Confused by your health options? Reform could make it worse

Sun reports: “Proponents of the new health care law claim to have seen the future of American health care — and they say it’s a lot like air travel. According to some, come January 2014, choosing a health insurance plan in the new exchanges will be as easy as shopping on Orbitz. By cutting insurance agents from the transaction and forcing consumers and employers to buy policies direct, advocates claim that the exchanges will trim costs. Of course, these folks seem to overlook that selecting a health insurance policy is a tad more complicated than buying a plane ticket. Many consumers rely on agents and brokers to help them make informed insurance choices and take advantage of cost saving opportunities — and should be allowed to consult with them if they so choose. Most of the products consumers buy online are simple commodities. For instance, to buy a plane ticket through a Web portal, all a traveler needs to know is where he’s from, where’s he going, and when he’d like to leave. The amount of legroom, the quality of the food and the reputation of the airline may factor into his decision, but most folks are just looking for the lowest possible fare. When it comes to health insurance, consumers are looking for more than just the lowest price — they’re also searching for the best value. For some folks, that may be the cheapest available plan. But other individuals and small businesses may have more specific needs in navigating the system, requiring help when problems arise and information when new products and changes are introduced that may impact them. Imagine if buying airline tickets were as complicated as picking a health insurance policy. Travelers wouldn’t have to simply select their destination and date of departure. They may not even know anything about their future destination or journey toward it. They’d have to select the thickness of their seat cushions. And tell the airline whether they planned to use the bathroom during flight. And whether they’d have chili or Indian food before boarding the plane. And if you’re an employer, the number of workers could change product offerings and cost. Each answer could change the price of their seat — or perhaps bar them from traveling altogether. The consequences for purchasing the wrong plane ticket are minor — loss of money and time. But buying the wrong health insurance can jeopardize a person’s health and financial security. And for small business owners that provide health benefits to their workers, the risks are magnified across many families and lives. That’s where licensed professional agents and brokers come in. Few things are more important than our health — and expert agents can ensure that individuals and businesses find the plans that best suit their needs. Unlike travel agents, insurance brokers are more than salespeople. They can assist their customers by helping them appeal denied claims and correct administrative errors. For small businesses, outside brokers frequently serve as virtual human resources departments, providing administrative savings by assisting in compliance, completing enrollment forms, answering questions about benefits, and ensuring that enrollees have the documentation they need to access medical care. According to the nonpartisan Center for Studying Health System Change, at least half of all small firms in the United States obtain their health benefits through a broker or agent. These companies appreciate the services brokers provide. A survey commissioned by IBM found that three-quarters of small-business owners were very satisfied with their agents’ work. The health reform law claims to offer some help to confused consumers by establishing so-called “navigators” to conduct public education activities, distribute information about enrollment and premium credits, and provide enrollment assistance. Unfortunately, the law does not specify what training or certification navigators must receive to advise customers — unlike professional agents who are state-licensed and accountable. Consumers may thus be at risk of encountering sham operators who could give them faulty advice or information. By empowering consumers with useful information, brokers make the health care marketplace more — not less — efficient. Janet Trautwein is CEO of the National Association of Health Underwriters.”