Kansas City Star, (Diane Stafford)
MD Sam Smith, CFP
CAHU VP, Public Affairs
“If you’ve lost your health insurance in a layoff…
If you’re confused about which retirement health plan you should take…
If you’re buried under hospital bills and don’t know what to do next…
Steve Luptak feels your pain.”
So begins a recent newspaper story about Steve Luptak, a member of a growing cottage industry of individuals who are making a business out of helping people navigate the confusing waters of health insurance and health care costs.
“Every part to the health care financing encounter has high-paid consultants working for them”, Luptak said, “But there’s usually nobody representing the consumer with the same level of advocacy.” After retiring from a health care industry job a few years ago, Luptak started helping, for a fee, people who had problems getting health insurance or negotiating medical bills. By charging those who could afford to pay, he has been able to help others for free. “I’m doing a lot of pro bono work to get off the ground. I consider this my mission.”
“I’ve gotten to be very efficient at analyzing health insurance,” Luptak said. “For a basic fee of $200, I can do an initial evaluation-what coverage do you have? What coverage do you need? Or I can charge a contingency fee if I negotiate down your medical bills and get hospitals or insurance companies to write off some of your debt.”
….and so the article goes, talking about how he charges in on his white horse helping those whose policies have been rescinded and whose claims have been denied…and then charges upfront fees and a percentage of negotiated claims.
Imagine that! Comparing policies for the consumer. Helping them understand what they have and what they need. Helping with claims and negotiating with hospitals and providers. What a great job!
When I spoke with the columnist for the Kansas City Star, Diane Stafford, we had a lively conversation about professional agents and their role as consumer advocates. It took some doing, but Ms. Stafford finally agreed that perhaps a professional agent might in fact have an advantage in dealing with insurance companies and health care providers because of the business we have and not in spite of it. That an agent is seen more as a partner and less likely to be viewed as an adversary when negotiating and that our internal knowledge of the system is an asset, not a liability. If we didn’t place our clients first, just how long would stay in business?
We finally ended the conversation on a positive note and a commitment to consider professional agents the premier health care advocate for the consumer…for all the right reasons.
This story is but one of a large number of articles coming out in the face of ever growing interest in health care reform and a good example of the great need for us to tell our story every chance we get. I am not confident that we can rely on the press to tell it fairly. In fact, I think it would be a safe bet that they will not. In the absence of their support, the job falls back to us.
This is why we must develop our Public Affairs Teams in every chapter across the state. We must have members who are committed to go out and tell our story in our communities. What we do and the important role we play as consumer advocates is a message that we must deliver and do it now. If agents continue to wait for someone else to do it, soon there will be no story to tell.
I was very pleased to see over the course of the last week evidence of the work that our National Association has done in making sure we have a place at the table in the looming health care reform debate. In many stories last week regarding the passage of the renewal of SCHIP funding in the US House of Representatives, the National Association of Health Underwriters was mentioned as one of the key players in the debate along with America’s Health Insurance Plans and the Blue Cross Blue Shield Association. A big part of what makes this possible is member support of HUPAC. In 2008, HUPAC was listed as the fourth largest player amongst professional agents and broker PACs by contributing $392,250 to federal issues and offices.
We’re number 4! We’re number 4! Somehow, that just doesn’t sound like something to be all that proud of.
Monday, January 19, 2009
Saturday, January 3, 2009
LAAHU & Hollywood Chamber of Commerce Health Care Conversation
The Hollywood Chamber of CommerceHealth Care Committee-LAAHU
Health Care Discussion Meeting December 30, 2008
On Thursday, December 30th, thirty two participants attended the Health Care Community Discussion hosted by the Health Care Committee of the Hollywood Chamber of Commerce and sponsored by the Saban Free Clinic of Los Angeles and Genesis SmithBenton, a local employee benefits consulting firm.
Moderating Thursday’s event was Abbe Land, Mayor Pro Tem of West Hollywood, California, and Co-Chief Executive Officer of the Saban LA Free Clinic. Participants included local health care providers, medical professionals, community leaders, educators and local business owners.
