Comments from the Community so far -

As interested persons continue to join the community, some provide comments at the time they join. I want to encourage everyone to post their ideas directly in the “Ideas” section of the Community, or to post Comments to these blog entries, but I thought I’d share some of the comments received from some of you at the time you join.

The comments below are unedited. Being these comments weren't directly posted, I've withheld the names. Some provide ideas, others discuss problems or advocate a point of view:

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A health care home page that is personalized to the consumer. I could personalize mine to show me the medical accumulators and HSA when I log in with links to all the other important information. Someone else may want to see their electronic medical record first. Some one else may want to go straight to claims history including family members they have access to. We need to personalize to the member not to what we think is important.

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There are several areas in simplifying the individual insurance process for the public that need to be addressed. 

1) Details of insurance coverage.  People who buy individual health insurance should be guaranteed the coverage they buy, rather than having to fight for benefits that have been committed to in the contract, but are being challenged at a later time by the company.  The mistrust of the industry was brought on by the industry. Simplify the benefit package, don't make a lot of exceptions in the contact that don't appear until the place where there is a lot of "fine print" to digest.

2) Expose the deceitful players in the industry, so that the honest and forthright companies can lead the way.  The states have Insurance Commissioners and they have an Association to share information about industry practices.  When one commissioner uncovers a questionable or deceitful practice, that should be put on a common agenda for public comments and discussion and action should be taken at once, rather than allowing it to continue as a practice.  Punishment or at least fines should be imposed on these practices.

3) Benefits Coverage:  When a package is put together, the benefits and the costs should be simply explained to the insurance prospect.  If there are exceptions, they should be highlighted in the marketing outline of coverage, rather than buried in the back of the brochure.  An example is Dental Insurance that does not cover any major procedure for 18 or 24 months, or a common major procedure that is not covered, such as orthodontics.  It is on the back inside cover of three different companies marketing documents in very small print.

As an industry, we look deceitful with "reasonable" and customary applied as the standard, rather than time-honored usual & customary as the standard. Changing the rules by changing the word doesn't communicate well.  It is meant to obfuscate and should be punished.

Burying the exclusions is another poor business practice.

It needs to be a format that is set by law that the exclusions be highlighted at the point where the benefit is sited.

Finally, the practice of denials by insurance medical directors has to be addressed and laws written to protect the public, whether covered by group or individual policies.

Until the poor practices of public companies or companies with public welfare in their hands are corrected, the business of health care will continue to get bad reviews.

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We are asking for government-run health insurance with these practices. There is a new book that offers an overhaul of our American health care system. EQUAL HEALTH CARE FOR ALL (ISBN: 978-0-9796994-0-5) describes a health care system that does the following:

 1. provides clear and equal access to vital, comprehensive health care for everyone living in America in an affordable manner.

 2. creates a single/payer administrator that administers payment for health care as opposed to paying for insurance company profit and the administrative business mechanisms used to garner that profit, and for the corporate greed in our health care businesses, including that in our "not-for-profit" hospitals, 3. re-establishes the doctor---patient relationship as the goal to be achieved for every patient in America by describing the necessary work from doctors, doctors' office staff, patients, and patients' families, 4. removes the burden of the employee health benefit from the shoulders of employers, 5. removes interference with the doctor---patient relationship from the payer while at the same time demanding that the doctor---patient relationship remain free of conflict of interest, 6. establishes a coordinated, coherent, centralized, electronic storage system for medical records by using medical identification cards for patients, doctors, and hospitals coupled with voice recognition computer programs,  7. re-establishes personal responsibility as a major condition for success of our health care system.

Please notify your members about EQUAL HEALTH CARE FOR ALL.

R. Garth Kirkwood M.D.

www.equalhealthcareforall.com

doctork@equalhealthcareforall.com

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It's so confusing!  I always feel stressed out in dealing with health insurance - the red tape is daunting and no one really wants to help me.

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Did anyone see the NBC news that showed fake companies in the Florida area stealing millions from Medicare on fake companies, billing, and scams payments to people that don't need surgeries?  More pressure needs to be put on government agencies to ensure that the money is going to creditable companies. Overbilling is a huge problem too.  Can senior advocate groups get involved in helping seniors with their billing questions and analysis of bills?      

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Today I read the electronic New York Times Article in today's edition, section Technology, called "Microsoft Rolls Out Personal Health Records" which reports on Microsoft's new HealthVault.  I thought it would be good to add to the news and I also wondered if it fits in with Mike McCallister's premise in "Change Healthcare Now" that we need to share and develop common electronic health record standards or if it violates the premise by building from the ground up something that has already been built?