what a patient would pay for deductibles, co-pays or coinsurance, and out-of-pocket expenses, as well as benefit limits within plans such as a limit on the total number of doctor visits a person may make per year. She is able to directly compare what the patient with the typical case experiences in each plan. This is a first in health policy. Do you know how well your plan would cover you if you or a member of your family is diagnosed with cancer? I donÈt, and I have worked in health insurance policy for 25 years. It is not because I am lazy or indifferent; it is because the details that matter are buried in small print legalese that is incomprehensible to virtually everyone, even those of us who work on these issues. When we buy something major such as a car or an appliance, we can get all kinds of information about its performance and quality, and we use such information to make an informed decision about what product is best for our needs. But when it comes to health insurance, which is potentially essential to maintaining our health and financial well-being if a serious disease like cancer strikes, we, as consumers, have virtually no ability to know what a good plan is. Hopefully, PollitzÈs study will give real impetus to legislators to tackle this critical issue in health reformthe need to make health plans more transparent to consumers. If we truly want competition and a viable private health insurance market, people need consumer informationinformation that the can easily understand at little or no cost. As Pollitz recommends, we need something much like the nutrition label on food products, a label that provides meaningful and comparable information that allows consumers to understand what the health plan would or would not cover if they develop a serious medical condition like cancer.
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