Also in attendance were members of the local Los Angeles Chapter of the National Association of Health Underwriters, including Bruce Benton, newly elected National Secretary of NAHU, Ross Pendergraft, President Elect of the Los Angeles Chapter, Dede Kennedy Simington (LAAHU Awards Chair) and Meg McComb, Vice Chair of Legislation for the California Association of Health Underwriters. Official representatives of the Hollywood Chamber of Commerce included Nicole Shehenian, Vice Chair of Public Policy, Bill Farrar, Senior Vice Chair of the Executive Board and Scott Moe, Co-Chair of the Legislative Action Committee of the Hollywood Chamber.
When asked what participants felt was the biggest problem in the health system, the overwhelming majority listed the cost of health insurance, while a significant number identified the cost of health care as the biggest problem. Many of the participants also mentioned the lack of coordination and interoperability of systems, claims processing and general confusion among consumers. There was significant discussion about the poor reimbursement level of providers that is driving out quality providers and eroding the quality of care. Several participants emphasized that the cost of health insurance is high because the cost of health care is high.
There was significant discussion about how to select health care providers and how to investigate the quality of outcomes and providers in general. While most participants were generally familiar with internet sources for information, few were familiar with sources that were free of charge. There was some conversation about the affluence of neighborhood and its affect on quality and generally, most indicated they would most readily depend on personal referrals more than any other method.
Most participants had either personally experienced or had friends or family members experience difficulty in paying medical expenses in the past. It was generally understood among all the attendees that medical expenses, either though being uninsured or being underinsured, was the leading cause of personal bankruptcy in the United States. Several suggestions were made regarding future public policy to address this including enforceable individual mandates, health insurance premiums indexed on income, national catastrophic illness coverage and the possibility of looking to other industrialized countries to find what has worked and not worked for them.
When participants were asked whether they wanted to be able to pick between a public and a private plan the conversation became divided between those that held no confidence in the government’s ability to manage such a system considering the significant problems within the Medicare and Medicaid systems and those that felt such a choice was necessary to force the private system to maximize efficiencies and outcomes. There was a general consensus that the imbalance between the current public system and the private system had to be addressed first to assure a level playing field. No matter what the eventual choices, the current reimbursement levels within the Medicare and Medicaid system has to be addressed to alleviate cost shifting to the private sector.
When discussing choice, there was almost unanimous consensus that everyone felt choice was very important. However, choice had to also be structed in a way that addresses containment of costs, quality and must include those segments of the population that have been historically overlooked. It was also felt that “choice” should also address the American culture of “wanting what we want when we want it” and allow for consideration of poor choices like smoking and obesity.
There was considerable difference of opinion when discussing the role of employers in the future of reform. While most supported a continued strong presence for employer based coverage, there was also significant support for fully portable individual coverage that could be assumed by an employer during employment and continued during periods of unemployment or self employment. While several participants emphasized the importance of individual responsibility in maintaining health insurance coverage, several attendees brought up the high rates of uninsured motorists in states that mandate auto insurance.
There were many suggestions from the group regarding preventive services and if and how they should play a role in reforming our health care system. There was general agreement that preventive care is an investment in the future and that future savings were a goal, not an immediate outcome. Preventive care and current healthy living had to become a part of the American culture. Examples such as once again making physical education a part of the regular curriculum of American schools was mentioned as well as penalties for poor lifestyle choices like smoking, obesity, etc. Another suggestion on what needed to be restored was the ban on pharmaceutical advertising. It was also felt that parents had to be held more accountable for the health of their children.
Another issue that came up repeatedly during the course of the conversation was the present and growing chasm emerging in the form of a two tier health care system. Those currently covered in many public programs experience a different level of care than those insured by private plans. There was no clear consensus on whether those in attendance felt this two tier level of care either could or even should be avoided. The principal of “social solidarity” was not universally supported.
The full report and survey findings of the meeting were reported to the Office of the President-Elect.
Health Care Discussion Meeting December 30, 2008
On Thursday, December 30th, thirty two participants attended the Health Care Community Discussion hosted by the Health Care Committee of the Hollywood Chamber of Commerce and sponsored by the Saban Free Clinic of Los Angeles and Genesis SmithBenton, a local employee benefits consulting firm.
