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Health reform’s yogurt label

By Jay MacDonald · Bankrate.com
Tuesday, August 23, 2011
Posted: 9 am ET

Will shopping for health insurance one day be as easy as shopping for yogurt? The engineers behind the health care reform rollout are giving it their best shot with their draft of a simplified standard summary form that aims to take the "un" out of unintelligible.

The draft summary, published by the Department of Health and Human Services, attempts to lose the legalese and mumbo-jumbo nomenclature that effectively -- and some would say intentionally -- renders most health insurance plan summaries useless, at least for comparison shopping by everyday peeps. It was developed by a group headed by the National Association of Insurance Commissioners and has already been tested on humans without adverse reaction.

At first glance, the streamlined draft looks something like a six-page credit card disclosure statement, horizontal in design, with three to six logical columns. Kudos to the architects of the Affordable Care Act for specifying that all forms be short and all fonts be at least 12-point; no fine print here.

The first page works like a new-car sticker: it attaches a dollar value to the plan's premium, overall deductible, specific deductibles and out-of-pocket expenses, and also explains what each term means. Come to think of it, I wish new-car stickers provided as much detail.

The next two pages list common medical events (primary care visits, cancer screenings, inpatient/outpatient care, rehab services, etc.), breaks out the costs for each at participating versus nonparticipating providers, and summarizes the limitations and exclusions for each event.

The final three pages include a more detailed breakdown of three sample events (having a baby, breast cancer treatment and managing diabetes) to help us compare coverage from company to company, additional coverage and exclusion details, and a Q&A on the summary form itself.

Granted, the simplified form won't change the lives of the majority of Americans who are covered by employer-sponsored health insurance. That's because employer plans are underwritten at the group level, not the individual level.

But for those of us who do have a choice, I'd rate this as a monumental leap toward transparency.

Having experienced firsthand the frustration of trying to make an apples-to-apples comparison between health insurance providers, I can attest to the levels of obfuscation, misdirection and outright hoodwinkery involved.

It was so bad that I would rather sit through back-to-back screenings of Leonardo DiCaprio's "Inception" before attempting it again.

Of course, there's no telling what balderdash the health insurance companies will come up with to shovel into these innocent-looking blanks. But that's another battle for another day.

Just making them commit to this much transparency is reason enough to cheer.

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4 Comments
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August 24, 2011 at 2:18 am

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