My letter today to Health Policy Institute of Ohio:
I’m reading your new publication about health insurance in Ohio. It has a lot of good information, but I see nothing for the consumers of Ohio, i.e., about effective rate review. We have no transparency in this state, and that must be why we have the highest premiums after tax credit than any other state. We also have a low median household income compared to other states, and in Toledo, it went down 17.4% in 10 years. Not that that should make any difference at all to the price of health insurance or healthcare for Ohioans, healthcare that we receive locally, in our poor local economy. If we had effective rate review in this state, you’d be hearing the consumer voices in public forums. And maybe it’s about time?
We have serious problems that I wish an independent, nonpartisan, statewide center like yours could analyze and report to policymakers, state agencies, the media, and the public. I see that your reports are reviewed by a lawyer who represents insurance companies. I don’t think it serves the people of Ohio very well, when an insurance company lawyer is involved in what you give to policymakers. Shouldn’t a consumer voice be somewhere in your report?
Here are the problems that I see, and nothing gets done (because obviously the insurance companies run everything and everyone).
1. Provider network directories are absolutely bogus, as I have proven in my survey of all of the family practice and internal medicine PCP doctors in Toledo, on the individual market health insurance plans. An average of 80% of the doctors across the plans, who are listed as accepting new patients, are not accepting new patients when you call them! I did! I called 308 doctors and my results are here: http://ohiocitizenratereview.info/
2. Complaints about provider networks to the Ohio Department of Insurance get buried. They become classified as confidential, and nothing ever gets done. I know, I made two complaints, and nothing got done to change the inaccurate directories! A report of the 30% increase in provider network complaints in 2014 would have been helpful, and to know the number of complaints in 2015 as well.
See, here: http://ohiocitizenratereview.info/provider-network-complaints-get-buried/ , http://ohiocitizenratereview.info/letter-complaint-examiner/,http://ohiocitizenratereview.info/rate-reviews/caresource-2017-rate-review/
3. Now the people in the individual health insurance market do not even have the option to buy PPOs anymore — we can only buy HMOs with extremely narrow networks that are made five times narrower by the lying, bogus, misleading, extremely inaccurate network directories. So what, someone might think, that 6% of the Ohio population can’t find a doctor? It’s only 6%! But let me show you how that hurts everyone — all 11.6 million people in Ohio. It locks people into their jobs, so they feel trapped by the need for decent health insurance, so they don’t test their brilliance to go out on their own, because there is no good insurance to buy if you are an individual; you can only work for a company or for the state to be privileged enough to have a PPO health insurance plan. After all, good insurance is for the privileged only. HMOs (with really bad inaccuracies, to boot) are what you get if you are an individual, even though just three years ago, 82% of the individual market was comprised of PPO health insurance plans. It’s discrimination. Who is ever going to want to be an individual, when individuals are flat-out discriminated against? Martin Luther King Jr’s famous quote has a whole new meaning now, with Medical Mutual removing PPOs from the individual market in Ohio: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Discrimination against the poor, this is what we think of when we think of that quote, but it is also discrimination against the geniuses, who perhaps do not want to give up their intellectual property to work for a corporation just to receive a superior health insurance plan that is now only possible to have when you work for the man (or for the state.) It’s not going to help the advancement of society to give it all up to the corporations. America is about freedom — life, liberty, and the pursuit of happiness. I don’t think that means we have to sacrifice equality in healthcare to pursue our American Dream. Please see my latest post: http://ohiocitizenratereview.info/brief-history-health-insurance/
4. We need transparency in this state. Consumer complaints should be made public in a database on a website that is consumer-oriented, and the Ohio Department of Insurance should start looking at how other states are doing it, because even though we are securely in the Midwest, you would think we lived in Russia, by the looks and feel of the Ohio Department of Insurance. http://ohiocitizenratereview.info/outrageous-health-insurance-rate-increases/if-other-states-can-do-it-why-cant-we/ http://ohiocitizenratereview.info/outrageous-health-insurance-rate-increases/database-of-consumer-complaints/http://ohiocitizenratereview.info/outrageous-health-insurance-rate-increases/rate-review-for-dummies/
5. Why don’t you report on the second lowest cost silver plan SLCSP discrepancy, where in the big cities in Ohio, the tax credit SLCSP is not the same as the second lowest cost silver plan SLCSP one has the option of buying — it doesn’t exist in the big cites and Ohioans are losing millions of dollars of promised tax credits. This is one big reason why Ohio is the most expensive state on the marketplace for health insurance premiums — we are losing out on both ends. see,http://ohiocitizenratereview.info/outrageous-health-insurance-rate-increases/slcsp-discrepancies/, http://ohiocitizenratereview.info/rate-reviews/buckeye-ambetter-2017-rate-review/
I can see how none of this would be discussed in your Health Insurance Basics, since it was reviewed by an insurance lawyer who represents insurance companies. An insurance lawyer? Really? I wish you could be more of a voice for the consumer, because the balance in Ohio is certainly skewed.