Interstate Insurance: More Questions Than Answers
I listened to the Healthcare Summit . For me, it was riveting. It was of course political. I was struck by the determination of the Republicans to push the interstate insurance concept. Wow it sounds so incredible. But I don't follow their logic. I kept hearing as an example that if someone in California had high premiums, they could shop for a policy say in Oregon or Nevada where costs were maybe 30-40% less. This , they said was free market thinking. Here is my concern. Once the Californians start flooding the marketplace in Nevada or other states, those states will raise their rates for the same reasons rates are raised now. The people in those states will no longer have cheaper insurance and the cycle starts over.
No one has addressed whether or not buying healthcare insurance in another state, eliminate "out of network" doctors or hospitals. I can only hope it would mean, I could go anywhere in the country and my health insurance would cover it. Will contracted or reasonable and customary fees be the same across the board nationally for providers and hospitals? Will the doctor in New York get the same reimbursement as the doctor in Jackson Hole, Wyoming? Or will there be a sliding scale based on regional economic levels? This all sounds "socialistic "to me.
If an interstate plan is now considered out of network, then the cost to the consumer will rise. Out of network per cent of payment is higher for the consumer usually 40-50% of cost. Some plans won't even pay out of network cost. If all your medical bills are now out of network, your cost per visit and hospitalization will rise. It sounds good to have lower premiums but it won't help if out of pocket costs are higher.
Another issue is the credential process of the doctors and hospitals for all the plans nationally. Currently individual plans control their own credential process. There is a central clearing house for documents but each company has their own contracts and specific needs. Large practices and hospitals have departments that handle this process but smaller and rural practices will suffer if multiple credential processes are going to be necessary. It is time consuming and labor intensive. The government would have to mandate by law a central credential center. More big government and this is a Republican idea!
Overall, I don't see this idea as a viable concept. The insurance companies would have to be made to change much of the way the offer plans and make money. I don't think the Republicans intend to ask the insurance companies to make such major changes. Plus it would take multiple laws to control the interstate commerce of health plans. There would need to be oversight and control. Again, not a basic Republican calling card.
Posted by HealthCare Whisperer at 2/25/2010 11:00 AM 
Categories: healthcare reform, interstate insurance, republicans
Tags: insurance healthcare reform out of network republicans
Categories: healthcare reform, interstate insurance, republicans
Tags: insurance healthcare reform out of network republicans
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