By Jill Zorn
UConn’s Health Disparities Institute hosted a symposium on health insurance literacy which highlighted the absurd reality that too often, choosing and using health insurance feels like a game of “gotcha.”
Health insurance complexity presents a huge, unfair barrier that ultimately can prevent people from receiving the care they need. It can keep people from choosing the plan that best meets their health concerns, and it can prevent them from using their coverage to access care because they fear incurring unexpected, unaffordable medical bills.
People shopping for insurance have an instinctive feeling that the game is rigged. This CT Mirror article on the symposium opens by quoting one of the speakers, Lynn Quincy, director of the Health Care Value Hub at Consumers Union, saying that, “Consumers would rather go to the gym or pay taxes than shop for health insurance.”
Speakers at the conference talked about how it is particularly difficult for most people to understand the deductibles, co-pays and co-insurance rules of their health plans. Quincy’s talk featured a slide that illustrates, “it’s Greek to me” when it comes to how people perceive the explanation of what they might have to pay for care if they get sick.
Another speaker, researcher Kathryn Paez, related a story about a man who took a bus to the emergency room while having a heart attack because he was afraid his insurance might not cover an ambulance ride.
Another challenge posed by insurance complexity includes obtaining up-to-date information on provider networks and what the financial consequences could be for obtaining out-of-network care. Which prescription drugs are covered and what the out-of-pocket costs for those medications could be, is also often very difficult to determine.
Here at Universal Health Care Foundation, we agree with Rev. Efrain Agosto, who spoke at our recent Reform to Transform summit, that bold action is needed on this issue. Near the end of his keynote speech he stated that a crucial principle of the health care system should be “simplify and clarify.” As Rev. Agosto says, the average person wants to know, “When they get sick they can be treated quickly and efficiently without going broke.”
One of the policy briefs the foundation commissioned to complement the topics covered at the summit was written by Dr. Victor Villagra, associate director of the Health Disparities Institute. His paper, Enhancing the Value of Health Insurance by Making it Simpler, states that complexity, “can perpetuate health inequities and ultimately undermine the goals of health reform.”
Villagra makes recommendations regarding improving health insurance literacy so that people can have a better understanding of how to choose and use their health insurance. But he also emphasizes that the ultimate goal should be to make health insurance “as simple as possible.”
Insurance should not be designed so that people are afraid to shop for it or are terrified to use it.