News In Healthcare

Pres­i­dent Obama and Con­gress entered marathon nego­ti­a­tions over health reform bills on this day in 2010. Hope­fully those efforts weren’t for noth­ing. More to come on the sta­tus of Health Care Reform as we get closer to the US Supreme Court review­ing the mat­ter in March.

I can­not believe that we needed to con­duct a study in order to know that indi­vid­u­als who under­stand their health insur­ance cov­er­age require­ments, will make bet­ter choices about seek­ing med­ical ser­vices.  The Boston Her­ald recently pub­lished the find­ings of just such a study.  What was found was that indi­vid­u­als who knew what their co-payments were for med­ical ser­vices were more cost-conscious when decid­ing when to seek those med­ical ser­vices.  These indi­vid­u­als were con­sid­ered “savy.”

I don’t call it being savy.  I call it using com­mon sense.  If you know that each emer­gency room visit is going to require you to pay $250 out of your pocket  ver­sus $25 for each physi­cian office visit, com­mon sense says that you will visit your physi­cian and not the hos­pi­tal emer­gency department.

In a let­ter to Health and Human Ser­vices Sec­re­tary Kath­leen Sebe­lius, Karen Ignagni head of America’s Health Insur­ance Plans and the nation’s top health insur­ance indus­try offi­cial, said that the indus­try will fully com­ply with new reg­u­la­tions pre­vent­ing cov­er­age denials for chil­dren with pre-existing con­di­tions.  The reg­u­la­tions are expected to be issued within the next few weeks.

It is trou­bling that Ms. Ignagni was in a posi­tion where she had say to the fed­eral gov­ern­ment that the health insur­ance indus­try will fol­low the rules and not cause prob­lems.  How­ever it is believ­able that this was required given the recent actions by health plans to hap­haz­ardly rescind cov­er­age based upon pre-existing conditions.