Colorado is trying to slow down rate increases for health insurance companies by requiring pre-authorization from the State Insurance Commission for rates increases. Colorado is also trying to strengthen the recourse of insured individuals who are treated fraudulently by their insurers by strengthening penalties imposed on health insurers for wrongful actions against consumers, also through the office of the State Insurance Commissioner.
Reported on April 7, Colorado introduced its FAIR act (Fair and Accountable Insurance Rates) http://www.cohealthinitiative.org/ which will give Colorado's Insurance Commissioner the authority to review proposed insurance rates increases and approve them or disapprove them before companies can raise their rates.
It's not perfect, but it is a step in the right direction. Of course insurance companies point out that medical costs have increased as unconscionably as their own greedy rates increases. True enough and health services providers will ultimately have to become part of the solution of putting a cap on the endless rising costs of health services.
Colorado Representative Morgan Carroll (D-Aurora) is a pro-consumer representative and is named in conjunction with the FAIR act. While insurance companies argue that it is the rising cost of medical services that is responsible for the rising cost of health insurance (in part true as noted above), the bigger fact is that insurance companies keep raising rates for less insurance coverage. Less coverage takes the form of lower reimbursement rates or lower payments to providers that reduces health services participants in plans and exclusion of more and more health services and equipment from plans altogether...this is the greed factor. While lower insurance rates will not solve either of these problems, lower payments from insurers and exclusions, it will stop the trend of charging more for less coverage.
Other Colorado actions reported in the article includeHouse Speaker Andrew Romanooff and Senate Majority Leader Ken Gordon's the "Insurance Accountability Act of 2008" (which must be approved by the General Assembly) and gives the Insurance Commissioner the power to PENALIZE companies for insurance tactics of delaying reimbursements and other wrongful actions against consumers.
The obvious downside of this right direction is that it's going to be too much for government to tackle without huge additions of staff for the insurance commissioner.
However, all governments have waste and hopefully Colorado will do the work to fund the necessary staff to implement these laws as well as to oversee itself and prevent more cushy government jobs that accomplish nil. Further, maintaining oversight of its own conduct will be a key challenge for government...avoiding bureaucracy as usual. In theory it is a step in the right direction.
It would be more encouraging if the dialogue about health insurance stopped the scare tactic of telling consumers that we NEED insurance. Health insurance need has reduced with health insurance inadequacy in helping people pay for needed health services. It is irresponsible to argue that people die for lack of health insurance...this shorthand lingo for explaining that people die from lack of health services (which are theoretically less available for people without health insurance) perpetuates the inaccurate and mistaken theory that health insurance is necessary for medical services. This is not true unless that health insurance sufficiently pays for needed medical services when people are sick so that they are not made sicker by the stress of paying for their care and the threat of bankruptcy. Many people with health insurance do not get medical services or screenings they need because of the fact that they can't afford either the endless diagnostic costs nor the costs of treatments WITH health insurance. Insurance companies are a financial vehicle for helping consumers pay for medical services, if the vehicle fails, then another vehicle needs to be available to consumers.
Insurance companies are not vital, medical services are and nobody ever died because they didn't have health insurance...never, we die from failed access, affordability and quality of health services in our market place.
Why is this an important language distinction? Because for years, health insurers have argued that when they deny coverage they are not liable for practicing medicine without a license, nor are they responsible for any consequent medical result, including death, why? Because they are only denying payment, consumers decide whether they will get the medical services they need. Not only that, but the argument is successful.
So why are we elevating this industry to something more than it claims to be? Because nobody wants to take on the fact that the cost of medical services has to be controlled in some way. Nobody wants to tell Johnny Doctor that if he has his nurse see patients, if he has his physician assistant see patients then he cannot charge the same fee he charges for his own services, regardless of the job performed. And if non-physician personnel can perform the service, good enough, charge less for the service.
Insurance is designed to assist in paying for needed medical services. By remembering what health insurance is, consumers can stop being held hostage to the idea that without the health insurance product we are all doomed. Consumers contribute to the limitless power over policy that health insurance companies have when they talk about ethics, wellness programs, policy roles for the health insurance business...this has been exploited by insurers who become poorly qualified educators instead of clerks, fulfilling contractual obligations to help consumers pay for needed medical services...period. By targeting ONLY the health insurance companies we also fail to hold our medical services providers responsible.
So hurray for Colorado, first things first: control the nothing for something approach of insurance companies. Hopefully you'll take on the bigger issues of controlling the cost of medical service providers as well...
