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Insurers Insist We Really Don't Need A Public Plan. Sorry, Guys, We Don't Trust You.

As someone who spent two hours on the phone talking to six different insurance reps Monday, trying to find out why my insurer was trying to stick me

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As someone who spent two hours on the phone talking to six different insurance reps Monday, trying to find out why my insurer was trying to stick me with a $12,000 emergency room bill, I can only repeat what has become my personal mantra: The only people who are really satisfied with their health coverage are those who have never had to use it.

The industry that helped scuttle health reform 15 years ago with its "Harry and Louise" ads is back, voicing support for a central element of the Obama administration's plans: making sure everyone is covered.

That does not mean the industry is backing the administration. Indeed, the leader of the insurance lobby has sent lawmakers a message: Be careful what you change, because "77 percent of Americans are satisfied with their existing health insurance coverage."

Karen Ignagni, president of America's Health Insurance Plans (AHIP), invoked the statistic to argue against the creation of a government-run insurance option. But the polls are not that simple, and her assertion reveals how the industry's effort to defend its turf has led it to cherry-pick the facts.

The poll Ignagni was citing actually undercuts her position: By 72 to 20 percent, Americans favor the creation of a public plan, the June survey by the New York Times and CBS News found. People also said that they thought government would do a better job than private insurers of holding down health-care costs and providing coverage.

In addition, data from a Kaiser Family Foundation poll last year, compiled at the request of The Washington Post, suggest that the people who like their health plans the most are the people who use them the least.

Those who described their health as "excellent" -- people who presumably had relatively little experience pursuing medical care or submitting claims -- were almost twice as likely as those in good, fair or poor health to rate their private health insurance as excellent.

The level of satisfaction expressed with private insurance was essentially the same as that with Medicare, the government program for the elderly and disabled.

The industry's stance against a public health plan revives shades of 1994, when it was instrumental in blocking President Bill Clinton's health-care proposals.

"A government-run plan would turn back the clock on efforts to improve the quality and safety of patient care," AHIP has argued. Such a plan "will ultimately limit choices and access," the big insurer WellPoint contends.

But systemic problems have persisted for 15 years, and it is not clear how much private insurers have done, or can do, to solve them.

"Insurers promise choice, they promise innovation, they promise a lot of things, but I think they've delivered very little," said Alan Sager, professor of health policy and management at Boston University. "I think net they give us very bad value for the 10 to 20 percent share of the health dollar they skim off the top."

Instead of choice, they offer "the illusion of choice," he said.

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