Sen. Rockefeller's Very Good Idea
Most of the attention will focus on the public plan outlined in Sen. Jay Rockefeller's Consumer Health Choices Act. Think of it as the "strong" version of the public plan: For the first few years at least, it can use Medicare payment rates.
But it's not the most interesting part of his proposal, nor the part most likely to make it into law. That honor goes to America’s Health Insurance Trust, Rockefeller's proposal for an independent agency that would gather data, conduct consumer satisfaction surveys, and release comprehensive and easily understandable ratings of the health insurance options -- both public and private -- offered in the insurance exchanges.
Quick story: As you may know, I just began at The Washington Post. That meant I had to set up my benefits package. There were two options: Kaiser Permanente's HMO, and Aetna's modified version of a PPO. I'm not sure if I've said so, but I like to think I know a little something about health insurance. But you know what? I knew nothing about those health insurance plans. I know Kaiser is good in California, but their DC-area network looked thickest in Maryland, and I don't want to be traipsing out to Maryland for care. But a friend who'd had Kaiser assured me that he'd had few problems. Aetna, by contrast, offered more convenient options but was pricier. I called my benefits manager. She assured me both were pretty good. I pored over the literature. There were few obvious differences.
There are two relevant policy points. One is that even a large employer like The Washington Post offered only two options. That should be fixed in the Health Insurance Exchanges, where in theory many insurers will compete for taxpayer business. Second is that even with a mere two options, I didn't have a trusted source with comprehensive information on their relative quality.
That's what Rockefeller's agency would attempt to fix. The trust would be a nonprofit corporation staffed by experts chosen by the well-respected Government Accountability Office. The trust would conduct surveys, pore over claims data, and rate plans on administrative expenditures, affordability, adequacy of coverage, consumer claims processing (including timeliness), consumer complaint systems, grievance and appeals processes, transparency and customer satisfaction. The ratings would be as simple as possible, with letter grades. All the information would be available online, on the same sites where people would choose their insurer.
It is, in other words, a good and obvious idea responding to a real need in the marketplace. I'd guess that it'll be overshadowed by the public plan portion of Rockefeller's bill. But whatever happens with the public plan, both parties should be able to agree on the inclusion of something like this consumer-oriented trust. The health insurance market will never work unless people have access to the information and choices that would allow them to identify and reward high-performing companies.
(Photo credit: Jay Rockefeller's Senate homepage.)