Demand grows for Senate to open health insurers' books

tranparency

WASHINGTON-The Senate must break through insurance company secrecy, adding stronger language in their health care bill requiring Aetna and other insurance giants to disclose what their insurance policies cover and how much of the premium dollar goes to health care and how much for profits.

So said Rep. Rosa DeLauro, a Connecticut Democrat, during a telephone news conference Dec. 8 sponsored by the Campaign for America's Future (CAF). She told reporters that the health care reform bill approved by the House would require insurance company "transparency" and "accountability" adding, "Under the status quo, health insurance is essentially a black box."

Consumers, she said, assume they are buying comprehensive coverage only to discover "huge gaps" when they get sick and need expensive care and medication. Often, she said, health insurance policies are so long and complicated "you need to get a lawyer" to find out what is and is not covered.

CAF Health Care Project Director, Diane Archer, told reporters that far too little attention has been paid in the eight days of Senate debate to transparency. "We know almost nothing about what the insurance industry is doing with our health insurance dollar," she said, treating that information as a closely guarded trade secret.

She cited a report just released by Sen. Jay Rockefeller, West Virginia Democrat, charging that Aetna was forced to file a $4.9 billion "correction" of its report to health insurance regulators in 2008. The Enron-style book-keeping was uncovered in a four-month investigation of the health insurance industry by the Senate Commerce Committee which Rockefeller chairs. It shouldn't take a full Senate investigation to bring that to light," Archer said.

Rockefeller said in a press release, that Aetna's new filings "show that Aetna spends less on small business health care than they claimed previously, only 79 percent instead of 82 percent."
He added, "Health insurance companies have a duty to provide accurate financial information both to consumers and to their regulators about how much they actually spend on health care and how much they spend on profits, on executive salaries, and on denying care to people when they really need it."

Skirting full disclosure "not only violates the law," it makes it impossible for consumers and regulators to determine if they are "getting a fair value for their health care premium dollar" Rockefeller concluded.

Karen Pollitz, a Georgetown University Professor told the phone conference the so-called "public option" does a lot "to insure transparency ... Monitoring health insurance is a little tricky. If there is a public plan, chances are that a lot of people hit by the lack of transparency will probably end up in the public plan."

Asked if the votes are there to push through language guaranteeing transparency, DeLauro said, "We are close. We've got good language in both the House and Senate. I'm optimistic."
Yet she voiced exasperation at the behavior of the Senate Republicans. "There is a philosophy among the Republicans of ‘just say no!' Every step of the way there is obstruction. There isn't much interest on the Republican side in health care reform."

The Republicans, she added, rant and rave about the "cost" of health care reform. "It is just a lot of rhetoric," she said.

Archer echoed her point: "Transparency is a very important tool for cost containment. If we are going to reduce costs, we need this tool for oversight and accountability. Why aren't the Republicans getting behind this proposal?"

Photo: http://www.flickr.com/photos/ragesoss/ / CC BY-SA 2.0

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