Moderating Thursday’s event was Abbe Land, Mayor Pro Tem of West Hollywood, California, and Co-Chief Executive Officer of the Saban LA Free Clinic. Participants included local health care providers, medical professionals, community leaders, educators and local business owners.
Also in attendance were members of the local Los Angeles Chapter of the National Association of Health Underwriters, including Bruce Benton, newly elected National Secretary of NAHU, Ross Pendergraft, President Elect of the Los Angeles Chapter, Dede Kennedy Simington (LAAHU Awards Chair) and Meg McComb, Vice Chair of Legislation for the California Association of Health Underwriters. Official representatives of the Hollywood Chamber of Commerce included Nicole Shehenian, Vice Chair of Public Policy, Bill Farrar, Senior Vice Chair of the Executive Board and Scott Moe, Co-Chair of the Legislative Action Committee of the Hollywood Chamber.
When asked what participants felt was the biggest problem in the health system, the overwhelming majority listed the cost of health insurance, while a significant number identified the cost of health care as the biggest problem. Many of the participants also mentioned the lack of coordination and interoperability of systems, claims processing and general confusion among consumers. There was significant discussion about the poor reimbursement level of providers that is driving out quality providers and eroding the quality of care. Several participants emphasized that the cost of health insurance is high because the cost of health care is high.
There was significant discussion about how to select health care providers and how to investigate the quality of outcomes and providers in general. While most participants were generally familiar with internet sources for information, few were familiar with sources that were free of charge. There was some conversation about the affluence of neighborhood and its affect on quality and generally, most indicated they would most readily depend on personal referrals more than any other method.
Most participants had either personally experienced or had friends or family members experience difficulty in paying medical expenses in the past. It was generally understood among all the attendees that medical expenses, either though being uninsured or being underinsured, was the leading cause of personal bankruptcy in the United States. Several suggestions were made regarding future public policy to address this including enforceable individual mandates, health insurance premiums indexed on income, national catastrophic illness coverage and the possibility of looking to other industrialized countries to find what has worked and not worked for them.
When participants were asked whether they wanted to be able to pick between a public and a private plan the conversation became divided between those that held no confidence in the government’s ability to manage such a system considering the significant problems within the Medicare and Medicaid systems and those that felt such a choice was necessary to force the private system to maximize efficiencies and outcomes. There was a general consensus that the imbalance between the current public system and the private system had to be addressed first to assure a level playing field. No matter what the eventual choices, the current reimbursement levels within the Medicare and Medicaid system has to be addressed to alleviate cost shifting to the private sector.
When discussing choice, there was almost unanimous consensus that everyone felt choice was very important. However, choice had to also be structed in a way that addresses containment of costs, quality and must include those segments of the population that have been historically overlooked. It was also felt that “choice” should also address the American culture of “wanting what we want when we want it” and allow for consideration of poor choices like smoking and obesity.
There was considerable difference of opinion when discussing the role of employers in the future of reform. While most supported a continued strong presence for employer based coverage, there was also significant support for fully portable individual coverage that could be assumed by an employer during employment and continued during periods of unemployment or self employment. While several participants emphasized the importance of individual responsibility in maintaining health insurance coverage, several attendees brought up the high rates of uninsured motorists in states that mandate auto insurance.
There were many suggestions from the group regarding preventive services and if and how they should play a role in reforming our health care system. There was general agreement that preventive care is an investment in the future and that future savings were a goal, not an immediate outcome. Preventive care and current healthy living had to become a part of the American culture. Examples such as once again making physical education a part of the regular curriculum of American schools was mentioned as well as penalties for poor lifestyle choices like smoking, obesity, etc. Another suggestion on what needed to be restored was the ban on pharmaceutical advertising. It was also felt that parents had to be held more accountable for the health of their children.
Another issue that came up repeatedly during the course of the conversation was the present and growing chasm emerging in the form of a two tier health care system. Those currently covered in many public programs experience a different level of care than those insured by private plans. There was no clear consensus on whether those in attendance felt this two tier level of care either could or even should be avoided. The principal of “social solidarity” was not universally supported.
The full report and survey findings of the meeting were reported to the Office of the President-Elect.
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